Can You Afford Breast Cancer Treatment In Singapore?
Ask a woman what her greatest health fear might be, and there’s a good chance that her answer might be ‘breast cancer’. It’s not without good reason – cancer was responsible for 29.6% of total deaths in Singapore in 2016, making it the leading cause of death in the country. Between 2011 and 2015, breast cancer was the most common cancer among women, and the leading cause of fatality among female cancer patients.
Despite the risk breasts cancer poses, a survey conducted by The Breast Cancer Foundation found that only 45% of 1,005 respondents perform breast examinations, on their own and at the doctor’s. In the nationwide survey conducted this year, about a quarter of the female respondents had never performed a self-examination or gone to a doctor for a medical check.
That’s a dismal proportion of women who have never undergone a breast examination, especially since we know that early diagnosis can drastically improve one’s chances of survival. According to Singapore’s latest cancer registry report, of the 2,105 women who were diagnosed with breast cancer between 2011 and 2015, those who were diagnosed at stage 1 had a 91% chance of surviving beyond five years, compared to 21% for those who were diagnosed at stage 4.
Financial costs of breast cancer
On top of its physical and emotional challenges, breast cancer can also be financially debilitating. Here, we consider the costs of breast cancer screening and treatment:
Costs of breast cancer screening
|Type of screening||Cost|
|Mammogram||S$50 – S$200|
|Breast MRI||Approx. S$1,400, private class|
|Ultrasound||Approx. S$160 – S$300, private class or at private centres|
Women aged 39 and below are advised to perform monthly breast self-examinations, while women aged 40 – 49 should perform monthly breast self-examinations in addition to annual mammograms. Women aged 50 and above should perform monthly self-examinations and get mammograms every two years.
Some patients may need a breast MRI to examine suspicious areas. An ultrasound scan may also be used to target areas found on the mammogram.
Costs of breast cancer treatment
Treatment options of breast cancer depend on the stage of cancer, the type of breast cancer and the health of the patient. Most women with breast cancer will undergo surgery:
|Lumpectomy||Removal of the cancer and |
a small amount of
|Mastectomy||Removal of the whole breast|
** Unsubsidised bills
Source: Ministry of Health
On top of that, if you’ve opted for breast reconstruction after a mastectomy, it might cost you S$20,000 to S$50,000 at a private hospital, depending on the type of reconstruction.
Common non-surgical treatments of breast cancer include radiotherapy and chemotherapy. Radiotherapy uses high-energy rays to kill cancer cells. It conventionally comprises of 30 sessions delivered over six weeks, and each session can cost up to thousands of dollars.
Chemotherapy uses anti-cancer drugs to kill cancer cells. It is delivered in cycles, varying from once a week to once every three weeks, over the course of a few months. Like radiotherapy, chemotherapy is expensive and can cost up to thousands of dollars per session.
Other costs of breast cancer
1. Loss of income
Coping with cancer is time-consuming and physically demanding. Recovery from surgery or attending treatment sessions – which could be administered through the course of a few months – will cut into your working hours. An employee who has been diagnosed with cancer might need to take days off, or an extended time off work, for recovery or treatment. Additionally, common side effects from treatment like pain, fatigue and discomfort could also affect your ability to work. These factors can make it hard for someone to continue working full-time.The loss of income that accompanies the reduced capacity to work will likely make it hard to deal with existing financial commitments, such as home and car loans, credit card payments and other living expenses.
2. Physical rehabilitation
The side effects of surgical treatment may include weakness and limited mobility, necessitating patients to undergo physical rehab. The rehabilitation process can help patients reattain the physical function they had before diagnosis, but it’s a process that can take months – adding yet again to the list of expenses incurred.
A cancer diagnosis means many trips to hospitals, clinics or cancer centres. Radiotherapy, for instance, conventionally comprises of 30 sessions delivered over the course of five days a week for six weeks. The costs of commuting for treatment can be especially high for patients experiencing treatment side effects like fatigue, as they cannot use public transportation and must rely on more expensive commuting options like taxis.
4. Follow-up care
After treatment, a patient will need regular checkups. If you’ve undergone a breast-conserving surgery, you’ll need to get yearly mammograms. A patient who has also undergone mastectomy will need yearly mammograms on the remaining breast. Other types of checkups might also be required to look for signs of treatment side effects.
Patients experiencing hair loss might choose to wear a wig. However, wigs can be pricey – wigs made of human hair can cost over S$1,000. They also require regular washing – a schedule that depends on the material the wig is made out of, and how often the wig in question is worn. For wig-wearers who aren’t comfortable in washing their hair themselves, trips to the salon will do, but will also add to expenses.
How to finance breast cancer screening and treatment
Unless you’re sitting on piles of cash, you’ll probably need to rely on medical insurance or financial and welfare aid in the event of a breast cancer diagnosis:
This compulsory savings scheme helps working Singaporeans save a portion (8% – 10.5%) of their monthly income to pay for selected medical expenses. Here are some breast cancer-related expenses you can use Medisave to pay for:
|Inpatient hospitalisation||S$450 per day for daily hospital charges|
|Approved day surgeries||S$300 per day for daily hospital charges|
|Surgical operations||S$250 to S$7,550 depending on the complexity of the operation|
|Home palliative and day hospice care||S$2,500 per lifetime|
|Day rehabilitation centres||S$25 per day, up to a maximum of S$1,500 per year|
|Screening mammograms |
(for women aged 50 and above)
|S$400 per year per account|
|Chemotherapy||S$1,200 per month|
2. Medishield Life
All Singaporeans and permanent residents are automatically covered by Medishield Life, a medical insurance scheme that can help pay for large hospital bills and selected outpatient treatments:
|Daily ward and treatment charges|
• normal ward
• intensive care unit ward
• community hospital
S$700 per day
S$1,200 per day
S$350 per day
|Surgical procedures||S$200 - S$2,000|
|Chemotherapy||S$3,000 per month|
• external or superficial
S$140 per session
S$500 per session
Medifund is an endowment fund set up by the government to help Singaporeans still facing financial difficulties with their medical bills, even after utilising 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
- Patient and 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.
If your application for Medifund assistance has been approved, 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.
4. ComCare Short-to-Medium Term Assistance
If you have a monthly household income of S$1,900 and below, you may be able to apply for the Community Care Endowment Fund (ComCare)’s financial assistance scheme. This scheme provides financial aid and medical assistance to Singaporean citizens and permanent residents who are temporarily unable to work due to illness.
Other financial aid
For patients who require rehabilitation, Singapore Cancer Society (SCS) also offers cancer rehabilitation programmes at only S$50.00 for a 12-month membership period.
Additionally, SCS has several financial and welfare schemes to help those in need. Successful applications may receive temporary financial assistance, medical supplies and subsidies for approved drugs or treatments.
Private medical insurance
However, Medisave and Medishield Life might not cover all the costs of your treatment, and you probably would not want to rely on financial or welfare assistance. In this case, getting the right medical insurance from a private insurer could mean the difference between being able to cover your treatment costs and being saddled with medical debt. You’ll want to consider these three types of medical insurance: integrated shield plans, critical illness policies and cancer insurance plans.
1. Integrated shield plans
An integrated shield plan (IP) is a medical insurance plan that provides additional benefits on top of what Medishield Life offers. Singaporeans can apply for IPs through participating private insurers (AlA Singapore, Aviva, AXA Life, Great Eastern Life, NTUC Income and Prudential Assurance) and pay for premiums through CPF Medisave funds.Why you should consider an integrated shield plan:
|Has a claim limit for each treatment.||Cover 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|
|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.|
2. Critical illness policies
Under Medisheld Life or an IP, you would only get to claim for hospitalisation or treatment fees. In contrast, a critical illness policy provides coverage for 37 illnesses that include major cancers, and pays a lump sum upon diagnosis. You can use the lump sum payout at your own discretion, and it can be especially useful for covering a temporary loss of income, additional medical costs or even non-medical expenses.
3. Cancer insurance plans
If you are concerned about having an increased risk for cancer due to family history or other lifestyle factors, you may want to consider a cancer-specific insurance plan. Unlike a critical illness policy that pays a single lump sum, a cancer insurance plan may pay lump sums at both early and advanced stages of cancer. Cancer insurance plans could also include aftercare benefits like coverage for physical rehabilitation, health counselling, hair loss treatments and other expenses.
For most women, an IP and a critical illness policy might be sufficient to cover the expenses a breast cancer diagnosis would entail. However, when choosing an insurance policy, you should consider how much premium you are able to afford, keeping in mind that these premiums will increase as you age.
Jen writes about personal finance at iMoney. Prior to this, she was a children’s educational writer.