As part of an ongoing review of MediShield Life benefits and premiums, the MediShield Life Council is seeking views from the public on the preliminary recommendations and suggestions for enhancements to the scheme.
Keeping healthcare affordable
MediShield Life is a basic health insurance plan launched in November 2015 to protect all Singaporeans against large medical bills regardless of pre-existing conditions, for life. The MediShield Life Council was appointed by the Minister for Health to provide recommendations on the policy and scheme parameters of MediShield Life, and to review its administration.
This is the first major review of the scheme since its launch, and the changes are expected to be implemented in early 2021.
Preliminary enhancements are identified in three areas:
(a) Refreshing and refining claim limits to provide better coverage
MediShield Life claim limits should be refreshed to cover 9 in 10 subsidised bills, and should be reviewed more regularly to ensure that they offer adequate protection in light of inflation and medical advancements. In addition, the Council proposes the following refinements:
i. Introduce treatment-specific claim limits for community hospital care and outpatient radiotherapy to improve coverage for patients receiving sub-acute care [1] or costlier outpatient radiotherapy.
ii. Raise the policy year claim limit from $100,000 to $150,000, to better protect Singaporeans against exceptionally large bills arising from long or multiple periods of hospitalisation during the year.
(b) Enhancements to support larger healthcare transformation
In line with larger healthcare transformation efforts to keep healthcare costs sustainable, the MediShield Life Council recommends enhancements to better support Singaporeans who can be more appropriately cared for in the community or at home, to reduce the need for expensive hospital care:
i. Introduce higher claim limits for daily ward and treatment charges for the first two days of acute hospital stay, as higher charges tend to be incurred during the first two days due to diagnostic tests and investigations. This is to better support patients who can be discharged home earlier.
ii. Lower the deductible [2] for day surgeries for older patients, so that they are not discouraged from choosing a day surgery over an inpatient stay.
(c) Other proposed enhancements
The MediShield Life Council also proposes other enhancements:
i. Lower the pro-ration factor [3] for private hospitals to 25%, to better reflect the actual charges and ensure greater parity in payouts between subsidised and private patients.
ii. Remove the standard exclusions for treatments arising from attempted suicide, intentional self-injury, drug addiction and alcoholism, as treatment plays an increasingly important part in the support and recovery of these patients.
Review of premiums and premium affordability
Premiums need to be adjusted periodically to support enhancements that provide better coverage and higher payouts, and to keep pace with healthcare cost inflation and actual claims experience. In particular, MediShield Life payouts have increased by close to 40% over the last four years, and the number of claimants has increased by almost 30%.
The MediShield Life Council recommends adjusting the premiums this round as proposed by the actuary to ensure that the scheme continues to be sustainable.
As MediShield Life premiums had been kept constant for the first five years in line with the Government’s commitment, premiums were not adjusted when several benefit enhancements were implemented from 2018 to 2020. This round of adjustments will also take these enhancements into account.
Public invited to contribute their views and feedback on the preliminary recommendations. The Council will carefully consider the feedback received before making the final recommendations by end 2020.
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