Individual Health Insurance vs Family Health Insurance

The health insurance market in Singapore has witnessed significant growth over the last decade. Technological advancements in diagnostic procedures and treatment methods have resulted in healthcare becoming more expensive, and sometimes difficult for the average Singaporean to afford. It is for this reason that the Singaporean government has itself taken the effort to roll-out a comprehensive health insurance scheme for Singapore citizens and Permanent Residents. The two most commonly available types of insurance are the individual health insurance and family health insurance. Let’s look at what you can expect, as an individual, from each of these types of health insurance plans. Note that several other types of insurance plans like the critical illness cover and disability insurance are covered under one or both of the insurance policies.

Difference between Individual Health Insurance and Family Health Insurance Plans

The fundamental difference between both these types of plans is that an individual health insurance plan, as the term suggests, is an insurance plan purchased by the individual, and the cover is only applicable to the individual. A family plan on the other hand covers the individual as well as his family members.

Features of an Individual Health Insurance Plan

Individual health Insurance under MediShield Life

  • Under MediShield Life, Singapore’s government-sponsored health insurance scheme, Singapore citizens and Permanent Residents are provided with health insurance cover.
  • In addition to being covered by MediShield Life, an individual can opt for a private insurance provider to enhance the extent of his/her cover.
  • MediShield Life pays for hospital bills and certain expensive out-patient treatments at public health hospitals. Doctor’s fee, consultation charges and other hospital expenses are not covered by MediShield Life.
  • The premiums for MediShield Life have to be paid through the individual’s Medisave account. The whole idea of MediShield Life is that Singapore citizens and Permanent Residents can get subsidised treatment at public health hospitals.
  • Subsidies in premiums are available to low-income and middle-income people. Individuals of the pioneer generation will also receive premium subsidies.
  • MediShield Life covers individuals of all ages – it, however, covers Singapore citizens and Permanent residents only. Foreigners aren’t covered under this insurance scheme.
  • The premiums for MediShield Life are determined by your monthly income, age, and the value of the residence (annual) mentioned in your NRIC.
  • As a citizen or a Permanent Resident, MediShield Life covers you for pre-existing medical conditions as well. The premiums will be higher and whether or not the cover for a pre-existing condition is available or not will depend on the condition itself.
  • MediShield Life can also be used at private hospitals. However, the extent of the insurance cover will be reduced to a good extent.

Individual Health Insurance by private insurers

  • Individuals can choose to purchase an individual health insurance plan from a private insurance provider as well.
  • The premiums in the case of health insurance plans provided by private insurers are more than the premiums for MediShield Life.
  • The extent of cover is also more – MediShield Life is mostly good if you are undergoing treatment in a public hospital.
  • The advantage of choosing a private insurance provider is that you can customise your plan based on your requirements.
  • As an individual, you can choose from different health insurance policies that are available, and also add riders to your policy. For instance, if you want to be covered for a critical illness, you can opt for a critical illness cover. If you want to add an accident rider along with your main plan, you can do so at an extra premium cost, of course.
  • Private insurance providers also allow cases with pre-existing medical conditions. It depends on the choice of plan and the terms of the plan.
  • Health Insurance provided by private players have additional benefits including several in-patient treatments, out-patient treatments, coverage for diagnostic tests and surgical procedures, and complex medical conditions.
  • Private providers also have good customer service centers to help you initiate a claim 24-hours a day.
  • An individual can also be provided with an insurance cover by his/her employer. Any additional cover that isn’t provided by the employer can be purchased with a private insurer.

Features of a Family Health Insurance Policy

Family Health Insurance under MediShield Life:

  • Under MediShield Life, every Singapore citizen and Permanent Resident is covered.
  • The premiums are to be paid from an individual’s Medisave account, which is linked to his/her CPF account. Every working Singaporean will have a CPF account.
  • Under MediShield Life, an individual can pay for his/her spouse as well. The individual’s children are the sole responsibility of the individual until his/her ward attains the age of 18.
  • The premiums, as in the earlier case, are calculated based on the individual’s income, age and annual value of the property mentioned in the NRIC.
  • An individual can pay for anyone he/she likes – the way to do this is to top-up their Medisave account.

Family Health Insurance under private insurance providers:

  • Family insurance plans offered by private insurers are more comprehensive in nature.
  • Under a family health insurance policy, the entire family will be covered and premiums will depend on the number of family members, and on the extent of insurance cover.
  • Common family plans that are offered in the insurance landscape are mother-and-child plans, plans for an individual and his/her spouse, and coverage for the individual’s children.
  • Mother and child plans cover treatments and conditions pre and post hospitalisation. Plans also cover treatment costs towards complications that may arise during pregnancy.

An Example of What Private Insurance Provide

Let’s take the example of one of Singapore’s top health insurance providers and see what the insurer offers under individual and family health insurance plans:

AXA Individual Health Insurance

AXA offers a bunch of health insurance plans to suit different medicare needs of individuals. It provides health insurance solutions as well as surgical and hospital care insurance solutions. Let’s take a brief look at what these plans are and what they have to offer.

  • AXA offers a total of 8 health insurance plans. These plans are:
    • AXA Shield
    • AXA Family Advantage
    • Mum’s Advantage
    • GlobalCare Health Plan
    • Smartcare Executive
    • IntenrationalExclusive
    • SmartCare Optimum Enhanced, and
    • The Health Cash Plan
  • Each of these plans cover a mix of preventative and wellness coverage, in-patient and out-patient coverage, coverage for pre-hospitalisation and post-hospitalisation expenses, emergency medical assistance overseas, coverage for complex conditions and costly out-patient treatments like dialysis and chemotherapy, chronic medical conditions and even pre-existing conditions on a case-by-case basis.
  • Along with the main insurance plan, an individual can also opt to choose riders. Accidental death rider, dental rider in case of a dental emergency sustained due to an accident, or a travel inconvenience rider.
  • The Mum’s Advantage plan covers the mother and her child. Any medical complications resulting from pregnancy will also be covered.
  • The policy can be used across several private hospitals in Singapore.

AXA Family Health Insurance

  • The AXA Family Health Insurance product, known as Family Advantage, covers both the individual and his/her spouse.
  • The plan provides a comprehensive cover for an expectant mother and her child. As already mentioned earlier, conditions requiring pre and post hospitalisation will also be covered.
  • There are separate health insurance plans offered for the newborn baby. These plans are:
    • INSPIRE Flexi Protector
    • INSPIRE Flexi Saver and
    • AXA Life MultiProtect
  • For the pregnancy plan (Mom’s Advantage), the entry age of the mother has to be between 18 and 45 years.
  • The child under the AXA Family Advantage Plan can be covered for three years or six years.

FAQs on Individual Health Insurance and Family Health Insurance

Q. Under MediShield Life, if I’m a working individual and wish to pay for my mother’s insurance premiums, will that be possible?

A. Yes, of course that is possible. You can transfer funds to your mother’s Medisave account and she can make her premium payment.

Q. Will the amount be deducted directly from my Medisave account towards the premiums for my MediShield cover?

A. Yes, the money will automatically be deducted from your Medisave account. Before the money is deducted from your account, you will be notified about it. You can even prevent money from being deducted by cancelling the agreement.

Q. What if a family member has paid the premiums for several years, but expires unfortunately?

A. If a case like that happens, the amount will be directed to the common pool and used for people making claims. The amount paid as premiums will not be given to the immediate family members.

Q. How can I apply for a private health insurance?

A. You can apply for a private health insurance by visiting the official website of the insurance provider and filling out the insurance enquiry form. Once the enquiry form is filed, you’ll receive a callback from the provider. You can also contact the insurance provider directly (on the phone number listed on the website) or send an email evincing interest to apply for the policy (again, the email address will be listed in the insurer’s website).

Q. How do I make a claim under MediShield Life?

A. If you are hospitalised, you can simply tell the hospital authorities that you wish to make a claim under your MediShield Life cover. The hospital will take care of the rest.

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