17 Oct 2024
SOURCE: CPF Board
What exactly makes this national health insurance scheme so crucial for your well-being? Let's uncover the benefits that could make a world of difference when you need them the most.
What is MediShield Life?
MediShield Life is a health insurance that helps you pay for large hospital bills and selected outpatient treatment costs. This coverage isn’t restricted to public hospitals; it can cover private hospitals as well, although the coverage for private institutes may not be as extensive. All Singapore Citizens and Permanent Residents are automatically covered, which means no sign up is required. MediShield Life helps to offset part of your bill, and the remaining amount can be paid with MediSave savings and/or cash.
What are the premiums and coverage for MediShield Life?
Paying the annual premiums for MediShield Life can be done fully via MediSave. You can use your own, or your family member’s MediSave to do so. Furthermore, to ensure that the premiums are affordable, such that everyone remain covered, the Government also provides significant subsidies and support such as Medisave top-ups. Any applicable subsidies are automatically applied before the payment is made.
When planning for your long-term healthcare financing, it’s important to consider that premiums will increase with age. The premiums for different age groups before subsidies are as follows:
*Applicable for policy start/renewal date on or after 1 Jan 2024.
Members with pre-existing medical conditions are also covered under MediShield Life, which differs from private insurance plans that may not provide such coverage. For members with serious pre-existing medical conditions, a nominal Additional Premium of 30% for 10 years in addition to the standard MediShield Life premiums will be required. A pre-existing condition is a medical condition or illness that an individual already has before he or she is covered under an insurance plan. If the medical condition developed after the start of an insurance cover, it is not considered a pre-existing condition.
What are the upcoming enhancements to MediShield Life?
In light of evolving healthcare landscape and rising costs and claims, there will be changes to MediShield Life coverage and premiums to better protect Singaporeans against major health episodes that result in large hospital bills.
Key changes include:
- Increasing claim limits, such as for inpatient and day surgery. For example, the daily claim limits for the first two days of a normal ward stay will go up from $1,000 to $1,630. The policy year claim limit will also be increased from $150,000 to $200,000 to provide greater assurance for patients with exceptionally large bills.
- Refreshing scheme parameters, such as increasing the inpatient deductible and revising the pro-ration factors for private unsubsidised bills.
- Enhancing outpatient coverage significantly, by increasing outpatient claim limits and expanding coverage to new outpatient treatments and home-based medical care to enable more access to convenient care options. For example, the claim limits for kidney dialysis will increase from $1,100 to $1,750 per month. Co-insurance for outpatient treatments will also be decreased to a tiered structure ranging from 3% to 10%, to make larger bills more affordable, while a new outpatient deductible of $500 per year will be introduced to keep coverage focused on larger bills.
- Expanding coverage to high-cost treatments that are both clinically and cost-effective, to improve affordability and access. This includes Cell Tissue and Gene Therapy Products (CTGTPs) that have demonstrated the potential to treat cancers and serious diseases effectively, as well as high-cost drugs for blood conditions with childhood onset.
With higher claim limits and expansion of MediShield Life’s coverage, premiums will need to increase to ensure the scheme remains sustainable, starting from April 2025 upon policy renewal.
To help Singaporeans manage the premium increase, the Government will provide the following support measures:
- Total premium increase will be capped at 35%, and phased in evenly over 3 years, from April 2025 to March 2028. This means that premiums will increase by an average of 22% per policyholder by the end of the third year.
- Existing premium subsidies will be enhanced by 5% to 10% for lower- and middle-income Singaporeans in older age groups. From 1 April 2025, they will receive premium subsidies of up to 60%, from up to 50% today.
- Provide additional MediSave top-ups for Pioneer Generation, Merdeka Generation, young seniors and Singaporeans born between 1974 and 2003 (inclusive). From 1 April 2025, the MediSave Grant for Newborns will also be increased from $4,000 to $5,000 to fully cover a Singaporean citizen’s MediShield Life premiums until age 21.
- Allow Singaporeans aged 41 and above to offset their premiums using discounts redeemed from Healthpoints earned through the Healthy 365 programme, from Q3 2025.
For more details, please refer to the Ministry of Health’s website on the MediShield Life 2024 review.
Is MediShield Life enough to cover your needs?
MediShield Life is designed to cover large bills in Class C/B2 wards in public hospitals. The benefits and premiums are reviewed regularly to ensure that the scheme remains sustainable and relevant to your needs.
If you prefer additional coverage, on top of what MediShield Life already provides, you can buy an Integrated Shield Plan (IP). IP is a private medical insurance plan that offers additional coverage for the cost of stay in private hospitals, as well as Class B1/A wards in public hospitals.
Before getting an IP, the important question to ask yourself is: what is it you really need?
Having a wider range of options may seem great, but it comes with additional costs. MediShield Life is sufficient in covering you for large hospital bills in a subsidised ward of a public hospital. If you do not think it is likely for you to opt for higher class wards in public hospital or seek treatment in private hospitals, you probably don’t need an IP. If you’re considering one, do think about your preferences for the additional support, as well as the long-term affordability of such coverage.
The information provided in this article is accurate as of the date of publication.
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