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CPF administered medical insurance vs private insurance

Citizens and Permanent Residents of Singapore receive Health Insurance under Medishield Life, which is paid via CPF MediSave contributions, but how exactly does Medishield Life work? Most of us don’t know until we need to be hospitalised for treatment. In addition to Medishield Life, there are optional enhanced coverages like the Integrated Shield Plans and Integrated Shield Plan Riders. There are also Group Medical Insurance Plans taken up by some employers for their employees.

This article explains the differences between these insurance plans and how they will respond in the event of a hospitalisation claim.

WHAT IS MEDISHIELD LIFE/INTEGRATED SHIELD PLAN?

A national health insurance scheme, Medishield Life provides basic health insurance for all Citizens and Permanent Residents of Singapore. Medishield Life can be fully funded by an individual’s CPF Medisave funds. While Medishield Life does not restrict the ward choice, coverage levels are based on the treatment costs for Class B2 or C wards at public hospitals. This means if the insured chooses treatment in a Class B2 or C ward at a public hospital, they can expect Medishield Life to cover most of the related costs. Co-payment would only be required for the deductible and co-insurance components.

However, to receive treatment in private hospitals or Class A/B1 wards in public hospitals, consider upgrading to an Integrated Shield Plan. Integrated Shield Plan is an additional private insurance coverage component run by private insurers, typically to cover Class A/B1 wards in public hospitals or private hospitals. Similar to Medishield Life, the Integrated Shield Plan can be purchased using the individual’s CPF Medisave funds.

Below is list of Integrated Shield Plan providers:

  • AIA HealthShield Gold Max
  • Aviva MyShield
  • AXA – AXA Shield
  • Great Eastern SupremeHealth
  • Income – Income Shield
  • Prudential – PruShield

WHAT ARE INTEGRATED SHIELD PLAN RIDERS?

These are plans that can be added to the Integrated Shield Plan to reduce out-of-pocket cash outlay such as deductibles and co-insurance. These are also known as co-pay or co-payment.  Integrated Shield Plan Riders that cover the cost of co-insurance and deductibles can be purchased. Integrated Shield Plan Riders are optional private insurances and the additional insurance premiums are payable by cash only. Premiums for Integrated Shield Plan Riders cannot be paid using CPF Medisave funds. Examples of Integrated Shield Plan Riders include NTUC Plus & Assist Riders, GE TotalCare Plus riders, MyHealthPlus rider, and AIA Max Essential rider.

COMPARISON OF MEDISHIELD LIFE, INTEGRATED SHIELD PLAN, & INTEGRATED SHIELD PLAN RIDERS

WHAT IS A GROUP MEDICAL INSURANCE PLAN?

These are medical plans taken up by some employers to cover their employees as part of an employee benefits program. The medical plans typically include Group Term Life, Group Hospital & Surgical, Group Outpatient, Group Specialist, and Group Personal Accident polices. In contrast to Medishield Life and Integrated Shield Plan, these are considered private insurances.

A NOTE ON INTEGRATED SHIELD PLAN RIDERS IF YOU ARE COVERED UNDER A GROUP MEDICAL PLAN

Medishield Life and Integrated Shield Plan premiums are CPF-approved, and they can be fully paid for by an individual’s CPF Medisave. These are administered by CPF to help individuals pay for large hospital bills and selected costly outpatient treatments such as dialysis and chemotherapy. If an individual is also insured under private insurance (personal or Group Medical Insurance Plan), the private Group Medical Insurance Plan should be utilised first. In the event of a claim and the Medishield Life or the Integrated Shield Plan is somehow utilised first, the individual can seek reimbursement from the Group Medical Insurance Plan to their Medishield Life or the Integrated Shield. However, as Integrated Shield Plan Riders are considered private insurance, no amount paid out by Integrated Shield Plan Riders can be reimbursed by the Group Medical Plan.

WITH YOU ALL THE WAY

To find out more, please reach out at any time.

Meng Chuan Chia

Senior Claims Executive – Honan Asia

mengchuan.chia@honan.com.sg

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