Singapore’s Integrated Shield Plans to Stop Paying for Entire Hospital Bills

Updated 25 March 2021

You might have heard from your insurer or read on the grapevine that insurers are going to require people on the Integrated Shield Plan to pay for part of their hospital bills soon. That is to say, they’ll stop footing the entire bill in future.

The Integrated Shield Plan is a supplement to the government’s MediShield Life scheme, and seven providers in Singapore offer it.

Some insurers like NTUC Income, AXA and Prudential have announced that there will now be a co-pay component of at least 5 percent of their hospital bills.

The good news is, premiums will be reduced by up to 50 percent, depending on age of the policyholder and terms of the policy.

This move was prompted by a directive from the Ministry of Health (MOH) three years ago in 2018. The idea is for people to be encouraged to be prudent with their healthcare costs, and to keep health insurance sustainable for everyone.

NTUC Income had told the Straits Times that the over-consumption and over-charging of healthcare services had pushed up the cost of health insurance premiums. The government had noted back in 2018 that there was a “buffet syndrome” amongst policyholders, when hospital bills were covered in full.

We’ve been receiving lots of questions from users on what all this means for them, so here’s an FAQ. Feel free to contact us if you have questions too!

Frequently Asked Questions:

Does this mean I always have to pay (part of the bill) from now on?

Yes you will have to. This move aims to reduce over consumption of healthcare services so as to keep healthcare costs affordable in the long run.

Will the amount I pay be capped at 5 percent?

It’s currently 5 percent, but there’s no clear indication that it will stay that way perpetually.

For some insurers, the co-payment will be capped at $3,000 per year you’ve had the policy, if the treatment is done by a doctor under their panel, with pre-authorisation done.

Will this move lower premiums that I have to pay?

Yes, the new premiums for these riders with co-payment will be lower than the current riders without co-payment.

What about people with critical illnesses for the rest of their lives? How will this impact them 

The same will apply. To manage costs,we recommend that these people visit panel doctors with pre-authorisation from their insurer. This will activate the cap (usually $3000/policy year) on the co-payment.

What is the difference between Deductible, Co-insurance and Co-payment?

Deductible refers to the first cut of the bill, it ranges from $500-$3,500 per policy year. Co-insurance refers to a fixed percentage (usually 10%) of the remaining bill after considering the deductible. Co-payment has been defined in two ways amongst the insurers. Please refer to the images for illustrations.

Here are the changes from each insurer:

 

AIA Healthshield riders

Type 2 co-payment

From 1 April 2021, all existing policyholders of AIA Max Essential rider will automatically be converted to the following plans, effective from their policy renewal on / after 1 April 2021*. All AIA IP riders will include the 5% co-payment  features moving forward.

Current nameNew name from 1 April 2021
AIA Max Essential AAIA Max VitalCare
AIA Max Essential A SaverAIA Max VitalHealth A
(with Emergency and Outpatient Care Booster)
AIA Max Essential B / B LiteAIA Max VitalHealth B / B Lite
AIA Max Essential CWill continue to be referred to as AIA Max Essential C

 

ComponentCurrent AIA Max Essential riderAfter 1st April 2021 – AIA Max Vitalhealth rider
Co-paymentInformation not available(a) Treatment provided by panel doctor: Co-payment of 5% of the claimable amount applies, capped at S$3,000 per policy year

(b) Treatment provided by non-panel doctor: Co-payment of 5% of the claimable amount applies.

Note that for AIA Max VitalHealth A, reimbursement of Co-insurance incurred under AIA HealthShield Gold Max is only up to S$5,000 per policy year.

DeductibleInformation not available

(a) Treatment provided by panel doctor: You will have no deductible on your first AIA Max VitalHealth A claim, whether it is for treatment at a private or public hospital. The deductible waiver will reset if there are no private hospital claims over 3 consecutive policy years. You may refer to My AIA SG to find out the Deductible Waiver Pass status at any time.

(b) Treatment provided by non-panel doctor: Deductible up to S$3,500 applies.

You may request to switch to other riders by making a request for change. Please note that your request may be subject to underwriting.

AIA Max VitalCare policyholders may switch to:

  • AIA Max VitalHealth A – No underwriting is required if the request was submitted between 01 April 2021 to 30 September 2022. Thereafter, the request will be subject to underwriting.
  • AIA Max VitalHealth B or AIA Max VitalHealth B Lite – No underwriting is required.

AIA Max VitalHealth A policyholders may switch to:

  • AIA Max VitalCare – No underwriting is required if the request was submitted between 01 April 2021 to 30 September 2022. Thereafter, the request will be subject to underwriting.
  • AIA Max VitalHealth B or AIA Max VitalHealth B Lite – No underwriting is required.

AIA Max VitalHealth B policyholders may switch to:

  • AIA Max VitalCare or AIA Max VitalHealth A – Underwriting is required.
  • AIA Max VitalHealth B Lite – No underwriting is required.

AIA Max VitalHealth B Lite policyholders may switch to:

  • AIA Max VitalCare, AIA Max VitalHealth A or AIA Max VitalHealth B – Underwriting is required.

AIA Max Essential C policyholders may switch to:

  • AIA Max VitalCare, AIA Max VitalHealth A, AIA Max VitalHealth B or AIA Max VitalHealth B Lite – Underwriting is required.

When contemplating switching, please do consider factors like age, pre-existing conditions, appropriate healthcare for your needs and affordability of future premiums. It is important to understand the risk of switching plans, as this could lead to an exclusion of pre-existing conditions or an increase in premiums (loading). Speak with your financial advisor before you decide on any switches. For more information, refer to this announcement.

 

Aviva Myhealth riders

Type 1 co-payment

All existing policyholders of Aviva Myhealth riders will will include the 5% co-payment  features moving forward, effective from their policy renewal on / after 1 April 2021.

Please note that the deductible mentioned here is on top of the deductible incurred under Myshield main plan.

MyHealthPlus Riders A, B, and C

ComponentCurrentAfter 1st April 2021
Co-paymentNo co-payment(a) Treatment provided by panel:

Co-payment 50% of MyShield co-insurance applies, capped at S$3,000(Panel specialist in a private hospital with certificate of pre-authorisation, restructured hospital, community hospital,subsidised centre for kidney dialysis, panel private dialysis centres or panel overseas hospital)

(b) Treatment provided by non-panel:

Co-payment 50% of MyShield co-insurance applies

MyHealth Plus Deductible (not applicable to Rider A)Inpatient claims:

  • Class A-C wards in public hospitals, short stay ward: S$0
  • Non-panel specialist in private hospital: S$1,000
  • Panel specialist in private hospital:
    • S$0 (with pre-authorisation)
    • S$1,000  (without pre-authorisation)

Day surgery

  • Public/Community hospitals: S$0
  • Hospitals outside singapore: $500
  • Non-panel specialist in private hospitals: $500
  • Panel specialist in private hospital:
    • S$0 (with pre-authorisation)
    • S$500  (without pre-authorisation)
Inpatient claims:

  • Class A wards in public hospitals: S$300
  • Class B1 wards in public hospitals: S$200
  • Class B2/B2+ wards in public hospitals: S$150
  • Class C wards in public hospitals: S$120
  • Short stay ward: S$300
  • Non-panel specialist in private hospital: S$500
  • Panel specialist in private hospital:
    • S$300 (with pre-authorisation)
    • S$500  (without pre-authorisation)

Day surgery

  • Public/Community hospitals: S$250
  • Hospitals outside singapore: S$500
  • Non-panel specialist in private hospitals: S$500
  • Panel specialist in private hospital:
    • S$250 (with pre-authorisation)
    • S$500 (without pre-authorisation)

MyHealthPlus Riders A-II, B-II, and C-II

ComponentCurrentAfter 1st April 2021
Co-payment(a) Treatment provided by panel:

Co-payment 50% of MyShield co-insurance applies, capped at $3,000

(Panel specialist in a private hospital with certificate of pre-authorisation, restructured hospital, community hospital,subsidised centre for kidney dialysis, panel private dialysis centres or panel overseas hospital)

(b) Treatment provided by non-panel:

Co-payment 50% of MyShield co-insurance applies

No change
MyHealth Plus Deductible (not applicable to Rider A-II)Inpatient claims:

  • Non-panel specialist in private hospital or outside Singapore: S$2,000
  • Panel specialist in private hospital:
    • S$1,000 (with pre-authorisation)
    • S$2,000  (without pre-authorisation)

Day surgery

  • Non-panel specialist in private hospital or outside Singapore: S$500
  • Panel specialist in private hospital:
    • S$500 (with pre-authorisation)
    • S$1,000 (without pre-authorisation)
Inpatient claims:

  • Non-panel specialist in private hospital or outside Singapore: S$1,000 for Plan 1, S$500 for Plan 2 and 3
  • Panel specialist in private hospital:
    • S$500 for Plan 1 (with pre-
    • S$300 for Plan 2 and Plan 3 (with pre-authorisation)
    • S$1,000 for Plan 1 (without pre-authorisation)
    • S$500 for Plan 2 and Plan 3 (without pre-authorisation)

Day surgery

  • Non-panel specialist in private hospital or outside Singapore: S$500
  • Panel specialist in private hospital:
    • S$250 (with pre-authorisation)
    • S$500 (without pre-authorisation)

Premium changes

Myshield Plans premiums – Unchanged

MyhealthPlus Riders A, B, C – Reduced

MyhealthPlus Riders A-II, B-II, and C-II – No change

 

AXA Shield riders

Type 1 co-payment

AXA will switch all existing AXA Basic Care, General Care and Home Care riders to AXA Enhanced Care rider.

Basic care rider

ComponentCurrent Basic care riderAfter 1st April 2021 – Enhanced Care Rider
Co-paymentNo co-payment(a) Treatment provided by panel doctor: Co-payment of 50% of co-insurance incurred under AXA shield applies, capped at S$3,000 per policy year

(b) Treatment provided by non-panel doctor: Co-payment 50% of co-insurance insured under AXA applies.

DeductibleFull reimbursement for the deductible amounts payable by you under AXA Shield Policy.(a) Full reimbursement under panel doctor

(b) S$1,500 deductible applies per year under non-panel doctor

Premium changes

AXA Shield Plans premiums – Premiums increased only for Plan A

Enhanced care rider – Premiums increased only for Enhanced care A

AXA Basic Care, General Care and Home Care riders – These riders will be converted to Enhanced care rider where premiums are lower

NTUC IncomeShield

Type 2 co-payment

No changes to current Deluxe and Classic Care rider as they already include co-payments. Please refer to the table below for the changes in Assist and Plus riders which will be transited to Deluxe Care and Classi Care Rider upon polocy renewal from 1st April 2021 onwards.

Assist rider

ComponentCurrent Assist riderAfter 1st April 2021 – Classic care rider
Co-paymentCo-payment of 10% of claimable amounts, with limits for each plan:

  • Enhanced Preferred: S$3,000
  • Enhanced Advantage: S$2,500
  • Enhanced basic: S$2000
  • Enhanced C: S$1,500
(a) Treatment provided by panel doctor: Co-payment of 10% of claimable amount applies, capped at S$3,000 per policy year

(b) Treatment provided by non-panel doctor: Co-payment of 10% of claimable amount applies, capped at S$5,000 per policy year

DeductibleDoes not applyNo Change

Plus rider

ComponentCurrent Plus riderAfter 1st April 2021 – Deluxe care rider
Co-paymentNo co-payment(a) Treatment provided by panel doctor: Co-payment of 5% of claimable amount applies capped at S$3,000 per policy year

(b) Treatment provided by non-panel doctor: Co-payment of 5% of claimable amount applies

DeductibleDoes not applyNo Change

Premium changes

Incomeshield Plans premiums – Premiums reduction

Riders – Premiums aligned to new benefits. No additional information

(More information on changes here.)

Prudential PRUShield

Type 1 co-payment

Customers who have the PRUExtra Premier Saver rider will transition to the PRUExtra Premier Lite rider which requires customers to make a co-payment for private and public hospital claims.

ComponentCurrent PRUExtra Premier SaverAfter 1st April 2021 – PRUExtra Premier Lite rider
Co-paymentMaximum S$5,000 co-payment per year for ages 85 and below, and S$7,500 for those 85 and above(a) Treatment provided by panel doctor: Co-payment of 5% of the claimable amount applies, capped at S$3,000 per policy year

(b) Treatment provided by non-panel doctor: Co-payment of 5% of the claimable amount applies. 

DeductibleS$1,000 per year for ages 85 and below, and S$1,500 for those 85 and above50% of deductible incurred under PRUShield, up to a cap of S$1,750

Premium changes

PRUShield plans premiums – No information

Riders – Premiums reduction

(More information on changes here.)

 

Raffles Shield

Type 2 co-payment

Raffles Health Insurance is a new player in the integrated shield plan space, and started offering plans only after august 2018. All of their plans have already included a co-payment feature.

 

Great Eastern Totalcare riders

Type 2 co-payment

ComponentCurrent riderAfter 1st April 2021 –
Co-paymentInformation not available(a) Treatment provided by panel doctor: Co-payment of 5% of total bill applies, capped at S$3,000 per policy year

(b) Treatment provided by non-panel doctor: Co-payment of 5% of total bill applies.

DeductibleFull reimbursement for the deductible amounts.No Change

Leave a Reply

Your email address will not be published. Required fields are marked *