Healthcare financing in Singapore: Healthcare spending could hit $30 billion a year by 2030 says Health Minister Ong Ye Kung

The Price of Good Health

Healthcare that is affordable, accessible and high quality comes at a price. Salma Khalik finds out how Singapore is striking the right balance.

The Straits Times, 10 Apr 2025

Spending on healthcare in Singapore could soon become the single biggest item in the Government’s coffers, said Health Minister Ong Ye Kung, as he assured Singaporeans that their basic healthcare needs will continue to be affordable.

In 2025, the Government has set aside $20.9 billion for health, second only to spending on defence, which has a budget of $23.4 billion.

Citing the trajectory of government healthcare expenditure, which had gone up from $9 billion in 2015, the year he joined politics, to $18 billion in 2024, Mr Ong predicted that by 2030, it would likely be close to $30 billion a year.

A lot of the money will go towards building more facilities, including new hospitals, nursing homes and community care centres, and for manpower costs.

But a substantial portion will be spent on subsidies to keep costs down for patients.

“We can make it affordable to the patient, but there’s no doubt that with an older population, healthcare expenditure, whether by the Government or nationally, is going to go up,” he told The Straits Times in an exclusive interview.

Older people not only tend to get sick more frequently, but they are also more sick and stay longer in hospitals as many have more than one medical condition.

Mr Ong said: “You’re seeing a lot more older patients coming in, not because of very severe diseases, but due to infections. Because they are old, there is underlying illness after Covid-19. They are more frail and one infection is all it takes for them to be in the ICU (intensive care unit).”

As a result, the average length of stay in public hospitals has gone up, from 6.1 days in 2019 to seven days by 2022. This represents a 15 per cent increase in patient load, he added. While this trend worries him, Mr Ong is confident that the quality of healthcare for patients in the future will not suffer as a result of the higher demand.

Even as the quality of healthcare here has been getting better over the years, with advances in medical science and technology, he said the Government will continue to enhance the definition of basic healthcare, which it has always promised will remain affordable. As an example, he pointed to the announcement that from October, MediShield Life will start covering treatments using cell, tissue and gene therapy products.

These are individualised treatments tailored to a person’s specific medical problem, some of which were previously untreatable. As each treatment is designed and produced for a specific patient, the cost is high.

The move marks an “inflection point” for basic healthcare here, said Mr Ong. In spite of the high cost, he said “we decided that this is the way to go” because today, if there is an available treatment, people expect to have access to it.

“At some point, that becomes people’s expectation. So we have to start embracing this,” he said.

This is one reason why a large part of government expenditure will go towards subsidising healthcare costs. People will also have to share in the cost of better care, largely with insurance and their MediSave funds, Mr Ong said.

The good news is that the Government is unlikely to need to raise taxes to pay for the higher healthcare expenditure, he added.

Said Mr Ong: “We expect our GDP (gross domestic product) to grow. So long as the Singapore economy grows, tax receipts will go up. And a big part of it, a significant part of it in future, will be for healthcare.”

Official Opening of Woodlands Health Campus by SM Lee Hsien Loong on 13 July 2024

Providing only what is needed will keep healthcare costs sustainable: Senior Minister Lee

Don't over-treat, over-prescribe and be careful in adopting new treatments, he says

By Salma Khalik, Senior Health Correspondent, The Straits Times, 14 Jul 2024

Healthcare needs in Singapore will have to be managed not just by building new hospitals, but also through discipline in providing only what is necessary.

Speaking on July 13 at the official opening of the Woodlands Health (WH) campus, the third new general hospital opened in a decade, Senior Minister Lee Hsien Loong said the Republic cannot keep building new hospitals to meet the growing needs of a rapidly ageing population.

“We must also maintain discipline in not over-treating or over-prescribing, and be discriminating in adopting new medical treatments, procedures, drugs and technology, in order to keep our overall healthcare costs sustainable for the long term,” said SM Lee in outlining the path ahead for the healthcare system.

“At the same time, we must maintain the right mix of government subsidies, medical insurance and individual co-payment, to minimise wrong incentives, perverse incentives, which would lead to unsatisfactory outcomes.”

SM Lee said Singapore will continue to train more competent doctors, nurses and other healthcare professionals, and improve its healthcare facilities and infrastructure.

But he added that tough decisions and trade-offs are needed for the country to continue delivering high-quality, affordable healthcare to Singaporeans.

“There are too many examples elsewhere of healthcare services practically at breaking point. Populations suffer from poor healthcare delivery and long wait times, or exorbitant medical bills and high insurance premiums.

“And it shows in the outcomes – population health deteriorates, and so does the quality of life, even life expectancy,” said SM Lee.

Health Minister Ong Ye Kung, who was at the opening of WH, had also urged caution recently over the risks of escalating healthcare costs.

In comments made on July 12, he said the Ministry of Health (MOH) needs to rein in the unhealthy “buffet syndrome”, which sees patients picking expensive treatments and diagnostic tests because they have insurance to pay for them.

Mr Ong said over-generous insurance coverage is a key driver of spiralling healthcare costs.

Over the last 10 years, Singapore has built three new hospitals – the 700-bed Ng Teng Fong General Hospital in 2015, the 1,000-bed Sengkang General Hospital in 2018, and now the 1,400-bed WH.

On the cards are another two public general hospitals – in Bedok and Tengah – and possibly also a non-profit private hospital.

In less than five years, the ageing population here has pushed up the average length of hospital stay from six to seven days, which raises demand for hospital beds by 15 per cent.

SM Lee said the healthcare system remains in good shape, with people having access to high-quality and affordable treatments, with reasonable wait times.

But he added: “Do not underestimate the difficulty of keeping the healthcare system working well.”

Former health minister Khaw Boon Wan, who made the decision to build WH, was at the event on July 13.

He had instructed the team in charge of building the hospital to take their time and to study what other countries with older populations are doing.

Dr Jason Cheah, the hospital’s chief executive officer, said it took 10 years to build WH. Public hospitals here generally take seven years to complete.

A major reason for the delay was disruption to work and a shortage of labour as a result of the Covid-19 pandemic.

The hospital is designed to transform the way Singapore delivers healthcare services.

By integrating an acute hospital, community hospital and nursing home at a single campus, it makes it easier for WH to provide patients with the correct level of care.

SM Lee said that aside from the full range of hospital services, the hospital will also provide long-term care services including daycare, home care, and nursing home and palliative care.

“This makes it much easier to right-site patients, and also a lot more convenient for patients to transition seamlessly from treatment to convalescence, and receive the appropriate care in one place,” he added.

The hospital also uses technology to raise operational efficiency. It has an automated pharmacy and an automated laboratory for blood specimens, both of which reduce manpower needs and human error.

Patients are also provided with bedside terminals (PBTs) that allow them to engage more fully with their care plan.

Quipped SM Lee: “The PBT also functions like an inflight entertainment system where patients can order their preferred meals or even watch YouTube videos! Presumably, not too exciting ones.”

Thanking Ms Jennie Chua, chairman of the WH campus, Mr Lee noted that some of the touches that make it “a very woke hospital” must have come from her. Meals at the hospital include mutton vindaloo, plant-based mapo tofu and even Irish stew.

Ms Chua previously oversaw the establishment of the Khoo Teck Puat Hospital in Yishun.

MediShield Life coverage enhanced for cancer treatment from September 2022; to cover drug bills of nearly 90% of subsidised patients

Move to rein in cost of cancer care to help more patients

Insurance, MediSave to fully cover outpatient treatment for 90% of subsidised cancer patients

By Salma Khalik, Senior Health Correspondent, The Straits Times, 18 Aug 2021

More subsidised cancer patients here will get help paying for their outpatient treatments from next year, with changes to the national health insurance scheme.

More cancer drugs will be subsidised and the income criteria will be raised so that more people can get subsidies for certain high-cost drugs under the Medication Assistance Fund (MAF).

With these changes to MediShield Life coverage, 90 per cent of subsidised cancer patients will have their outpatient treatments fully paid for by insurance and MediSave from September next year - up from 70 per cent today.

The move will also have the effect of reining in soaring cancer drug prices.

The MediShield Life Council had set up a committee to look into the high cost of cancer care, and had recommended that the Ministry of Health (MOH) create a list of cost-effective outpatient cancer drug treatments to be covered by MediShield Life.

About 90 per cent of existing treatments in the public sector have been included in the list.

Based on this list of clinically proven treatments, the revised claim limits can range from $200 to $9,600 a month - depending on the drug used - when the changes kick in.

Currently, patients can claim only up to $3,000 a month for all cancer outpatient treatments. "This has the unintended effect of raising cancer drug prices to maximise the claims," said MOH.

The ministry explained that since MediShield Life has been reimbursing $3,000 a month for outpatient cancer treatments, some drug companies have kept their prices high, knowing that the cost would be covered by insurance.

As a result, Singapore has been paying up to double the price paid by Australia, New Zealand, South Korea and Taiwan for some drugs.

Having differentiated cost limits has enabled Singapore to negotiate better rates. On average, cancer drug prices have gone down by about 30 per cent. One drug for kidney cancer dropped in price, from $22,570 a month to $11,340 a month.

The move will address the issue of rising costs, since spending on cancer drugs here has been rising at an annual average rate of 20 per cent, compared with 6 per cent for other drugs, said MOH.

MOH also said 55 more drugs will be eligible for subsidies, bringing the total to 150 drugs.

The subsidised list is published on the MOH website and updated every four months. Oncologists may ask for drugs not on the list to be evaluated.

Meanwhile, about 3,000 more people will become eligible for subsidies under MAF, with the criteria being raised from a per capita household income of $2,800 a month to $6,500 a month.

While most existing cancer drug treatments will continue to be covered, some patients may find they can no longer claim for their current medication. The changes will kick in only in September next year to allow such patients to complete their current course of treatment and adjust their plans.

MediShield Life to offer Singaporeans more coverage and benefits under proposed changes to be implemented in early 2021

Government to provide about $2.2 billion to help Singaporeans with Medishield Life premium adjustments

MediShield Life Council recommendations includes higher annual claim limit of $150,000; premiums set to rise by up to 35%

By Salma Khalik, Senior Health Correspondent, The Straits Times, 30 Sep 2020

The compulsory national health insurance scheme is set to get a massive revamp next year, with wider benefits proposed so it can cover more and larger hospital bills.

The proposal includes raising the yearly claim limit under MediShield Life from $100,000 to $150,000.

To pay for these benefits and rising healthcare costs, premiums are expected to go up next year by as much as 35 per cent.

This will be the first increase in MediShield Life premiums since the scheme was launched five years ago.

At the upper end, the proposed hike will exceed $500 a year.

But given the difficult times Singaporeans are facing now, Health Minister Gan Kim Yong said the Government will soften the impact of the premium increase with a special COVID-19 subsidy for the first two years.

In the first year, all Singaporeans will get a 70 per cent subsidy on the increase. This goes down to 30 per cent in the second year. This will cost the Government $360 million.

This is on top of the existing subsidies of 15 per cent to 50 per cent given to middle-and lower-income groups, and 40 per cent to 60 per cent for the Pioneer Generation.

The Merdeka Generation receives additional age-based subsidies of 5 per cent to 10 per cent.

In all, subsidies for the next three years will amount to $2.2 billion.

The proposal will allow for wider benefits, including:

• Higher coverage for sub-acute care at community hospitals - such as for someone recovering from a heart attack - as this is 20 per cent more expensive than normal rehabilitative care.

• Higher annual claim limit of $150,000, from the current $100,000.

• Higher claim limits for some charges, such as for intensive care, which will be raised from $1,200 a day to $2,200 a day, dialysis and psychiatric care

.• An additional $200 a day claim for daily ward charges for the first two days of hospitalisation, when most tests and investigations are done. 

• MediShield Life will in future also cover treatment for attempted suicide, self-injury, substance abuse and alcoholism.

• Lower deductible of $2,000 (down from $3,000) for people 80 years and older for day surgery. This brings it in line with their deductible amount in a C-class ward, so patients will not need to be hospitalised just to qualify for insurance cover.

However, the cap on claims for people treated at private hospitals will be reduced from 35 per cent of the bill to 25 per cent.

Based on recent bills, 35 per cent of private hospital care amounts to far higher sums than bills incurred by subsidised patients.

The new claim limits should bring MediShield Life back in line with its original mandate to cover 90 per cent of subsidised bills beyond the initial deductible.

It was revealed last year that only 80 per cent of subsidised bills were fully covered.

These changes are expected to get rolling some time in the first quarter of next year.

MediShield Life Council chairman Fang Ai Lian said: "We have to periodically review and update the scheme benefits and premiums to keep pace with evolving medical practice, healthcare cost inflation and actual claims experience, so that it continues to provide assurance for Singaporeans, while remaining sustainable."

From now, reviews will be carried out every three years.

Dr Tan Wu Meng, head of the Government Parliamentary Committee for Health, supports the changes, although he said some of the premium increases are "significant".

He told The Straits Times: "The revised policy year claim limit and the ICU claim limits are consistent with supporting Singaporeans through catastrophic illness."

As for the removal of some exclusions, he said: "This would also be a key statement about inclusivity and the tone we want in our society."

CareShield Life: Singapore's national disability insurance will be launched on 1 October 2020

MediSave Care, which allows cash withdrawals from MediSave accounts for long-term care needs will also launch in October 2020
By Ang Hwee Min, Channel NewsAsia, 28 Aug 2020

Long-term care support schemes CareShield Life and MediSave Care will be launched on Oct 1, the Ministry of Health (MOH) announced on Friday (Aug 28).

The CareShield Life and Long-term Care Bill was passed in September 2019, allowing for Singaporeans born in 1980 or later, including those with pre-existing disabilities, to be enrolled in compulsory long-term disability insurance.

The MediSave Care scheme allows for cash withdrawals from MediSave accounts for long-term care needs.

CareShield Life was originally scheduled to launch in mid-2020, but was delayed because agencies and vendors had to reduce the “pace of development and testing work” due to COVID-19 safe distancing measures and the “circuit breaker” period, Minister for Health Gan Kim Yong had said in June.

Singapore residents aged 30 to 40 in 2020 - or those born between 1980 and 1990, inclusive - will be the first cohorts to join the scheme from Oct 1 or their 30th birthday, whichever is later.

These individuals will receive a CareShield Life welcome package by Sep 2, or up to two months before their 30th birthday.

Subsequent cohorts, or those born after 1990, will automatically join the scheme when they turn 30, and will also receive a CareShield Life welcome package before they turn 30.

Those who are enrolled between 2020 and 2024 will receive up to S$250 in transitional subsidies, said the Health Ministry in a press release on Friday.

The scheme is optional for Singapore residents born in 1979 or earlier. Details on when these cohorts can join CareShield Life will be released in 2021, said MOH.

They will have the opportunity to join CareShield Life, with the option to switch from ElderShield towards the end of 2021. The launch of the scheme for existing cohorts was originally planned for mid-2021.

At S$600 per month in 2020, starting CareShield Life payouts for Singaporeans with severe disability will be higher than under the existing ElderShield Scheme, and will increase annually until age 67, or when a successful claim is made, said the Health Ministry.

While ElderShield pays out S$300 or S$400 per month for up to six years, CareShield Life’s higher payout lasts potentially for life, and as long as the person remains severely disabled.

Singapore residents can use MediSave to pay for their own CareShield Life premiums and for approved dependents, said MOH.

“No one will lose coverage because of an inability to pay their premiums,” said the ministry, adding that the Government will provide support measures to ensure that premiums remain affordable.

Up to two-thirds of households will be eligible for CareShield Life premium subsidies of up to 30 per cent, with permanent means-tested subsidies for lower- to middle-income Singapore residents, it added.

“Singapore citizens in financial need who are unable to pay for their premiums even after the premium subsidies can apply for additional premium support from the Government.”



MEDISAVE CARE

Under MediSave Care, which also launches from Oct 1, Singapore residents aged 30 and above can tap on their own and their spouse’s MediSave accounts to withdraw cash of up to S$200 per month for long-term care needs, or a total of S$2,400 per year.

The amount that can be withdrawn is dependent on the MediSave account balance. A minimum of S$5,000 has to be set aside in the MediSave account “to ensure sufficient savings for other medical expenses such as hospitalisation and selected costly outpatient treatments”, said MOH.

Individuals whose MediSave account balances are insufficient can tap on their spouse’s MediSave account to supplement the withdrawal, up to a combined total of S$200 per month.

“As our population ages, we want to ensure that Singaporeans continue to have accessible and affordable long-term care. With CareShield Life, severely disabled Singaporeans can be assured that they will receive financial support for life,” said Mr Gan in Friday’s press release.

“They will also have another avenue to fund their long-term care needs, by tapping on their MediSave savings under MediSave Care," he added.

"Together with ElderFund, which provides discretionary government assistance to lower-income, severely disabled Singapore citizens, these schemes will collectively enhance support for long-term care costs.”



Claim applications for both schemes will be open from Oct 1, and interested applicants should arrange for a disability assessment by an MOH-accredited severe disability assessor and submit the scheme application to the Agency for Integrated Care.

COVID-19: Show support for healthcare workers on front lines, says Health Minister Gan Kim Yong

Broader community joins battle against coronavirus as infection hits 50 cases as of 12 Feb 2020
By Salma Khalik, Senior Health Correspondent and Timothy Goh, The Straits Times, 13 Feb 2020

As more cases of coronavirus infection surface, this is the time for people to rally around healthcare workers and not shun them, said Health Minister Gan Kim Yong.

He announced yesterday that three more people had been infected, bringing the total here to 50. But as the fight against the virus intensifies, there are signs that the broader community is rallying behind healthcare workers in the front lines.



Mr Gan urged: "Let us come together to show our support for them, and to support their work, so they continue to take care of our patients and families and our loved ones."

"Sometimes, a kind word or a warm greeting will go a long way to make them feel appreciated and give them a morale boost to continue the fight," he added.

Healthcare workers, who had been in the front lines of the fight during the severe acute respiratory syndrome (Sars) outbreak in 2003, had been shunned by those who feared they might pass on the infection. Mr Gan indicated that he does not want this to be repeated.



Meanwhile, one million masks will be distributed to general practitioners and specialists in private practice, who need them to protect themselves, their staff and patients.

"They will get the supplies that they need because they are a part of our team," said Mr Gan.

"In this challenging time, it is important for us to work together as a team, as a community and as a nation, to overcome this infection and to keep Singaporeans safe," he added.

Minister for Social and Family Development Desmond Lee, who was also at the news conference, said 90 per cent of the drivers from private-hire company Grab are keen to join a new service called Grabcare that will "help our healthcare workers get to and from healthcare facilities".

The service will start tomorrow for those working at Tan Tock Seng Hospital and the National Centre for Infectious Diseases, he said.



He said that for Singaporeans who are inspired by such actions, there are opportunities to contribute.

The Courage Fund that was launched for healthcare workers who battled Sars is still active.

Money from the fund helps patients, healthcare workers and their families, as well as the wider community affected by the outbreak.

Donations have started pouring in again.

In a Facebook post last night, President Halimah Yacob announced that the President's Challenge, which has been mobilising resources to help those who may be more susceptible, will be donating $250,000 to the Courage Fund to further support vulnerable groups to tide over this period.

"It is challenging times like this that will truly define who we are as a nation," she wrote.

Another $300,000 has been donated by the CapitaLand Hope Foundation.

Youth Corps will support Willing Hearts, a dignity kitchen, to distribute meals to seniors and the vulnerable, Mr Lee said.



Meanwhile, of the 50 infected, 15 have recovered and been discharged, but eight are seriously ill and in intensive care.

While most infected patients will recover, Mr Gan warned: "Some may get seriously ill, and a small number may succumb to the infection ultimately.

"We have to be prepared for the worst."

The fight against the virus ahead may get harder, he said.

Mr Gan said in Mandarin: "Because we are stepping up our surveillance and doing more testing, we can well expect to see more cases in the coming days and weeks."

CareShield Life Premium Calculator: Ministry of Health launches online tool to calculate premiums for disability insurance scheme to be launched in 2020; Government to run ElderShield scheme from 2021

Online calculator to work out premiums for CareShield Life
It tells Singapore residents how much they have to pay before and after subsidies, incentives
By Felicia Choo, The Straits Times, 28 Dec 2018

A new online calculator was launched yesterday to help people work out how much they will have to pay when disability insurance scheme CareShield Life is launched in 2020.

The Ministry of Health (MOH) said the gadget will provide Singapore residents with information about their estimated premiums before and after applicable subsidies and incentives.

Users will need to answer questions about their date of birth, gender, current ElderShield coverage as well as their income, housing type and citizenship status.



CareShield Life will replace ElderShield for younger residents, and it will be compulsory for people aged 30 to 40 to pay premiums from 2020.

Future cohorts will join CareShield Life at the age of 30, while those born in 1979 or earlier can choose to join CareShield Life in 2021 if they are not severely disabled.

Singaporeans who are currently insured on ElderShield - which is optional and provides payouts for a limited amount of time - can choose to upgrade to CareShield Life.

The premiums they have paid for ElderShield will be taken into account when calculating their CareShield Life premiums.

The calculator can be used by Singaporeans and permanent residents born between 1946 and 1990.

Singapore residents born in 1991 or later will be provided with their premium figures when they are enrolled in the CareShield Life scheme at age 30.

Those born before 1946 can call the Healthcare Hotline on 1800-222-3399 for more details about their estimated premiums, subsidies and incentives.

This group will have to pay higher annual CareShield Life premiums as they have fewer years over which to spread the payments, MOH said.

Meanwhile, those on other ElderShield policy arrangements will be able to find out more about their estimated premiums closer to 2021, when they are able to join the scheme.

This group includes people who opted out of ElderShield at age 40 but subsequently rejoined the scheme, those born between 1956 and 1967 who opted for a single-premium payment term for ElderShield, and those who have a paid-up policy.

CareShield Life premiums can be paid using Medisave, and subsidies and incentives will be provided.

Lower-to middle-income Singapore residents will receive means-tested subsidies. Up to two-thirds of Singapore resident households will be eligible for CareShield Life subsidies of up to 30 per cent.

Singaporeans in future cohorts (born in 1980 or later) will receive transitional subsidies of up to $250, spread over the first five years from 2020 to 2024.

Singaporeans in existing cohorts (born in 1979 or earlier) will receive participation incentives of up to $2,500, spread over the first 10 years of their policy, if they join CareShield Life in the first two years from 2021.

Singaporeans who are unable to pay for their premiums after subsidies can apply for additional premium support from the Government.

MOH said: "No Singaporean who joins CareShield Life will lose coverage due to an inability to pay their premiums."

Government to strengthen long-term care financing for all Singaporeans through CareShield Life, MediSave cash withdrawals and new ElderFund assistance scheme for the lower-income who are severely disabled

Severely disabled can withdraw up to S$200 a month from Medisave from 2020
By Salma Khalik, Senior Health Correspondent, The Straits Times, 4 Jul 2018

People who are severely disabled will be allowed to dip into their Medisave accounts for cash from 2020 - provided they or their spouse have at least $5,000 in their accounts.

This is the first time members can withdraw cash from Medisave since it was set up in 1984 as part of Central Provident Fund contributions to defray hospital bills.

The bigger the sum in their accounts, the more the members will be able to withdraw. Those with $5,000 in their Medisave accounts - a floor that covers three in four people aged 65 years and older - will be able to take out $50 a month.

On the other hand, those with $20,000 or more in their Medisave accounts will be allowed to withdraw $200 a month. This covers about half the people aged 65 or older, who are more likely to suffer from severe disabilities.

Separately, a fund is being set up to help needy disabled people.

Explaining the rationale to allow cash withdrawals from Medisave, Health Minister Gan Kim Yong said: "When a Singaporean is facing severe disability and, at the same time, facing financial difficulties, I feel that we can afford to be more flexible."

He said this change will not result in higher Medisave contributions. Those deemed severely disabled will be able to dip into their accounts from the age of 30.

Potentially half the population would be able to draw on this facility in their lifetime.

Mr Gan also revealed that a new safety net called ElderFund will provide needy disabled people up to $250 a month from 2020.



In the same year, a long-term disability insurance called CareShield Life will kick in and be made compulsory for people aged 40 years and younger. It will pay those who are severely disabled at least $600 a month for life.

Another two million people, aged 41 years and older when CareShield Life is launched in 2020, will be encouraged to join the scheme that is optional for them.

These Singaporeans will be offered a $500 to $2,500 incentive to offset their premiums over 10 years.

If they join the scheme within two years, those with chronic ailments and mild or moderate disabilities will be allowed into the fold despite their health conditions. There will be stricter underwriting for those who join later.

Asked if this is fair to healthy people joining the scheme as it could potentially push up premiums, Mr Gan said that "the Government will do its part", and details will be announced later.

ElderShield to be replaced by CareShield Life with higher, lifetime payouts from 2020; Parliamentary Debate on ElderShield Review Committee Report, 10 July 2018

New compulsory CareShield Life replaces optional ElderShield in 2020, will offer wider coverage for severely disabled
Scheme to be run by Government instead of private insurers will include everyone from age 30
By Salma Khalik, Senior Health Correspondent, The Straits Times, 28 May 2018

Another piece of the jigsaw to prepare Singapore for its ageing population, a national long-term care insurance to provide financial aid to those afflicted with severe disability, will be launched in 2020.

Called CareShield Life, the government-run scheme will be compulsory, automatically getting everyone who will be between the ages of 30 and 40 in 2020 to start paying premiums. Future cohorts will join at the age of 30.

For them, the scheme replaces the optional ElderShield, offered by private insurers. CareShield's scope of coverage is also wider.

Premiums start at $206 a year for men and $253 a year for women at the age of 30. They will make 38 payments until the age of 67.

Should disability strike and a policyholder require care, he will receive a payout of at least $600 a month, for as long as care is needed.

In contrast, the ElderShield scheme pays $400 a month for up to six years, but with lower premiums paid over a shorter period.

People above 40 in 2020 have the option of sticking with ElderShield or switching to the new scheme in 2021 by topping up their premiums.



Health Minister Gan Kim Yong said that over the past three years, the Government "has been preparing Singaporeans for an ageing population", including providing more nursing home and day-care facilities, the Pioneer Generation Package and MediShield Life.

This review "is another important step in this journey", he said.

"It is an important strategy for us, an important part of our social safety network for Singaporeans in terms of long-term care. It also reflects the inclusive society that we aspire to build."



To ensure premiums are affordable no matter the family's income, Medisave can be used to fully pay for it. There will be permanent premium subsidies of 20 per cent to 30 per cent for people who qualify, and additional support for those who still cannot afford the premiums.

People who are disabled at the age of 30 years will make one premium payment to join, and can start collecting payouts immediately.

New Integrated Shield Plan riders must incorporate a co-payment of 5%

New policyholders will eventually have to pay at least 5% of bill, but amount will be capped
By Salma Khalik, Senior Health Correspondent, The Straits Times, 8 Mar 2018

You can no longer go to an insurer and buy riders that pay your entire hospital bill, as the Government is rolling back a regime that threatens to make health insurance unsustainable.

Anyone buying a new rider from today will need to eventually pay at least 5 per cent of his hospital bill. But the total amount a policyholder has to pay can be capped at $3,000 a year, although insurers are free to set a higher threshold. This is to give people the peace of mind that they will not have to dig too deeply into their pockets, whatever the size of their hospital bill.

However, the $3,000 cap applies only if patients are treated by doctors on the insurer's approved panel, or if they had received prior approval from the insurer. Otherwise, they have to pay the 5 per cent, with no cap on their share.

These measures were announced in Parliament yesterday - the same day that The Straits Times reported that insurers had asked the Ministry of Health (MOH) to get people to pay at least part of the bill.

MOH has agreed to this for new riders. However, it has not mandated any change for the 1.1 million people who already have full riders for their Integrated Shield Plans (IPs) - which means they pay nothing for hospital bills.

MOH is giving insurers until April 1 next year to come up with new riders that include the co-payment and cap. At that point, no full riders for IPs can be sold.

Meanwhile, anyone buying a rider from today has to switch to the new scheme by April 1, 2021, at the latest.



Elaborating on the scheme, Senior Minister of State for Health Chee Hong Tat said: "Any pre-existing conditions that are covered prior to the switch will not be excluded."

This should also apply to people with full riders who want to switch to the new scheme. Mr Chee said: "We expect the new riders to have lower premiums than full riders, so the switch will result in premium savings for policyholders."

As for those who already have riders, Mr Chee said: "We recognise that existing rider policies are commercial contracts between insurers and their policyholders.

"If insurers intend to make changes to their existing policies, they should consider the interest and well-being of all policyholders, as they seek to keep premiums affordable for everyone in the longer term."

Health Minister Gan Kim Yong told Parliament that co-payment is an integral part of healthcare schemes as zero payment "dilutes the personal responsibility to choose appropriate and necessary care".

It would "encourage unnecessary treatment, leading to rising healthcare costs not only for those with such riders, but for all of us", he said.

ElderShield review committee proposes severe disability insurance scheme be made compulsory with coverage starting from age 30 instead of 40

* ElderShield to be renamed CareShield Life with higher, lifetime payouts from 2020 -27 May 2018

Review Panel wants to expand ElderShield coverage in interim recommendations
It proposes making scheme compulsory for future cohorts and starting premiums earlier
By Linette Lai, Health Correspondent, The Straits Times, 31 Jan 2018

ElderShield coverage should be made compulsory for all - including those with pre-existing disabilities - according to the committee reviewing the insurance scheme for people with severe disabilities.

It recommended that people start paying premiums at the age of 30 rather than 40, and suggested that the Government, rather than private insurance providers, administer the scheme. It also called for the claims process to be simplified.

The committee gave its interim update yesterday, with the full set of recommendations expected to follow by the middle of this year.

If accepted, its proposals will apply only to Singaporeans aged 30 to 40 who are joining ElderShield for the first time. People who have previously opted out will not be made to go back on the scheme.

"We want ElderShield to be a social safety net, and we all have a collective responsibility to take care of those with disabilities," said Mr Chaly Mah, who chairs the ElderShield Review Committee.

In a Facebook post yesterday, Senior Minister of State for Health Chee Hong Tat said an enhanced ElderShield scheme would enable Singaporeans to "pool our risks and resources in preparation for old age".

"It is an important pillar of Singapore's social safety net as our society ages," he said. "The Government will look at providing premium subsidies to keep the premiums affordable for lower-and middle-income Singaporeans."

Currently, all Singaporeans join the scheme automatically when they turn 40, and are covered by one of three private insurers - Aviva, Great Eastern or NTUC Income - but they are able to opt out.

Although the opt-out rate in recent years has been about 5 per cent, more than a third of people opted out when the scheme started in 2002.

Money is paid out when people cannot perform three of the six "activities of daily living" on their own. These are washing, dressing, using the toilet, feeding oneself, moving around indoors and getting from the bed to a chair or vice versa.

Mr Mah, who is also the chairman of the Singapore International Chamber of Commerce and the Singapore Accountancy Commission, said: "It is clear to us that the average Singaporean does not understand the risk of severe disability... When you underestimate this risk, it is easy to take the decision to opt out."