Medical Insurance

DO YOU NEED MEDICAL INSURANCE?

Medical Insurance or also known as Hospital Insurance, pays for your hospitalisation fees up to a specified limit.

When it comes to medical care, you want:

• The choice of the best doctors who may only be available in private hospitals.
• Be able to stay in good ward classes so that you have some privacy.
• To be able to access medical care immediately and not wait in a queue for months.
• To be able to meet extreme hospitalisation costs that you cannot afford on your own.

WHO SHOULD BUY MEDICAL INSURANCE?

Medical insurance is the most basic level of insurance that everyone should get. Even infants should be covered by Medical Insurance.

In Singapore, all Singapore Citizens and Permanent Residents are automatically covered by the national health insurance scheme, MediShield Life. MediShield Life is designed for B2/C wards in restructured hospital and has limits on the benefits. You may want to consider buying a Medisave-approved Integrated Shield Plan and its optional rider(s) from a private insurer if you prefer:

• Less out-of-pocket expenses (with as-charged benefits, lower/no co-insurance and/or deductible).
• To choose your own doctor and stay at ward B1/A in restructured or private hospital.
• Pre- and post- hospitalisation coverage.
• Special benefits e.g. Emergency overseas treatment.

As an Integrated Shield Plan provides additional private insurance coverage, there will be an additional premium that has to be paid using your Medisave up to an Additional Withdrawal Limit (AWL). The amount in excess of AWL will be payable by cash. It is important to consider the affordability of your Integrated Shield Plan premium in the long term.

If your employer already provides some medical coverage, you may still want to consider buying a policy with an Integrated Shield Plan as you would lose your employer's cover if you are in-between jobs or if your new employer does not provide medical coverage. Coverage provided by employers will also have a limit. This means that you will need to cover very large medical expenses that will be in excess of your employer's coverage.

If you are hospitalised for an extended period of time, your employer may terminate your employment, leaving you with insufficient medical coverage. Furthermore, should you change jobs, your coverage from your employer may not cover pre-existing conditions.

HOW MUCH AND WHAT TYPE OF MEDICAL INSURANCE SHOULD YOU BUY?

There are a few considerations when buying Medical Insurance:

• Claim limits: The claim limits may be set on types of claims or annual overall claim limits. The higher the limits, the more you can claim for each hospitalisation. The best coverage plans offer an "as charged" basis. That means that the plan will pay for whatever the hospital charges you, subject to any deductibles and co-payment.

• Deductibles & co-payment: Deductibles mean that you pay the first dollar of the fees up to the deductible amount. A co-payment is a percentage of the hospital bill that you pay after paying the deductible. A deductible and co-payment is a useful way to lower the premium rate and willing to pay for smaller medical expenses, or if you have some other coverage. Integrated Shield riders can be bought to cover the deductible and co-payment amounts.

• Pre-existing condition: Do note that while MediShield Life covers pre-existing conditions, the Integrated Shield Plan does not. If you have a pre-existing condition, you should continue with your current insurer.

WHAT DOES AN INTEGRATED SHIELD PLAN LOOK LIKE?

An Integrated Shield Plan will provide coverage for inpatient medical expenses.

The plan may not fully pay for actual medical expenses incurred if:

• You do not buy as charged plans as you will be subject to limit on treatments.
• You do not buy any riders to cover the deductible and co-insurance.
• A limited number of treatments will have limits even under the Private as charged plans.

You would need to weigh a more comprehensive coverage against the cost of premium and consider if you are able to afford the premium amount.

Premium rates for Medical Insurance will increase with age. While the premium amount is not guaranteed, insurers typically offer guaranteed acceptance of the policy for renewal.

The above are subject to the definitions as set out by the insurance companies.