Medishield Life Healthcare Scheme

IMPORTANT NOTE – MediShield Life has replaced MediShield starting from November 1, 2015.

What is MediShield Life?

This is a basic health insurance scheme that provides coverage for hospital bills and certain outpatient treatments including chemotherapy for treating Cancer and Kidney Dialysis.

Using MediShield Life:

MediShield Life is ideal for treatment in public hospitals at subsidized costs. However, you will still be covered under this scheme even if you choose to stay in private hospitals at Class A or B1 wards but the payouts here will be lesser. This is because this is a basic health insurance scheme that is pegged against Class B2 and C wards. MediShield Life will pay a small portion of your hospital bill in a private hospital and the balance needs to be paid by you in cash or savings in your Medisave Account (MA).

Why choose MediShield Life

MediShield Life offers you several benefits such as:

  • Higher payouts and enhanced protection. This way you have to pay lesser cash or use your Medisave savings when paying for large hospital bills.
  • Provides protection to ALL Singapore Citizens and Singapore Permanent Residents, members with pre-existing conditions and even old members.
  • Provides lifelong protection.

Find below the claim limits and payouts offered under MediShield Life:

  • Inpatient and/or Day Surgeries
    • Treatment charges and daily ward charges that included charges for meals, investigations, professional and miscellaneous charges:
      • Normal ward – S$700 for each day.
      • ICU ward – S$1,200 for each day.
      • Community Hospital – S$350 for each day.
      • Psychiatric – S$100 for each day.
    • Surgical Procedures – S$200 and up to S$2,000
    • Implants – S$7,000 for each treatment.
    • Radiosurgery – S$4,800 for each procedure.
  • Outpatient Treatments:
    • Chemotherapy for treating Cancer – S$3,000 for each month.
    • Radiotherapy for treating Cancer:
      • Superficial/External – S$140 for each session.
      • Brachytherapy – S$500 for each session.
    • Kidney Dialysis – S$1,000 for each month.
    • Immunosuppressant in case of Organ Transplant – S$200 for each month.
    • Erythropoietin treatment for Chronic Kidney Failure – S$200 for each month.

Claim Limits under MediShield:

The maximum amount that you can claim under the MediShield Life scheme is as follows:

  • Each Policy Year – S$100,000.
  • For a Lifetime – No Limit
  • Maximum Age Cover – No max. age.

The following deductibles are payable by the insured:

  • 80 years and below:
    • Day Surgery or Class C ward – S$1,500.
    • Class B2 ward – S$2,000.
  • 81 years and above:
    • Day Surgery or Class B2 ward – S$3,000.
    • Class C ward – S$2,000.

The following are the Co-Insurance payable by the insured:

  • S$0 and up to S$3,000: 10%.
  • S$3,001 and up to S$5,000: 10%.
  • S$5,001 and up to S$10,000: 5%
  • Above S$10,000: 3%.
  • All outpatient treatments: 10%.

MediShield Life Premiums and Subsidies:

The government offers various subsidies as a way of keeping the premiums on MediShield Life affordable to every Singaporean on the island. Members who have pre-existing medical conditions that are of a serious nature may need to pay additional premiums for a period of 10 years. Subsidies are offered on these premium payments as well.

The following are the subsidies that the government offers members for the payment of MediShield Life premiums:

  • Premium Subsidies – these are meant for low and middle income members.
  • Pioneer Generation Subsidies – these are meant for Pioneers only.
  • Transitional Subsidies – these are meant for Singapore Citizens only to ease the shifting to MediShield Life.
  • Additional Premium Support – these are meant to offer support to those members who can’t afford to make premium payments despite the premium subsidies offered to them.

Note – If you want to get an estimate of how much premium you need to pay for your MediShield Life cover after subsidies, you can try the “MediShield Life Premium Calculator”.

Paying Additional Premium – Who is it meant for?

One of the striking benefits of MediShield Life is that it offers full coverage even for those members who have pre-existing medical conditions unlike most other insurance schemes offered by private insurers.

The government offers extensive support to members with pre-existing conditions to cover their MediShield Life premiums. If you have been assessed as having serious pre-existing medical conditions after joining this scheme, you need to pay only 30% as Additional Premiums for a period of 10 years. After this period elapses, you will start paying the standard premium like any other member enrolled into this scheme.

What constitutes a serious pre-existing condition is based on an elaborate review conducted by the MOH of Ministry of Health along with advice from clinicians. You can find the list of the conditions on the MOH website.

If you need to pay Additional Premiums, the CPF will send you a notification in writing when they notify you regarding your eligibility for the MediShield Life cover.

MediShield Life Cover for different wards in public and private hospitals

After MediShield Life replaced MediShield in November 2015, the cover under this insurance scheme has been extended to ALL wards. However, the benefits that you receive from this scheme will be based on the Class B2 and C ward costs in public hospitals.

Although you will get the same benefit levels no matter what ward and hospital you choose, the cost for all claims will be based on the costs of public hospital Class B2 and C wards.

Therefore, if you want additional or extensive cover to pay your large hospital bills in a private hospital, you can apply for IP or Integrated Shield Plan which will be managed by a private insurer. An IP consists of 2 components – MediShield Life and additional insurance cover offered by a private insurer that extends cover to Class A and B1 wards in both, public as well as private hospitals.

Claims under MediShield Life – How does it work?

When you want to claim your MediShield Life cover, you have to first inform your hospital staff regarding the same when you are admitted or during your outpatient treatment. After you authorize the medical intuition to process the claim, they will send the claim request to the CPF Board.

The CPF Board will make the payment on your behalf after taking into account the deductibles, co-insurance and the claim limits.

If you have an IP or Integrated Shield Plan (it comprises of 2 components – higher cover provided by a private insurer and MediShield cover), your private insurer will process the claim request on your behalf and make the payment which will include a part of your MediShield payout as well.

The balance of the bill will be payable by you by cash or savings in your Medisave Account.

MediShield Life Exclusions

The following were NOT covered under MediShield Scheme:

  • Any expenses you had incurred before your MediShield cover commenced.
  • Any expenses you had incurred during your entire hospital stay upon being admitted before your MediShield cover commenced.
  • Cosmetic surgery expenses.
  • Ambulance fees.
  • Charges for private nursing.
  • Maternity charges or abortions (this includes Caesarean operations).
  • Any dental work expenses with the exception of dental work requirements resulting out accidental injuries.
  • Charges for sex change operations.
  • Any medical treatment that occurred overseas.
  • Other items that do not fall within the purview of medical treatment.
  • Sub-fertility/infertility, any assisted conception/contraceptive operation.
  • Purchasing any machines for kidney dialysis.
  • Purchasing iron-lung or any other special appliances.
  • Any treatment for which you had already received full reimbursement any form of insurance cover or Workmen’s Compensation cover.
  • Surgical interventions in case of rare congenital conditions, either fatal or severe from the following:
    • Alobar Holoprosencephaly
    • Anecephaly
    • Bart's Hydrops
    • Bilateral Renal Agenesis
    • Trisomy 13
    • Trisomy 18
  • Treatment for alcoholism/drug addiction.
  • Treating injuries that had resulted from a nuclear fallout/war or any related risks.
  • Treating injuries that had occurred from your direct participation in riot/strike/civil commotion.
  • Treatment for self-inflicted injuries (including suicide attempts).
  • Vaccination.

Applying for MediShield Life

There is no need for you to apply for MediShield Life, if you are a Singaporean Citizen or Singapore Permanent Resident, you will be automatically enrolled under this basic insurance scheme.

If you are covered under MediShield Life, during your annual renewal you will receive a letter from CPF regarding your premiums under this scheme and any subsidies you may be eligible for.

If you are covered under an IP, during your annual renewal you will receive a letter from the private insurer regarding your premiums under this scheme and any subsidies you may be eligible for the MediShield portion of your IP.

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