How MediShield Life Works

Singapore citizens and permanent residents get health insurance coverage under the MediShield Life package. The scheme covers most ailments and its benefits are available on a lifelong basis. This is a major advantage as illnesses and medical expenses increase as people age.

Launched by the Singapore government towards the end of 2015, MediShield Life is a basic health insurance plan designed to pay for the hospitalisation and certain outpatient treatments of the nation’s citizens. It was designed to replace MediShield, and therefore its health insurance premiums are paid from individual’s Medisave account in the Central Provident Fund. Why did the government introduce a new plan? MediShield Life is superior to MediShield in several ways:

Does MediShield Life cover all medical expenses?

MediShield Life pays for a host of serious ailments and the coverage is fairly generous. For example, the maximum payout for implants is S$7,000. Radiosurgery is capped at S$10,000 per treatment course.

Similarly, the limit for expenses on chemotherapy for cancer is S$3,000 per month. Patients requiring kidney dialysis are covered for an amount of S$1,100 per month.

But there are a number of exclusions as well. Some of the expenses that MediShield Life does not pay are:

Important features of MediShield Life

There three important features of MediShield Life that you need to understand: claim limits, deductible and coinsurance. Below, we explain each concepts and how they impact your usage of MediShield Life.

Claim limits

MediShield Life insurance policy covers hospitalisation, charges for surgery, and the payment that you are required to make for staying in the hospital ward. The maximum amount that you can claim in a year is limited to S$150,000, which should be significant enough to cover most minor procedures. There is no lifetime limit on claims. The S$150,000 limit is broken into a number of individual items. For example, the daily ward and treatment charges are limited to S$800. If you need to stay in an intensive care ward, this limit is hiked to S$2,200 per day. Different surgical procedures, on the other hand, have individual limits of between S$240 and S$2,600.

Deductible

MediShield Life doesn’t cover your entire hospital bill. It usually requires the patient to pay an amount, called deductible, up to a certain level before MediShield kicks in. The deductible is intended to reduce the number of small claims that most people can pay for relatively easily. Deductibles also help to keep premiums low by keeping the overall cost of health care at a manageable level. Our chart below summarises the deductible amount to be borne by an individual by age and the medical service received.

Co-insurance

In addition to the deductible, you need to bear an additional portion of your hospital bill called co-insurance. Co-insurance typically varies between 3% and 10% of the total bill amount, and falls as the value of the bill rises.

Pro-rating

You are entitled to MediShield Life payouts that are calculated on the basis of the subsidised bills payable at Class B2/C wards. For outpatient treatment and day surgery, the payout is also pegged to the subsidised rates that are applicable. In the event that you stay in a Class A/B/B2+ ward in a public hospital or a private hospital, the payout will be reduced on a pro-rated basis.

What is the premium payable for MediShield Life?

Premiums for MediShield Life are calculated based on your age on your next birthday. They're fully payable by Medisave and there are subsidies available for seniors and citizens who are in lower income levels and living in residences with Annual Values of up to S$21,000. Depending on your age bracket and your home's Annual Value, you can see a premium reduction of up to 50%. The current premiums for MediShield Life before subsidies are as follows:

You should note you won't be eligible for subsidies if you own more than one property. Furthermore, if you're a Permanent Resident, you will only be eligible for half the applicable subsidy rates for Singapore Citizens.

Enhance your coverage with an Integrated Shield Plan

It is possible to get additional medical insurance coverage by paying a premium to a Medisave-approved private insurance company and obtaining an Integrated Shield Plan (IP). This has two components – the MediShield Life component and the additional private insurance coverage.

Below is a list of IPs that are available in Singapore:

Many Singaporeans prefer to top up the basic coverage that MediShield Life offers. If you are planning to do that, you can get some tips by reading 5 Mistakes You Are Making When Buying Insurance in Singapore.

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