MediShield Life Singapore: Facts, How It Works & How To Claim
If you’re reading this, you are most likely a Singaporean who wants to know what MediShield Life is, how to use it, and what its limitations are.
To keep it simple, MediShield Life is a universal healthcare programme in Singapore administered by the Central Provident Fund. As long as you are a Singaporean Citizen or a permanent resident, you are covered under MediShield Life.
What is MediShield Life?
MediShield Life is a basic insurance plan that replaces the old MediShield programme and has been in effect since November 2015. It is a programme that aims to help Singaporeans with hospital bills, with a special focus on providing the lower and middle classes robust basic healthcare at affordable prices.
MediShield Life can help to pay for costlier healthcare treatments such as chemotherapy for cancer and dialysis, and is structured to reduce the cash burden if such treatments are needed. Do note, though, that there are strict limits on what MediShield Life can cover, which we will get to at a later section.
Nobody will lose MediShield Life coverage due to an inability to afford the premiums.
Who Is Eligible for MediShield Life?
Every Singaporean Citizen and Permanent Resident (PR) is automatically enrolled in MediShield Life by virtue of their citizenship status in Singapore. This means that you will not need to apply for it, and will be able to draw on MediShield Life benefits when necessary.
All pre-existing conditions are covered under MediShield Life, with Singaporeans covered from the moment of birth.
MediShield Life Is Compulsory for All Singaporeans
A common question regarding MediShield Life is whether we can opt out of it. Unfortunately, because MediShield Life is a universal programme designed to cover all Singapore residents, the only way to opt out of it is to renounce your citizenship.
This includes Singaporeans and PRs who are living overseas.
MediShield Life Benefits: What Does MediShield Life Cover?
So, on to the important details of MediShield Life, including what it covers and what it doesn’t.
The main goal of MediShield Life is to ensure that the health needs of lower and middle-class Singaporeans and PRs will be taken care of. This is why MediShield Life’s coverage is designed to cover treatment at public hospitals’ B2 and C wards, as well as subsidised outpatient or day surgery treatments in public hospitals.
MediShield Life also, however, covers patients who “upgrade” to Class A/B1/B2+ wards or seek treatment at private hospitals. However, MediShield Life will cover a smaller portion of such bills, and you will have to pay for the rest of the bill either through MediSave, cash, or your private insurance.
Note that there is a claim limit of $150,000 per year.
Here are the details of what MediShield Life covers, as retrieved from the Ministry of Health on 20 March 2021.
|MediShield Life Benefits|
|Inpatient/Day Surgery||Claim limits|
|Daily Ward and Treatment Charges¹|
|- Normal Ward||$800/day*|
|- Intensive Care Unit Ward||$2,200/day*|
|*An additional claim limit of $200/day applies for the first 2 inpatient days|
|- Psychiatric (Up to 60 days per policy year||$160/day|
|- Community Hospital (Rehabilitative)²||$430/day|
|- Community Hospital (Sub-acute)²||$250/day|
|- Inpatient Palliative Care Service (Specialised)||$350/day|
|- Table 1 A/B/C (less complex procedures)||$240||$340||$340|
|- Table 2 A/B/C||$580||$760||$760|
|- Table 3 A/B/C||$1,060||$1,160||$1,280|
|- Table 4 A/B/C||$1,540||$1,580||$1,640|
|- Table 5 A/B/C||$1,800||$2,180||$2,180|
|- Table 6 A/B/C||$2,360||$2,360||$2,360|
|- Table 7 A/B/C (more complex procedures)||$2,600||$2,600||$2,600|
|Continuation of Autologous Bone Marrow Transplant Treatment for Multiple Myeloma||$6,000/treatment|
|¹Includes meal charges, prescriptions, professional charges, investigations and other|
²Claimable only upon referral from a hospital after an inpatient admission or from a public
hospital’s emergency department for further medical treatment.
|Chemotherapy for Cancer||$3,000/month|
|Radiography for Cancer|
|- External (Except Hemi-Body)||$300/treatment|
|Immunosuppressants for Organ Transplant||$550/month|
|Erythropoietin for Chronic Kidney Failure||$200/month|
|Long-term Parenteral Nutrition||$1,700/month|
|Maximum Claim Limit|
|Per Policy Year||$150,000|
How Much of Your Medical Bill Is Covered under Medishield Life?
There are 4 parts to your medical bill:
- MediShield Life
- Bill above claim limit
Infographic from CPF Board.
Deductibles refer to a fixed amount you must pay out-of-pocket before MediShield Life kicks in. You will only have to pay the deductible once per calendar year, and it can be paid in cash or via your MediSave.
|Table I: Deductible|
(Based on age next birthday at the start of the policy year)
(Applicable for admissions or treatments received on or after 1 March 2021)
|Ward Class/Treatment||80 and Below||81 and Above|
|Class B2 and above1 (including stay in private hospitals)||$2,000||$3,000|
|Outpatient Treatments||Not Applicable|
|1 Subsidized patients will follow the deductible for Class C and non-subsidised patients will follow the deductible for Class B2 for Community Hospital, Inpatient Palliative Care Service, Short Stay Wards and Continuation of Autologous Bone Marrow Transplant for Multiple Myeloma|
2. MediShield Life
For this portion of the medical bill, you can refer to the table in the previous section titled MediShield Life Benefits: What Does MediShield Life Cover?. Do note that bills for Class A/B1/B2+ wards, private hospitals, and non-subsidised treatments, as well as for Permanent Residents will be prorated.
You will not have to pay out-of-pocket for this portion of the bill.
The co-insurance portion of the bill is a percentage that you will have to pay to supplement MediShield Life. The co-insurance for MediShield Life starts at 10%, and goes down as the bill increases. This helps to ensure that the more serious the condition, the less of a financial burden the medical bill will have on you.
|Claimable Amount for Inpatient and Day Surgery||Co-insurance|
(Percentage of Claimable Amount)
|$0 - $5,000||10%|
|$5,001 - $10,000||5%|
|Co-insurance for all Outpatient Treatments||10%|
Information from CPF Board, retrieved 20 March 2021.
4. Portion Above Claim Limit
If your medical bill exceeds the claim limits, you will need to pay the balance through cash or MediSave. There is a limit of $150,000 per policy year, with no lifetime limit.
MediShield Life Exclusions
There are, however, a list of medical expenses that you cannot claim from MediShield Life. This is the full list as retrieved on 20 March 2021*, and you can check the Ministry of Health for the most updated list of exclusions.
*As applicable for admissions or treatments received on or after 1 March 2021.
A general rule of thumb is that if the procedure is optional (such as cosmetic surgery), it is more likely to be excluded.
- Ambulance fees
- Cosmetic surgery
- Dental work (except due to accidental injuries)
- Infertility, subfertility, assisted conception or any contraceptive operation, including their related complications
- Sex change operations, including their related complications
- Maternity charges (including Caesarean operations) or abortions, including their related complications, except treatments for serious complications related to pregnancy and childbirth
- Treatment for injuries arising from the insured’s criminal act
- Treatment of injuries arising directly or indirectly from nuclear fallout, war and related risk
- Treatment of injuries arising from direct participation in civil commotion, riot or strike
- Expenses incurred after the 7th calendar day from being certified to be medically fit for discharge from inpatient treatment and assessed to have a feasible discharge option by a medical practitioner
- Surgical interventions, including related complications, for the following rare congenital conditions which are severe and fatal by nature: Trisomy 13, Bilateral Renal Agenesis, Bart’s Hydrops and Anecephaly
- Optional items which are outside the scope of treatment
- Overseas medical treatment
- Private nursing charges
- Purchase of kidney dialysis machines, iron-lung and other special appliances
- Treatment which has received reimbursement from Workmen’s Compensation and other forms of insurance coverage
How Do You Make a Medishield Life Claim?
If You Have An Integrated Shield Plan
You may reach out to your private insurer or insurance agent and they will make the payment on your behalf, including the MediShield Life portion of the bill. You may settle the remainder of the bill via MediSave or cash.
If You Have No Integrated Shield Plan
Inform the attending nurse that you would like to make a MediShield Life claim. The medical institution will submit the claim on your behalf, and you may settle the remaining amount via MediSave or cash.
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MediShield Life vs Integrated Shield Plans
Now, you may be wondering if MediShield Life is enough, or if you should “upgrade” your coverage to include an Integrated Shield Plan.
Integrated Shield Plans are offered by private insurance companies and are designed to complement MediShield Life. This means that if you do get an Integrated Shield Plan, you will not be charged twice for the same coverage.
The Ministry of Health has a summary of Integrated Shield Plans you can refer to.
The main benefits of Integrated Shield Plans is that they allow coverage for private hospitals or Class A/B2+ Wards in public hospitals. You will be able to pay for some Integrated Shield Plans with your Medisave, with the following limits:
- $300 per year for those at age 40 years and below on their next birthday
- $600 per year for those at age 41 to 70 years on their next birthday
- $900 per year for those at age 71 years and above on their next birthday
Any additional costs will have to be paid by cash.
How Much Are MediShield Life Premiums?
MediShield Life is administered by CPF and you will be paying for the premiums annually via your CPF Account, under the MediSave component.
The older we get, a larger percentage of our CPF contribution goes to Medisave. This is because the older we get, the higher the likelihood of us needing medical assistance. CPF’s policy ensures that each generation remains independent and supports itself.
|MediShield Life Premiums (before subsidies)|
|Age Next Birthday||Annual Premiums (Inclusive of 7% GST)||Age Next Birthday||Annual Premiums (Inclusive of 7% GST)|
|1 – 20||$145||74 – 75||$1,320|
|21 – 30||$250||76 – 78||$1,530|
|31 – 40||$390||79 – 80||$1,590|
|41 – 50||$525||81 – 83||$1,675|
|51 – 60||$800||84 – 85||$1,935|
|61 – 65||$1,020||86 – 88||$2,025|
|71 – 70||$1,100||89 – 90||$2,025|
|81 – 73||$1,195||>90||$2,055|
Information retrieved from CPF Board on 20 March 2021.
While MediShield Life covers all pre-existing conditions, those with serious pre-existing conditions like cancer, kidney failure, stroke, or heart diseases will have to pay an additional premium of 30% for 10 years due to higher health risks.
You can pay for your own as well as your family members’ MediShield Life premiums with your MediSave.
There are rebates and subsidies for MediShield Life to ensure the scheme remains affordable as we grow older.
The MediShield Life rebates structure ensures that members pay higher premiums before age 66, which reduces the premiums they pay after 66. You can find more information here.
The MediShield Life subsidies are slightly more complex, and are designed for lower to middle-income Singaporeans.
- Subsidies are available if you have
- An average monthly income per household of $2,800 or below and
- Are living in residences with an Annual Value of $21,000 or below
- Individuals who own multiple properties are not eligible for MediShield Life subsidies
- Permanent Residents will receive half the subsidy rates applicable to Singapore Citizens
Those who are older and have lower incomes will receive greater subsidies.
For a more specific check of how much you need to contribute, you can use the MediShield Life Premium Checker.
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