Baffled by rule for medical expenses

12 Nov 2004, Streats

Question

Name of the Person: Mark Fong

Baffled by rule for medical expenses

I HAVE recently become aware how illogical some of the Medisave and Medishieldrules are.

Having gone for an operation at the Singapore General Hospital last month,my operation expenses were covered jointly by my company insurer, Medisave andMedishield.

Perfect, I thought, as I didn't have to pay out of pocket for the operationexpenses totalling over $5,000.

However, I was dumbfounded when I found out through the Ministry of Health(MOH) website, as well as a CPF customer service officer, that medical expenses(totalling more than $2,000) incurred before my operation could not be coveredby either Medisave or Medishield, even though these medical tests ultimatelydecided my need for an operation.

MOH confirmed that this was the case to ensure that there was sufficientmonies in Medisave to meet hospitalisation costs, especially when one is notworking in old age and where needs are the greatest.

I find this illogical since the only reason I had the operation was that theprior medical tests confirmed the need. So, if the operation can be covered byMedisave and Medishield, surely the directly related tests and scans can becovered, too?

It's time MOH reconsidered its policies to allow for Medisave and Medishieldto be used when there is a direct relation between the medical tests done toconfirm the need for an operation and the actual operation carried out, sincethese two events are not mutually exclusive.

Reply

Reply from MOH 

Why Medisave and Medishield should not be used for pre-op charges

Mr Mark Fong's letter "Baffled by rule for medical expenses" (Today, Nov 12) suggested the use of Medisave and Medishield to pay for the charges incurred for pre-operation medical tests.

Medisave was designed primarily to help individuals meet their personal or immediate familyyyys inpatient, i.e. hospitalization expenses. We therefore have to be prudent in extending the use of Medisave to other non-inpatient purposes. Such extension will deplete Medisave prematurely, creating future problems for patients and their families.

MediShield is a basic catastrophic medical health insurance scheme to help Singaporeans cope with large but uncommon hospitals bills. In other words, MediShield only kicks in for large bills. Extending MediShieldyyys coverage to include all pre-operation medical investigations and tests will increase its premiums and go against its original purpose of covering the large bills.

Based on these considerations, Medisave and Medishield do not cover medical investigations and other outpatient medical expenses incurred prior to an operation. However, inpatient charges for medical treatments, investigations, medicines, rehabilitative services, medical supplies and other surgery-related items are eligible for Medisave and MediShield coverage.

We thank Mr Fong for his feedback.