SINGAPORE: The Ministry of Health (MOH) has proposed enhancements to MediShield, its catastrophic illness insurance scheme, to provider greater coverage from the first quarter of next year.
MOH is proposing to extend coverage and increase payouts, but this means premiums will also be raised. However, it said that for the vast majority of MediShield policyholders, the increase will be less than S$10 per month.
The ministry plans to increase the annual policy limit from the current S$50,000 to S$70,000. The lifetime claim limit will also be raised from S$200,000 to S$300,000.
The proposed increase in lifetime claim limit will help to cover his expenses for the next eight years, provided he does not incur any huge hospitalisation or medical bills.
The Health Ministry says MediShield claims have increased -- both in terms of the number of claims and the average payout per policyholder -- since 2008 when the MediShield scheme was last adjusted.
The number of claims per policy holder has increased by 9 per cent per year.
The average payout per policyholder has also risen by 12 per cent per year, due to inflation of medical costs by some 3 per cent a year.
With enhanced coverage and payouts, MediShield deductibles will also be adjusted accordingly.
The deductible for Class C bills will be increased from S$1,000 to S$1500 and S$1,500 to S$2,000 for Class B2 bills. The deductible is the amount of a hospital bill that patients have to pay before claiming insurance.
Premiums are also set to rise slightly under the proposed amendments.
MOH also plans to extend MediShield coverage for treatment in short-stay wards in the Emergency Departments. The MediShield coverage will also be extended from age 85 to 90.
To help Singaporeans with mental illness, MediShield will also be extended to cover newly diagnosed patients who require inpatient psychiatric treatment. And as bills for subsidised inpatient treatment are generally lower, the daily claim sum will be S$100.
To encourage patients who are well to be discharged promptly, policyholders will be able to claim up to a maximum of 35 days of hospital stay per year.
MOH is also seeking public feedback on its plans to extend MediShield to cover congenital and neonatal conditions. A congenital disorder is a medical condition that is present at or before birth.
Kenneth Wee, whose five-year-old daughter Zoe was born with congenital conditions, said it would have helped if his family could have used MediShield to help pay for Zoe's treatments.
Zoe was born without a thumb on her left hand, and two thumbs on her right. Her parents later discovered she also had a hole in her heart.
To fix these medical conditions, Zoe underwent two major surgeries in the first year of her life. One surgery was to seal the hole in her heart, and the other to fuse her two thumbs together.
The surgeries cost her parents about $55,000, paid mostly through government subsidies and Medisave, but the couple still had to cough up some S$10,000 in cash for Zoe's medical bills.
Mr Wee said: "We were still quite a young family, so cash was always quite tight. It (being able to use Medishield) would have benefited us in terms of just easing a little bit of the financial burden."
Sylvia Mun, chief medical social worker at KK Women's and Children's Hospital, said: "What we normally see is that in a dual income family, one of the parents actually gives up their job to care for the child so it means a reduction in income for the family.
"The reality right now is that there are a lot of these families who are unable to actually put their children on insurance, the reason being that the (insurance) companies will say, 'we won't take it up because the child is born with a congenital problem'."
Currently, there are a handful of insurers that offer integrated shield plans for congenital abnormalities. Integrated shield plans are medical expense insurance policies that pay for hospitalisation costs, subject to limits.
There are five insurers that offer such plans: AIA,. Aviva, Great Eastern Life, NTUC Income and Prudential.
A spokesperson from Life Insurance Association Singapore said the "as-charged" integrated shield plans provides congenital abnormalities benefit for the insured, subject to a 24-month waiting period.
To cover congenital and neonatal conditions, the Ministry of Health is proposing that the cost of coverage be S$12 a year.
Parents may choose to opt out of this during the auto-cover exercise, but the Health Ministry says a high opt-out rate would result in higher premiums. The MediShield opt-out rate for each newborn cohort is less than 5 per cent.
With the extension, all new-born Singaporeans will be covered from birth throughout their lifetime so long as they do not opt out. MOH said the bulk of the cost borne will be in the younger ages, from one year old to 20 years old.
The public consultation on the extension of MediShield coverage ends August 15.
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