MediShield is an individual catastrophic medical insurance designed to help Singaporeans pay part of the large hospitalisation bills for treatment of serious illnesses or prolonged hospitalisations at Class B2/C wards in restructured hospitals.
Besides citizens, the scheme is also extended to Singapore Permanent Residents (SPRs) who are eligible for subsidised medical care in restructured hospitals in Singapore. From 1 December 2007, all newborns and SPRs are offered MediShield coverage. School-going children have also been offered MediShield coverage through invitation packages sent to their parents/guardians from June 2008.
The benefits will be enhanced from 01 December 2008 to provide higher claim limits(from 60% to 80%) for members insured under MediShield from 1 December 2008.

MediShield only covers hospitalisation/surgical/day surgery and approved outpatient treatments sought on medical grounds in MOH-accredited medical institutions in Singapore.
Any expenses overseas will also not be allowed to claim from Medishield.


MediShield covers hospitalization expenses and certain approved outpatient treatments, such as kidney dialysis, chemotherapy and radiotherapy for cancer treatment.

Benefits for Singapore PR and foreigners would be the same as that of a Singaporean as shown in Table A. However, as a non-Singaporean, [Singapore Permanent Resident (SPR) and foreigner], hospital bill will be larger than that of Singaporeans due to the lower government subsidies that you will enjoy (from 1 January 2008 and 1 July 2008). Therefore, a pre-determined percentage is applied to the charges incurred by you before the MediShield claim is computed to equalise the MediShield payout for Singaporeans and non-Singaporeans.

Ward Class
Percentage of charges incurred for non-Singaporeans1
SPR
Foreigners
1 January 2008
1 July 2008
1 January 2008
C
80%
67%
20%
B2
87%
78%
35%
Subsidised Day Surgery
87%
78%
Not Eligible
Subsidised Specialist Outpatient
90%
83%
Not Eligible
1The applicable percentages may change if there are further changes to hospital subsidies for non-Singaporeans.

However, as MediShield is designed to cover bills incurred in B2/C class wards for Singaporeans, the MediShield claim for hospital stays in higher class wards or private hospital will be calculated based on a percentage of your hospital bill. Similarly, if you go for unsubsidised day surgery, your MediShield claim will be calculated based on a percentage of your bill. This is done to equalize the payout under MediShield for members who choose to go for higher class wards or use unsubsidised services. The percentage to be applied to your hospital bill is shown in Table B.
Table B: Percentage of Charges Incurred for higher class wards or private hospitals (For admission on or after 1 January 2008 and 1 July 2008)

Ward Class
Percentage of charges incurred for higher class wards or private hospitals
Singaporean
SPR1
Foreigners1
1 January 2008
1 January 2008
1 July 2008
1 January 2008
B2+
70%
63%
58%
35%
B1
43%
40%
38%
35%
A / Private Hospital
35%
35%
35%
35%
Private Day Surgery
35%
35%
35%
35%
Unsubsidised Specialist Outpatient
100%
100%
100%
100%

1
The applicable percentages may change if there are further changes to hospital subsidies for non-Singaporeans.


Payment of Medishield
Annual premiums can be paid from your Medisave Account. The premium is calculated based on your attained age at your next birthday when the cover commences. The premium will be higher as you get older (please see Table below).
Annual Premium Table
Age (Next Birthday)
Yearly Premium
(Inclusive of 7% GST) *

30 and under
$ 33
31 - 40
$ 54
41 - 50
$114
51 - 60
$225
61 - 65
$332
66 - 70
$372
71 - 73
$390
74 - 75
$462
# 76 - 78
$524
# 79 - 80
$615
# 81 - 83
$1,087
# 84 - 85
$1,123

For your convenience, renewal is done automatically every policy year, unless any of the following occurs:
• You have reached 85 years of age.
• You have decided not to be insured and informed us in writing.
• You have claimed the maximum claim limit per life-time.
• Your renewal premium was not paid.

You can top up your MediShield premium payment online using your CPF Account Number if you have an internet banking account.

You can also top up your MediShield premium via NETS at any AXS stations or SingPost branches. If you wish to pay by cash, you can only do so at any of the SingPost branches. Alternatively, you may send in a cheque made payable to "The CPF Board".

If you have insufficient cash to do a top up, you may request one of your immediate family members (i.e. your spouse, parent, child or grandchild) to take over the premium payment of your policy so that you can continue to enjoy the coverage under MediShield.


Medishield Claims

You can claim from MediShield through the hospital by informing them that you are insured under the scheme and you wish to make a claim. The hospital will submit your claim to CPF Board. After determining the amount payable from MediShield, CPF Board will make payment directly to the hospital. The remaining amount may be settled with Medisave and/or cash.
Examples:
Claim Computation for Singaporean aged 50 years old¹ staying in B2 Class Ward
Ward Class: B2
Length of stay: 54 Days (including 2 days in ICU)
Hospital Procedure Performed: Pancreas & Gall Bladder Operation


Hospital Bill2
Claimable Amount
Daily Ward & Treatment Charges
(for 52 days + 2 days ICU)

$26,000
$25,2003
Surgical Procedure (Table 6)
$728
$7284
Total
$26,728
$25,928
Less Deductible

($1,500)
Claimable Amount
(less Deductible)

$24,428
Less Co-insurance

($2692.80)5
MediShield pays
(% of hospital bill)


$21,735.20
(81%)



1
The insured member is below age 80, subject to a Deductible of $1,500 for Class B2 Ward.
2
As the insured member is a Singaporean staying in a B2 class ward, the MediShield claim is computed based on 100% of the bill.
3
Lower of the claim limit in Table A for Daily Ward & Treatment Charges, [($450 X 52 days) + ($900 X 2 days)] = $25,200, or 100% of the charges incurred $26,000, i.e. $25,200.
4
Lower of the claim limit in Table A for the surgical procedure, $960, or 100% of th charges incurred, $728, i.e. $728.
5
Co-insurance = ($1,500 x 20%) + ($2,000 x 15%) + ($20,928 x 10%) = $2,692.80.


Claim Computation for Singaporean aged 50 years old¹ staying in A Class Ward

Ward Class: A
Length of stay: 18 Days
Hospital Procedure Performed: Hip Replacement




Hospital Bill
35% of hospital bill2
MediShield Claim Computation
Daily Ward & Treatment Charges
(for 18 days)

$7,500
$2,625
($7,500x35%)

$2,6253
Surgical Procedure
(Table 5)

$5,000
$1,750
($5,000x35%)

$8404
Implant5
$4,000
$1,400
($4,000x35%)

$1,400
Total
$16,500
$5,775
$4,865
Less Deductible


($1,500)
Claimable Amount
(less Deductible)



$3,365
Less Co-insurance


($579.75)6
MediShield pays
(% of hospital bill)



$2,785.25
(17%)

Medisave and/or Cash


$13,714.75
||

1
The insured member is a Singaporean below age 80, subject to a Deductible of $1,500 for Class A Ward.
2
As the insured is a Singaporean staying in an A class ward, the MediShield claim is computed based on 35% of the bill.
3
Lower of the Medical claim limit in Table A for Daily Ward & Treatment Charges, ($450 X 18 days) = $8,100, or 35% of the charges incurred of $7,500 = $2,625. Therefore, the claimable amount is $2,625.
4
Lower of the Medical claim limit in Table A for the surgical procedure, $840, or 35% of the charges incurred of $5,000 = $1,750. Therefore, the claimable amount is $840.
5
Lower of the Medical claim limit in Table A for implant, $7,000, or 35% of charges incurred of $4,000 = $1,400. Therefore, the claimable amount is $1,400.

Co-insurance = ($1,500 X 20%) + ($1,865 X 15%) = $579.75.


Claim Computation for SPR aged 50 years old¹ staying in B2 Class Ward

Ward Class: B2
Length of stay: 54 Days (including 2 days in ICU)
Hospital Procedure Performed: Pancreas & Gall Bladder Operation



Hospital Bill
78% of hospital bill2
(refer to Table B)

MediShield Claim Computation
Daily Ward & Treatment Charges
(for 52 days + 2 days ICU)

$16,157
$12,602.46
($16,157x78%)

$12,602.463
Surgical Procedure
(Table 6)

$823
$641.94
($823x78%)

$641.944
Total
$16,980
$13,244.40
$13,244.40
Less Deductible


($1,500)
Claimable Amount
(less Deductible)



$11,744.40
Less Co-insurance


($1,424.44)5
MediShield pays
(% of hospital bill)



$10,319.96
(61%)

Medisave and/or Cash


$6,660.04

1The insured member is below age 80, subject to a Deductible of $1,500 for Class B2 Ward.
2As the insured is an SPR staying in a B2 class ward, the MediShield claim is computed based on 78% of the bill.
3Lower of the claim limit in Table A for Daily Ward & Treatment Charges [(52 X $450) + (2 X $900)] = $25,200 or 78% of the charges incurred of $16,157 = $12,602.46. Therefore, the claimable amount is $12,602.46.
4Lower of the claim limit in Table A for the surgical procedure, $960 or 78% of the charges incurred of $823 = $641.94. Therefore, the claimable amount is $641.94.
5Co-insurance = ($1,500 X 20%) + ($2,000 X 15%) + ($8,244.40 X 10%) = $1,424.44.

Make linkages to show how Singapore’s management of social issues reveals good governance/sound policies.

First of all, this policy gives benefits to both Singaporeans and non-Singaporeans. This ensure the harmony between the different groups in the society and even foreigners are given this benefit, thus ensuring that everyone in Singapore is given the same benefit, while giving Singaporeans more subsidy in their healthcare prices. This encourages Singaporeans to continue staying in Singapore to receive such benefits and also to encourage foreign talents in Singapore to become Singaporeans so as to receive more benefits.

Secondly, this policy is also a opt-out* one, therefore the government is actually protecting citizens, when in case of economic crisis, they will still have enough money to pay for hospital bills.

Such a policy also ensures that regardless of religion, everyone will receive the same amount of benefit, ensuring social stability.

Medishield only applies to certain government hospitals, which in turn will encourage citizens to visit government hospitals rather than private ones, thereby helping to contribute to Singapore’s economy.

*An opt-out policy means that it is not compulsory; however, you must opt-out of it if you do not wish to participate in it.