1. The Ministry of Health (MOH) has extended MediShield Life coverage to better protect Singaporeans against large medical bills in the following areas:
a. Direct admissions from emergency departments of public hospitals to community hospitals (direct ED-CH admissions);
b. Parenteral nutrition (PN) bags and consumables for patients on long-term PN due to chronic intestinal failure; and
c. Surgical interventions for two rare congenital conditions – trisomy 18 and alobar holoprosencephaly.
2. There will be no premium adjustments at this point.A review of premiums will be conducted by end-2020 (about five years from the launch of MediShield Life), taking into account actual claims experience and healthcare cost inflation as well as possible future enhancements.
Direct ED-CH Admissions
3. MediShield Life is designed primarily to provide coverage for large acute inpatient bills. Previously, MediShield Life covered community hospital stays only for patients transferred from an acute hospital after an acute inpatient stay.
4. MOH has assessed that patients who have been reviewed by the emergency departments (ED) of public hospitals to be in a stable condition with a clear diagnosis, and requiring a period of medical, nursing and/or rehabilitation care can benefit from direct admission in a community hospital (CH). ED-CH admissions facilitate the provision of care at the most appropriate setting. Some examples of the conditions suitable for direct ED-CH admissions include urinary tract infection, non-surgical wound care requiring inpatient medical care, or inpatient rehabilitation to improve patients’ ability to perform daily activitites.
5. MediShield Life coverage has been extended to direct ED-CH admissions since 15 July 2018. Patients can claim up to $350 per day from MediShield Life, which is the prevailing inpatient limit for community hospitals. Patients can continue to tap on their MediSave, up to the prevailing inpatient limits at the community hospital.
Long-Term Parenteral Nutrition
6. PN refers to the provision of nutrition intravenously, bypassing the digestive system. Patients with intestinal failure require PN if they are unable to meet their nutritional requirements through oral routes alone. PN feeds may be required for the long term, resulting in large, recurrent bills for patients.
7. From 1 November 2018, MediShield Life coverage and MediSave have been extended to patients on long-term PN (90 days or longer), who meet the clinical criteria. Eligible patients can claim up to $1,700 per month from MediShield Life and withdraw up to $200 per month from MediSave, for PN bags and consumables necessary for the administration of PN. The clinical criteria can be found in the Annex and on the MOH website[1].
Surgical Interventions for Trisomy 18 and Alobar Holoprosencephaly
8. Trisomy 18 and alobar holoprosencephaly are rare congenital conditions which were fatal by nature in the past. Surgical interventions for these conditions were previously excluded from MediShield Life coverage as treatment was not effective.
9. More recent international studies have shown that surgical interventions can now improve the quality of life and survival of patients. As such, MediShield Life has been extended to cover surgical interventions for Trisomy 18 and alobar holoprosencephaly from 1 November 2018, up to the prevailing surgical claim limits. MediSave use can continue, up to prevailing limits.
10. MOH will continue to review MediShield Life regularly to ensure that it provides protection for Singaporeans against large hospitalisation bills and selected costly outpatient treatments, in keeping with developments in medical care. Any patient who cannot afford their bills after subsidies, MediShield Life and MediSave, can apply for MediFund. No Singaporean will be denied appropriate healthcare due to the inability to pay.