Comparison of Integrated Shield Plans

Important Information

The information and materials contained in this website are for education and general information purposes only. They are not intended to substitute any professional or specific advice relevant to particular circumstances. 

The information provided is based on what was provided to us at the date of Publication. We are not responsible for 

• the correctness of the information, or

• any third party contents which can be accessed through the website

You are strongly advised to seek the professional advice of insurance professionals before making any decision with regard to any of the Medisave-Approved Integrated Shield Plans.

List of Integrated Shield Plans (IPs) and their targeted level of coverage

(As at 1 April 2024)

Sample Policy Contracts of Integrated Shield Plans

(As at 1 April 2024 unless stated otherwise)

Service Indicators

1. Claims Processing Duration
   
   The following claims return rate table shows how long it takes each insurer to process Integrated Shield Plan claims with positive payouts. Please note that the durations below do not apply to rider claims.

2. Pre-authorisation Turnaround Time (TAT)
   
   For scheduled treatments, Integrated Shield Plan (IP) insurers may offer pre-authorisation. This allows policyholders to know the amount that is covered by the insurer prior to undergoing treatment, so they can make more informed care decisions and have a greater peace of mind.
   
   Turnaround Time is defined as the number of working days an insurer takes to determine the outcome of a pre-authorisation request, from the time all required documentation is submitted by medical providers and policyholders. For more details on pre-authorisation requests and processes including which treatments can be pre-authorised, policyholders should approach their respective insurers.

Common reasons why insurers may reject or not pay for claims

Depending on the features and exclusions under your policy, not every IP claim results in a payout. The table below shows some common reasons you may not receive a payout for the additional private insurance component. For more information regarding your claim (including reasons for your specific claim outcome), please contact your insurer.

Letter of Guarantee

When you are hospitalised, if your hospital can obtain a Letter of Guarantee (LOG) from your insurer, you may be able to reduce the upfront cash deposit amount that you have to make with the hospital. An LOG is a letter issued by insurers to selected hospitals to fully or partially waive the hospital upfront cash deposit for hospitalisations or surgeries, based on the estimated portion of the bill covered by the insurance. LOGs are provided by insurers as an additional service, according to their respective terms of service.

All IP insurers provide LOGs and you may check with your IP insurer for more information.

Following the hospital discharge, you may still be required by your hospital to settle your hospital bill, while your insurer assesses your claim according to your insurance coverage. You will be reimbursed by the hospital, after your insurer makes payment to your hospital.

Common reasons why insurers do not provide a Letter of Guarantee in specific cases

The table below shows some common reasons why insurers may not provide policyholders with a LOG. For more information regarding LOGs and your insurance coverage, please check with your insurer.

Medical Record Costs

To process claims, insurers may require your medical records. Either you as a claimant, or your insurer, can request medical records from medical institutions. This request, however, is usually chargeable by the hospital and the charges may vary depending on the complexity of the medical report. You may check with your healthcare institution for the exact cost. IP insurers may not absorb the cost of obtaining medical records.

What if I have a claim dispute with my insurer?

For claim disputes of a contractual nature

Financial Industry Disputes Resolution Centre (FIDReC) is an independent and impartial institution that helps to resolve consumer financial disputes through mediation and adjudication. It is an accessible and affordable alternative to legal proceedings. FIDReC's services are available to consumers who are either individuals or sole proprietors for claims against licensed financial institutions who are subscribers of FIDReC.

Before filing a dispute at FIDReC, the consumer must first approach the financial institution. If the financial institution has not been able to resolve the dispute satisfactorily, the consumer can then proceed to file a claim at FIDReC. The consumer must file the claim within six months of receiving a final reply from the financial institution.

FIDReC can handle disputes of a contractual nature, this includes disputes involving disagreements over the interpretation of contractual terms. FIDReC also handles disputes involving issues of misrepresentation, service lapses and mis-selling.

Learn more about FIDReC and its dispute resolution process.

For claim disputes of a clinical nature

From 9 November 2021, a Clinical Claims Resolution Process (CCRP) was established to resolve claim disputes of a clinical nature between private Integrated Shield Plan (IP) policyholders, IP insurers, medical practitioners and medical institutions.

The CCRP will help to facilitate the resolution of clinically related IP claim disputes, including concerns on unfair rejection of claims for medically appropriate treatment or procedures, concerns on over-charging by medical practitioners and medical institutions, and concerns on over-servicing by medical practitioners.

The CCRP is a voluntary process. The parties must mutually agree to participate in the CCRP, and enter into a contractual agreement to abide by the CCRP Panel's decision. Parties should, however, attempt to resolve the disputes amongst themselves at the first instance.

The CCRP is administered by a secretariat from the Academy of Medicine, Singapore. Complainants can file their disputes online via the CCRP website.

Further information on the CCRP and the CCRP agreement form can be obtained from the CCRP website.