MediShield Life claim limits to remain, but will undergo more frequent review

In the context of an 83-year-old who’s insurance only contributed S$4.50 toward his eye surgery, Senior Minister of State for Health Edwin Tong answered questions in Parliament concerning MediShield Life, the compulsory health insurance scheme for all citizens of Singapore.

Tong reiterated that the limits on how much patients can claim from MediShield Life are necessary, otherwise everyone’s premiums could rise by 30 percent or even higher.

But he also said that the Ministry of Health (MOH) would be reviewing claim limits more often in the future.

He said these would be reviewed every three years.

Members of Parliament Tin Pei Ling, of Marine Parade Group Representation Constituency (GRC) and Murali Pillai, of Bukit Batok, questioned Tong on January 15, Tuesday, specifically whether or not the insurance would be able to offer enough coverage for high medical bills.

The context was the case of 83-year-old Seow Ban Yam, whose story was featured in The Straits Times because MediShield Life had only paid S$4.50 for Seow’s S$4,477 subsidized bill.

With changes made to MediShield Life in 2015, claim limits were set to fully cover 9 out of 10 subsidized bills. Today, 8 out of 10 subsidized bills are covered by MediShield Life claim limits. Tong explained that this is due to the rise in the cost of healthcare.

He assured Parliament, however, that these limits would be reviewed and adjusted as needed. “However, even at present rates, in respect of the bills which fall outside the claim limits, about half exceed the claim limits by S$230 or less.”

In the case of the elderly Mr. Seow, Tong explained the specifics of his billing. Before the subsidy, the bill was set at around S$12,000. From this amount, S$7,500 was subsidized by the government. Seow’s balance of S$4,500 was S$1,400 beyond the MediShield Life claim limit.

Because of this, the amount that could be insured from his bill was only S$5.00. MediShield Life ended up covering 90 percent of it, S$4.50. The remainder was paid by Seow through his MediSave.

Tong further said that the Singapore National Eye Centre (SNEC), where Seow’s surgery had been held, had been asked by the MOH to review their prices. The SNEC has chosen to lower their fees for this and other difficult procedures, from March 1 onwards.

Read related: MOH admits MediShield Life claim limits fall short of the targets that were set when it was launched

https://theindependent.sg.sg/moh-admits-medishield-life-claim-limits-fall-short-of-the-targets-that-were-set-when-it-was-launched/