MOH confirms Eldershield has “benefitted more than 15,000” out of 1.3 million policyholders

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The Ministry of Health (MOH) confirmed today that the healthcare insurance scheme has “benefitted more than 15,000 policyholders”. Interestingly, a total of 1.3 million Eldershield policyholders were recorded at the end of last year.

According to the Ministry of Social and Family Development (MSF), 13.3 per cent of the resident population of 3.9 million comprise the number of disabled persons in Singapore above the age of 50. This means that more than half a million people above the age of 50 are presently disabled in Singapore.

MOH’s revelation, that only about 15,000 out of 1.3 million policyholders and over 15,000 out of over 500,000 have benefitted from the scheme, comes on the back of news that Eldershield paid out only $133 million while collecting $3.3 billion in premiums.

The Ministry made the revelation in a Facebook post today as it responded to the viral story of an elderly amputee who died weeks after his Eldershield benefits were re-instated. The story of the late Mr K tugged at the heartstrings of many Singaporeans after Workers’ Party chairman Sylvia Lim shared his story in Parliament last week.

The opposition MP revealed that the resident, an amputee who was suffering from advanced kidney failure, was an Eldershield policyholder until the scheme revoked his benefits since he could “partially” perform 6 activities of daily living (ADLs).

The Government considers individuals severely disabled and will pay out insurance benefits when they can do three out the following six ADLs: washing themselves; dressing themselves; feeding themselves; using the toilet by themselves; moving indoors by themselves; moving from a bed to an upright chair by themselves.

Even though the resident was so sick that he could only do these activities “partially,” the authorities decided to discontinue his benefits.

When Lim stepped in to appeal the decision on the resident’s behalf, she was told that the resident must fill out more paperwork. Since the resident was languishing in a hospice at this time, his daughter had to do the necessary. A month after the authorities decided to restore his Eldershield benefits, the resident died.

According to a netizen who claimed to be the elderly amputee’s brother, the disabled man’s wife went “from one institution to another and (kept) getting turned down bec we never met their protocol”. Adding that his young nieces who are in their 20s were the ones who kept the household running, the netizen shared his brother struggled before he passed.

In a Facebook post, MOH revealed today that Mr K joined ElderShield 300 at the age of 52 in 2002 and began submitting ElderShield claims in Sept 2014. Over the next two years, Mr K allegedly received payouts from a private insurer that amounted to a total of $7,500.

MOH made a point of noting that the payouts Mr K received were “higher than the total of amount of premiums he paid (~$3,100).”

According to the Ministry, the elderly Singaporean’s Eldershield benefits were revoked in Sept 2016 after a doctor said that Mr K did not meet the criteria to continue receiving payouts. It must be noted that the elderly amputee did not receive his Eldershield benefits for 7-8 months, between Sept 2016 and April 2017.

In March the next year, Sylvia Lim appealed the decision and the insurer resumed payments following another assessment. Mr K began receiving payouts again in April 2017. In May 2017, he passed away.

In its social media page, MOH claimed that it is now “checking with the insurer and doctor to find out the reasons for the Sep 2016 assessment. If there were lapses on the part of the insurer or doctor, we will not hesitate to take action against them.”

It is curious that MOH is only now checking on the Sept 2016 assessment, nearly two years after that assessment and more than a year after Mr K passed away.

MOH then proclaimed: “ElderShield has benefitted more than 15,000 policyholders since the scheme started in 2002. The cash payouts helped to reduce their long-term care costs. As the ElderShield policyholders get older, we can expect more to become severely disabled and total claims will increase in future.”

Referencing calls to review the strict eligibility requirements and claims process that the Government imposes on policyholders of schemes like Eldershield and the upcoming Careshield Life, MOH said:

“The ElderShield Review Committee recognised that the current claims process can be enhanced. It made several recommendations to simplify the claims process, and make it more convenient for policyholders. MOH will implement these improvements for CareShield Life, when the scheme starts in 2020.”