Medishield for special needs children

12 Nov 2007

Question No:  439  

Question

Name of the Person: Ms Denise Phua Lay Peng

To ask the Minister for Health (a) whether MediShield is self-funded by the Central Provident Fund; and (b) how much will it cost to enable families to cover special needs children (i) born with congenital or pre-existing illnesses and (ii) attending special schools, to allow them to enjoy the same health insurance coverage as normal children.

Reply

Reply From MOH

Basic MediShield and the enhanced plans offered by private insurers are all self-funded.  In other words, the premiums collected from policyholders must more than cover the anticipated payouts claimed by patients.  For the plans to be sustainable, premiums are determined on an actuarially-sound basis. 

Persons with congenital illnesses can join MediShield to obtain coverage for medical treatment that is not related to their congenital condition.  However, it will be unusual for insurers to cover pre-existing illnesses or to cover treatment related to congenital conditions.  To do so will be to load the burden on the rest of the policyholders who may not support a manifold increase in premiums to take on this additional liability.  More importantly, if MediShield were to cover pre-existing illnesses, it will encourage potential policyholders to delay subscription until they are sick.  This will defeat the principle of insurance based on the sharing of burden among policyholders with similar risk profile.   

Nevertheless, some private insurers do offer cash benefit products which pay lump sum amounts if a baby is diagnosed with specific congenital anomalies.  They include the Prudential PruSmart Lady's Maternity Rider, HSBC Lady FirstCare, and NTUC i-Maternity.  Subscription to these products must of course be made prior to the discovery of any known congenital anomaly.

As for children attending special schools or with special needs, the basis of coverage is the same as the basis for other children, that is, they should be healthy at the point of entry and have no pre-existing illnesses.  We therefore encourage all parents, including those who have children with special needs, to cover them under MediShield as soon as possible, before they develop any other illnesses that could disqualify them in future.