Understand MediShield Life Payouts

MediShield Life pro-ration factor

 

MediShield Life is a basic health insurance scheme for Singaporeans and Permanent Residents, designed to cover subsidised bills, i.e. hospitalisations in Class B2/C wards, and outpatient treatments and day surgeries in public healthcare institutions.

 

Non-subsidised bills will be pro-rated before the claims under MediShield Life are computed.

 

Similarly, Permanent Residents will also have their bills pro-rated before claims under MediShield Life are computed. The applicable pro-ration factors are shown in the table below.

 

For admissions or treatments received before 1 April 2025, please refer to the applicable pro-ration factors.

Pro-ration factors for ward charges

Ward Class
Percentage of charges incurred used to calculate MediShield Life Claim
Singaporean Permanent resident Foreigners
C (Public Hospital) 100% 50% 20%
B2 (Public Hospital) 100% 50% 35%
B2+ (Public Hospital) 100% 50% 35%
B1 (Public Hospital) 34% 29% 29%
A (Public Hospital) 27% 25% 25%
Private Hospital 16% 16% 16%
Community Hospital (Subsidised) 100% 60% 50%
Community Hospital (Non-subsidised) 45% 37% 37%
Inpatient Palliative Care Service (Subsidised) 100% 60% 50%
Inpatient Palliative Care Service (Non-subsidised) 45% 37% 37%
Short Stay Ward (Subsidised) 100% 50% 35%
Short Stay Ward (Non-subsidised) 27% 25% 25%
Day Surgery (Subsidised) 100% 54% Not applicable
Day Surgery (Public Hospital Non-subsidised) 33% 33% 33%
Day Surgery (Private Hospital/Clinics) 21% 21% 21%
Pro-ration factors for outpatient treatment charges

Ward Class
Percentage of charges incurred used to calculate MediShield Life Claim
Singaporean Permanent resident Foreigners
Outpatient treatment (excluding Kidney Dialysis and Erythropoietin for chronic kidney failure)
Outpatient Treatment (Subsidised) 100% 56% Not applicable
Outpatient Treatment (Non-subsidised) 35% 35% 35%
Outpatient Treatment (Private) 30% 30% 30%
Outpatient treatment (Kidney Dialysis and Erythropoietin for chronic kidney failure)
Outpatient Treatment (Subsidised)  100% 67% Not applicable
Outpatient Treatment (Non-subsidised) 100% 56% 56%
Outpatient Treatment (Voluntary Welfare Organisations)  100% 67% 56%
Outpatient Treatment (Private)  100% 56% 56%
Continuation of Autologous Bone Marrow Transplant for Multiple Myeloma (Subsidised)  100% 67% Not applicable
Continuation of Autologous Bone Marrow Transplant for Multiple Myeloma (Non-subsidised)  50% 50% 50%
Pro-ration factors for surgical charges  

Ward Class
Percentage of charges incurred used to calculate MediShield Life Claim
Singaporean Permanent resident Foreigners
C (Public Hospital) 100% 60% 20%
B2 (Public Hospital) 100% 60% 35%
B2+ (Public Hospital) 100% 60% 35%
B1 (Public Hospital) 35% 30% 30%
A (Public Hospital) 25% 25% 25%
Private Hospital 10% 10% 10%
Day Surgery (Subsidised) 100% 58% Not applicable
Day Surgery (Public Hospital Non-subsidised) 25% 25% 25%
Day Surgery (Private Hospital) 15% 15% 15%

Deductible

 

A Deductible is the amount you would need to pay for claim(s) made in a policy year, before there is a payout from MediShield Life. You only need to pay the full Deductible once in a policy year.

 

However, the Deductible is waived if your claim is for outpatient treatments.

 

For admissions or treatments received before 1 April 2025, please refer to the applicable deductible.

Deductible (Per Policy Year) As of age next birthday
Ward Classes For ages 80 and below For ages 81 and above
Class C1 $2,000 $2,750
Class B2/ B2+/ B11 $2,500 $3,500
Class A (including private hospitals)1 $3,500 $4,500
Community Hospital/ Short-stay ward/ Inpatient palliative care service (Subsidised)   $2,000 $2,750
Community Hospital/ Short-stay ward/ Inpatient palliative care service (Non-subsidised)  $2,500 $3,500
Day Surgery $1,500 $2,000
Outpatient Treatment Not applicable

1 Radiosurgery and Continuation of Autologous Bone Marrow Transplant for Multiple Myeloma received during hospitalisation will follow the deductible for Class C for patients in subsidized wards, and the deductible for Class B2 and above for patients in non-subsidised wards. 

 


Co-insurance

 

Co-insurance is the amount you need to co-pay after meeting the Deductible.

 

Co-insurance

Inpatient/Day Surgery
Claimable amount accumulated within a policy year

First $5,0001 10%
Next $5,000 5%
Above $10,000 3%
Outpatient Treatment 10%

1 Inclusive of deductible

 



Accumulated claimable amounts (before deductible and co-insurance) from previous hospitalisations

 

Claimable amounts (before deductible and co-insurance) from previous hospitalisations within the same policy year are accumulated to offset against the deductible.

 



Total paid from previous claims

 

Total paid claims from previous hospitalisations within the same policy year.