1. From 1 October 2024, the Ministry of Health (MOH) will make the following changes to improve patient affordability and facilitate right-siting of care:
a. Revising the monthly Per Capita Household Income (PCHI) thresholds;
b. Enhancing the Palliative Care subsidy framework; and
c. Enhancing the Community Hospital subsidy framework.
(A) REVISED MONTHLY PCHI THRESHOLDS
2. MOH provides means-tested subsidies and grants to support Singapore Residents with the costs of healthcare, with higher subsidies targeted at lower-income groups. As announced at Budget 2024, MOH will be revising the income criteria for healthcare schemes and grants that are means-tested using the monthly PCHI1 criteria, to reflect changes in household incomes and cost of healthcare. The revisions will take effect from 1 October 2024. Up to 1.1 million Singapore Residents are expected to benefit from higher subsidies.
3. The schemes and grants with revised income criteria are:
a. MediShield Life and CareShield Life Premium Subsidies
b. Community Health Assist Scheme (CHAS)
c. Subsidies at publicly-funded hospitals2
d. Subsidies for Palliative Care services3
e. Subsidies for residential and non-residential Long-Term Care services4
f. Subsidies for community haemodialysis and peritoneal dialysis
g. Subsidies for Standard Drug List and Medication Assistance Fund drugs
h. Seniors’ Mobility and Enabling Fund
i. Home Caregiving Grant
j. Interim Disability Assistance Scheme Programme for the Elderly
k. ElderFund
4. The monthly PCHI threshold for each subsidy tier will be raised, with increases ranging from $100 to $800. Table 1 below illustrates the changes in the PCHI thresholds to qualify for maximum subsidies or grants for a few key schemes. Detailed changes to all schemes and grants are at Annex A.
Table 1. Illustration of revised monthly PCHI thresholds to qualify for
maximum subsidies for key schemes
5. No action is required for existing or new patients and beneficiaries when they use the services and apply for subsidies or grants. The respective service providers and scheme administrators will automatically extend the corresponding subsidies and grants to those who are eligible. Existing CHAS cardholders who are eligible for a CHAS card with higher subsidies after the revision of income criteria will be automatically issued with new cards after 1 October 2024.
(B) ENHANCED PALLIATIVE CARE SUBSIDY FRAMEWORK
6. To enable more Singaporeans to fulfil their aspirations of leaving with dignity and comfort according to their preferences, MOH will enhance subsidies for Palliative Care services from 1 October 2024, in tandem with the revised monthly PCHI thresholds. These include inpatient hospice palliative care service, home palliative care, and day hospice.
7. Under the enhanced palliative care subsidy framework announced in the 2023 National Strategy for Palliative Care, all Singapore Citizens will receive subsidies of at least 50%, regardless of their monthly PCHI. This means that almost all patients will benefit from higher subsidies. This will complement recent adjustments to MediShield Life claim limits and MediSave withdrawal limits5 to improve affordability and access to palliative care.
8. The increased financing support will improve affordability for patients, and at the same time, enable palliative care providers to expand their capacity to support more patients in meeting their preference to pass away at home.
(C) COMMUNITY HOSPITAL SUBSIDY ENHANCEMENTS
9. Community hospitals play a pivotal role in providing continued post-acute care. As announced at MOH’s Committee of Supply 2024, MOH will implement two revisions to community hospital subsidies.
10. First, MOH will align the percentage of community hospital inpatient subsidies with that of acute hospitals from 1 October 2024, in tandem with the revised monthly PCHI thresholds. Under the enhanced Community Hospital subsidy framework, Singapore Citizens will minimally receive subsidies of at least 50%, up from 30% under the current framework.
11. Second, MOH will progressively expand the list of subsidised diagnostic services at community hospitals, with a view towards eventually aligning this with the list of subsidised diagnostic services at acute hospitals. This will be rolled out progressively across community hospitals, starting from 1 December 2024.
12. These enhancements will improve affordability for community hospital patients, while ensuring greater continuity of care and improved care integration across acute and community care settings.
13. No one will be denied appropriate healthcare because they are unable to afford it. Those who still face financial challenges after subsidies may approach their respective service providers for further financial assistance.
1 Monthly PCHI is computed as the total gross household monthly income divided by the total number of family members living together in the household. Gross monthly household income includes basic employment income, trade/self-employed income, overtime pay, allowances, cash awards, commissions, and bonuses.
2 These are Acute Hospital, Day Surgery, Extended Diagnosis Treatment Unit, Community Hospital, and Specialist Outpatient Clinic settings/services.
3 These include Inpatient Hospice Palliative Care Service (IHPCS), Home Palliative Care, and Day Hospice.
4 Residential Long-Term Care services include Nursing Home, Chronic Sick (High/Low), Psychiatric Rehabilitation Home, and Psychiatric Sheltered Home. Non-Residential Long-Term Care services include home-based services (e.g. Home Medical services, Home Nursing services, Home Help services, Home Personal Care) and centre-based services (e.g. Community Rehabilitation, Maintenance Day Care, Dementia Day Care, Psychiatric Day Rehabilitation).
5Since February 2024, MOH has increased the daily MediShield Life claim limits for inpatient hospice palliative care service from $250 to $460 for general inpatient palliative care and from $350 to $500 for specialised inpatient palliative care and removed the MediSave $2,500 lifetime withdrawal limit for all home palliative care and day hospice patients who use their own MediSave.
MINISTRY OF HEALTH
30 SEPTEMBER 2024
ANNEX A
REVISED PCHI THRESHOLDS FOR MOH SUBSIDY SCHEMES AND GRANTS
Table A-1: Revised Monthly PCHI Thresholds and Corresponding Subsidy Rates
for MediShield Life Premium Subsidies
Table A-2: Revised Monthly PCHI Thresholds and Corresponding Subsidy Rates
for CareShield Life Premium Subsidies
Table A-3: Revised Monthly PCHI Thresholds and Corresponding CHAS Cards
Table A-4: Revised Monthly PCHI Thresholds and Corresponding Subsidy Rates for
Acute Hospital (Class C and B2) and Day Surgery
Table A-5: Revised Monthly PCHI Thresholds and Corresponding Subsidy Rates
for Acute Hospital (Class B2+)
Table A-6: Revised Monthly PCHI Thresholds and Corresponding Subsidy Rates
for Specialist Outpatient Clinic
Table A-7: Revised Monthly PCHI Thresholds and Corresponding Subsidy Rates
for Community Hospital Sub-Acute and Rehabilitative Care
Table A-8: Revised Monthly PCHI Thresholds and Corresponding Subsidy Rates
for Inpatient Hospice Palliative Care Service
Table A-9: Revised Monthly PCHI Thresholds and Corresponding Subsidy Rates
for Home Palliative Care and Day Hospice services
Table A-10: Revised Monthly PCHI Thresholds and Corresponding Subsidy Rates
for Residential Long-Term Care Services
Table A-11: Revised Monthly PCHI Thresholds and Corresponding Subsidy Rates
for Non-Residential Long-Term Care Services
Table A-12: Revised Monthly PCHI Thresholds and Corresponding Monthly Subsidies
for Community Haemodialysis
Table A-13: Revised Monthly PCHI Thresholds and Corresponding Monthly Subsidies
for Community Haemodialysis with Tier 1 Transport
Table A-14: Revised Monthly PCHI Thresholds and Corresponding Monthly Subsidies
for Community Haemodialysis with Tier 2 Transport
Table A-15: Revised Monthly PCHI Thresholds and Corresponding Monthly Subsidies
for Peritoneal Dialysis
Table A-16: Revised Monthly PCHI Thresholds and Corresponding Monthly Subsidies
for High-Dependency Haemodialysis
Table A-17: Revised Monthly PCHI Thresholds and Corresponding Monthly Subsidies
for High-Dependency Haemodialysis with Tier 1 Transport
Table A-18: Revised Monthly PCHI Thresholds and Corresponding Monthly Subsidies
for High-Dependency Haemodialysis with Tier 2 Transport
Table A-19: Revised Monthly PCHI Thresholds and Corresponding Subsidy Rates
for Standard Drug List Drugs
Table A-20: Revised Monthly PCHI Thresholds and Corresponding Subsidy Rates
for Medication Assistance Fund Drugs
Table A-21: Revised Monthly PCHI Thresholds and Corresponding Subsidy Rates
for Seniors’ Mobility and Enabling Fund Consumables
Table A-22: Revised Monthly PCHI Thresholds and Corresponding Subsidy Rates
for Seniors’ Mobility and Enabling Fund Devices
Table A-23: Revised Monthly PCHI Thresholds and Corresponding Monthly Payout Amount
for Home Caregiving Grant
Table A-24: Revised Monthly PCHI Thresholds and Corresponding Monthly Payout Amount
for Interim Disability Assistance Programme for the Elderly
Table A-25: Revised Monthly PCHI Thresholds and Corresponding Monthly Payout Amount
for ElderFund
