By Arina Smith
In Singapore, there are both government and private health insurance plans that can be used to cover a range of medical services. The Ministry of Health (MOH) offers two types of universal health care programs.
First, MediShield Life provides a standardized level of coverage for life-threatening diseases and accidents. Second, the ElderShield program covers disabilities due to severe disability or chronic ailments such as Parkinson’s disease, multiple sclerosis (MS), and stroke.
Both these public insurance programs offer partial reimbursement for hospital bills when patients receive the necessary treatment in hospitals accredited by MOH under MediShield Life or in Singapore General Hospital (SGH; part of SingHealth group), Khoo Teck Puat Hospital (KTPH; owned by the National Healthcare Group) and Gleneagles Hospital (owned by Parkway Health).
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What Is MediShield Life Insurance?
MediShield Life is a government-backed health insurance program available to Singapore citizens and permanent residents. It provides coverage for hospitalization due to accidents, critical illness, or pregnancy complications. The latest addition to this program is MediShield Life, which covers pre-existing illnesses such as cancer and stroke.
This is one of the health insurance plans in Singapore that also offer a lifetime renewal of your policy without any medical screening at the time of purchase. People who opt for this plan can choose from different co-insurance levels: 35%, 50%, and 90%.
Premiums depend on the level of premium you choose during purchase, but once it’s taken out, there are no further premiums throughout the duration of the policy.
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What Is An ElderShield Program?
The ElderShield program gives Singaporeans protection against severe disabilities due to illness or accidents. Premiums are set on a sliding scale depending on age, ranging from S$0 for those under 30 years old to S$21 per month for those over 60.
There are three coverage options available:
- Basic
- Enhanced
- Top-up
These all three coverage options have progressively higher levels of reimbursement at the time of claim. When you are in Singapore and want to purchase the coverage facility, you have to go through the written plans, including the terms and conditions of the policymakers.
If you need hospitalization or surgery in an accredited local or foreign private hospital, but your insurer denies your claim because it is considered not medically necessary, you can discuss this with them through their internal dispute resolution process (IDRP). If the insurer’s decision remains unchanged after IDRP, you have two choices available to you:
Is Your Insurer A Private Health Insurer?
- Find out if your private health insurer has a medical escalation process that allows you to escalate the dispute to an independent third party for review. Some insurers have outsourced their IDRP to MedAssist, a dedicated healthcare services firm, which manages the entire internal appeals and complaints management processes from beginning to end.
They will assign a team of trained professionals who listen first as neutral listeners, then provide impartial advice as independent reviewers before making a decision known only to the insurer and insured party involved. The team’s decisions are final once it’s presented as part of the appeal or complaint resolution process.
When You Insurer Does Not Have Third-Party Escalation Party
- If your insurer does not have a third-party escalation process, contact the Consumers Association of Singapore (CASE) to file a complaint. They will review your case and determine if there were any violations committed by your insurer during their investigation or handling process.
There are public hospitals in Singapore that provide subsidized rates for services such as antenatal care, deliveries, and postnatal care, among others. These subsidized rates follow the guidelines set by MOH on service costs under MediShield Life and ElderShield programs.
Conclusion:
Singapore has ample insurance providers. And when you want to purchase the policy from private insurance providers, always first check the government registration certificates. And then select the service-providing company. In Singapore, you will get plenty of insurance provider options. First, know the facts and do research on the government policies for the deals, and make the selection.
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