How To Cover Healthcare Expenses With Schemes, Subsidies And Insurance And Singapore
The Singaporean healthcare system is one of the best in the world – at least according to the Bloomberg 2014 Health-Care Efficiency Index. The index, which ranked 55 countries, placed Singapore at number 2, just after Hong Kong. More recently, the Bloomberg 2017 Global Health Index named Singapore the fourth healthiest country in the world out of 163 countries.
However, efficient healthcare doesn’t always equate to affordable healthcare. Most of your healthcare costs may be financed out of pocket – and with a gross medical inflation of 10% in 2017, that amount is increasing year by year.
So what exactly are your options for financing healthcare costs in Singapore?
Healthcare schemes and subsidies in Singapore
With the myriad of schemes and subsidies available, you may only be required to pay part of your healthcare expenses if you opt for public healthcare treatment. In Singapore, there are four layers of protection to help Singaporeans afford healthcare:
1. First layer: subsidised wards and treatment
If you’re a Singaporean citizen, you can receive subsidies of up to 65% for day surgeries. You can also get hospitalisation subsidies up to 80% by choosing a Class C ward at a public hospital:
|A||own room, air-con, TV||0%|
|B1||4 beds, air-con, TV||20%|
|B2||6 beds||50 – 65%|
|C||8 – 10 beds||65 – 80%|
In addition, the Ministry of Health (MOH) also subsidises selected drugs at public hospitals, specialist outpatient clinics (SOCs) and polyclinics.
2. Second layer: Medisave
Medisave is a compulsory savings scheme that helps working Singaporeans save a portion of their monthly income to pay for selected medical expenses.
If you earn more than S$750 a month, here’s how much of your monthly income you’re contributing to Medisave:
(% of wage)
You can use Medisave to help pay for the following expenses:
- surgery and hospitalisation
- conception, pregnancy and delivery expenses
- selected screening tests, vaccinations and chronic disease treatments
- selected repeated treatments, like renal dialysis or chemotherapy
- stay in a community hospital or rehabilitation at a rehabilitation centre
- palliative care at a hospice or at home
However, each treatment type is subject to claim limits.
3. Third layer: Medishield Life
If you’re a Singaporean citizen or a permanent resident, your Medisave account will be automatically deducted to the premiums of Medishield Life, a medical insurance scheme that can help pay for large hospital bills and selected outpatient treatments:
|Type of treatment||Claim limit|
|Daily ward and treatment charges|
· Normal Ward
· Intensive Care Unit Ward
· Community Hospital
· Psychiatric (up to 35 days per year)
S$700 per day
S$1,200 per day
S$350 per day
S$100 per day
|Surgical Procedures||S$200 – S$2,000, depending on complexity|
|Implants||S$7,000 per treatment|
|Radiosurgery||S$4,800 per procedure|
|Chemotherapy||S$3,000 per month|
· external or superficial
S$140 per treatment
S$500 per treatment
S$1,800 per treatment
|Kidney dialysis||S$1,000 per month|
|Immunosuppressants for organ transplant||S$200 per month|
|Erythropoietin for chronic kidney failure||S$200 per month|
You can claim up to S$100,000 per year under Medishield Life.
4. Fourth layer: Medifund
Medifund is an endowment fund that help Singaporeans still facing financial difficulties with their medical bills, even after using Medisave and Medishield Life.
Patients can apply for Medifund assistance by approaching Medical Social Workers at Medifund-approved institutions. However, you’ll need to fulfill the following criteria:
- is a Singapore citizen
- is a subsidised patient
- has received treatment from a Medifund-approved institution
- you and your family have financial difficulties paying for healthcare bills despite receiving government subsidies and drawing on other means of payments including MediShield Life/Integrated Plans, Medisave and cash
Upon successful application, the amount of aid you’ll receive will depend on you and your family members’ financial and social circumstances, as well as the size of your medical bill.
Other government subsidies
Singaporean citizens and permanent residents are automatically covered by ElderShield at the age of 40, although you can choose to opt out.
If you’re enrolled in the scheme, you will receive the following monthly payouts in the event of severe disability:
2. Interim Disability Assistance Programme for the Elderly (IDAPE)
IDAPE provides financial help to needy and disabled elderly Singaporeans who were not eligible to join ElderShield when it was launched.
If you qualify for IDAPE, you’ll receive S$150 or S$250 a month, for a maximum period of 72 months, depending on your household monthly income:
|Household monthly income per person*||Monthly payout|
|$0 - $1,800||$250|
|$1,801 - $2,600||$150|
3. Community Health Assist Scheme (CHAS)
CHAS provides middle and lower income households with subsidised medical and dental care at participating clinics. Depending on your income, you can receive up to 70% subsidies. Singaporeans who are eligible for Pioneer status will receive an additional 50% off.
The CHAS eligibility tiers include:
** refers to the estimated annual rent if it is rented out
Here are the list of subsidies you can get under CHAS:
|Subsidies||CHAS Blue||CHAS Orange||CHAS for Pioneer Generation|
|Common illnesses||Up to S$18.50||-||Up to S$28.50|
|Chronic conditions||Simple||Up to S$80 per visit (S$320 yearly cap)||Up to S$50 per visit (S$200 yearly cap)||Up to S$90 per visit (S$360 yearly cap)|
|Complex||Up to S$120 per visit (S$480 yearly cap)||Up to S$75 per visit (S$300 yearly cap)||Up to S$135 per visit (S$540 yearly cap)|
|Selected dental services||S$11 - S$256.50||S$50.00 - S$170.50||S$21 - S$266.50|
|Selected health screenings||Fixed fee of S$2||Free|
Do you need private medical insurance?
Despite the various schemes and subsidies available, you might still end up paying for part of your healthcare expenses. Medisave and Medishield Life may only cover part of your healthcare costs, as they are subject to certain claim limits. In addition, you might not qualify for other financial or welfare assistance.
In order to cover the remaining costs, you’ll have to consider getting private medical insurance – otherwise, you’ll have to cover the expenses out of your own pocket.
Integrated Shield Plans
An Integrated Shield Plan (IP) is a medical insurance plan offered by private insurers in Singapore. You can use your Medisave savings to pay for the premiums of your IP. An IP provides additional benefits on top of what Medishield Life offers:
|Medishield Life||Integrated Shield Plan (IP)|
|Has a claim limit for each treatment.||Covers you “as charged” as long as it's under the annual claim limit.|
|Annual limit of S$100,000.||Higher annual limits depending on your premium.|
|Does not cover pre-hospitalisation and post-hospitalisation treatment.||Provides coverage for pre-hospitalisation and post-hospitalisation treatment.|
|Applicable to any ward class in public or private hospitals with coverage based on Class B2/C wards. Additional costs will be covered by the patient.||Depending on your type of IP, you may be covered for your hospitalisation costs in Class A/B1 wards and in private hospitals.|
Even if you are in superb health, have an excellent family medical history and live a fairly safe, desk-bound life, you should still consider getting an IP. Medishield Life may not sufficiently cover your medical expenses should a serious medical illness befall you – for medical conditions that require recurring treatments, like cancer or diabetes, having an IP could mean the difference between being able to afford treatment costs and being saddled with debt.
Other types of private insurance policies
Other than IPs, there are other types of private insurance policies that can help cover your healthcare expenses, such as:
|Type||What does it do?|
|Critical illness insurance||Pays out a lump sum if you have been diagnosed with one of the policy’s covered critical illnesses.|
|Disability income insurance||Pays out a monthly income if you have experienced income loss due to disability or illness.|
|Long-term care insurance||Pays out a fixed monthly amount for long-term nursing treatment.|
|Hospital cash insurance||Pays out a fixed amount for each day for each day that you are hospitalised.|
While you won’t be able to use your Medisave account to pay for these policies, it’s a good idea to consider them anyway – these policies can cover expenses not directly related to treatment, such as income loss due to inability to work or special dietary requirements.
Know your options
While the Singaporean healthcare system has schemes and subsidies in place to make paying that hefty medical bill more affordable, you may still need to rely on other financing options such as private medical insurance. If you don’t already have an action plan for facing medical eventualities, it’s best to start preparing now.