MediShield Life payout computed separately from pensioner coverage

MOH's Reply

Straits Times Online, 31 Dec 2015

Mr Tan Kwong Moh hoped that the Ministry of Health can consider lowering the MediShield Life deductible amount for pensioners (“Lower MediShield Life deductible for pensioners”; Dec 23).

MediShield Life is a basic hospitalisation insurance plan that is designed to pay for large hospital bills and selected costly outpatient treatments, such as dialysis and chemotherapy for cancer. It is sized for subsidised treatment in public hospitals.

MediShield Life has co-payment features, such as the deductible and co-insurance, to help keep premiums affordable. The deductible is a fixed amount to be paid by the insured before MediShield Life pays out on claims. It is cumulative, and payable only once every policy year. This allows MediShield Life to pay for larger bills, while Medisave savings can be used to pay for smaller, more affordable amounts.  

We would like to clarify that MediShield Life payout is computed separately from the pensioner’s medical benefit scheme. In other words, for the example that Mr Tan cited, the MediShield Life payout will be calculated based on the total subsidised bill of $13,000, and not based on the smaller, remaining amount of $1,950 after pensioner coverage.  The pensioner can claim from his medical benefits first and any remainder could be claimed from MediShield Life if this amount does not exceed the claim allowable based on the MediShield Life computation. So in this instance, the pensioner can claim $11,050 from his medical benefits and the remainder $1,950 can be covered by MediShield Life if it falls within the computed MediShield Life claim amount, which it likely would be.  

A combination of the pensioner’s Civil Service benefits and MediShield Life payout will result in at least the same, if not a larger proportion of the pensioner’s hospital bill being covered compared to if he had only Civil Service benefits.  Pensioners thus benefit from MediShield Life coverage.  

We thank Mr Tan for his feedback.

Ms Lim Bee Khim 
Director, Corporate Communications
Ministry of Health 

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Straits Times Online, 23 Dec 2015

Lower MediShield Life deductible for pensioners 

All pensioners with Comprehensive Co-payment Scheme (CCS) medical benefits pay only 15 per cent of their total hospital bills.

But, if they want to make any claim from MediShield Life, they must pay the pre-claim amount of $2,000 first in cash or have it deducted from their Medisave account.

With the new healthcare scheme ("MediShield Life coverage to kick in at midnight"; Oct 31), pensioners with CCS medical benefits may feel this new scheme is unfair and not suitable for them.

For instance, if their hospital bill is $13,000, they will still be unable to make any claim from MediShield Life as the payable amount is only $1,950.

On behalf of pensioners who currently enjoy CCS medical benefits, I sincerely hope the Ministry of Health will consider lowering the pre-claim amount to $1,000, to help low-income pensioners cope with expensive medical bills and to also give them a chance to make claims on smaller bills.

Tan Kwong Moh