mshl brochure english

Contents

Examples of MediShield Life Benefits5

Premium Impact on Some Households12

What You Need to Know About MediShield Life2

Integrated Shield Plans14

MediShield Life Premiums and Subsidies8

What is MediShield Life? What is the difference between MediShield and MediShield Life? How does it benefit me?

What is universal coverage?

How will MediShield Life benefit me?

What You Need to Know About MediShield Life

MediShield is a basic healthcare insurance that helps to pay for large hospital bills and expensive outpatient treatments such as dialysis and chemotherapy for cancer. It is basic because it targets Class B2/C wards and subsidised treatment in the public hospitals.

MediShield Life, which will be implemented from end-2015, will offer:• BETTER PROTECTION and higher payouts, so that patients pay less

Medisave/cash for large bills• FOR ALL Singapore Citizens and Permanent Residents, including the very elderly and

those who have pre-existing illnesses• FOR LIFE

Universal coverage refers to the provision of MediShield Life coverage for all Singaporeans for life, regardless of pre-existing conditions or other reasons that they may not be covered under MediShield today.

With MediShield Life, all Singaporeans will be covered regardless of their health condition and life circumstances. Those who are currently insured under MediShield but have exclusions for pre-existing conditions will also have their exclusions lifted and be fully covered under MediShield Life.

MediShield Life will pay more of your hospital bills:• Higher claim limits for hospital bills and chemotherapy• No more lifetime claim limit

You will pay less.

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MediShield LifeBetter Protection. For All. For Life.

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Please refer to www.medishieldlife.sg/calculator to calculate your estimated MediShield Life premiums after the applicable premium subsidies.

MediShield Life premiums will be affordable, and can be fully paid from Medisave. Please refer to page 10 on MediShield Life premiums and subsidies for more details.

Government will provide significant support to Singaporeans to keep premiums affordable:• Premium subsidies for the lower- to middle-income (covering up to two-

thirds of households)• Transitional subsidies for all Singapore Citizens • Special premium subsidies and Medisave top-ups for the Pioneer

Generation for life

Premium subsidies for lower- and middle-income households are applicable to Singapore Citizens and Permanent Residents with monthly Per Capita Household Income (PCHI) of up to $2,600 per month and living in residences with an Annual Value of $21,000 or less. Refer to question 8 on how to calculate PCHI.

For Singaporeans who are unable to pay their share of premiums even after premium subsidies, the Government will provide additional premium support. No Singaporean will drop out of MediShield Life due to inability to pay for premiums.

How much are my MediShield Life premiums?

What are the different MediShield Life premium subsidies and who are eligible for them?

How will the Government help those who cannot afford their MediShield Life premiums?

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You do not need to. All Singapore Citizens and Permanent Residents will be automatically covered under MediShield Life when it is implemented in end-2015.

CPF Board will inform you of the details nearer to the implementation date.

Do I need to apply for MediShield Life? 07

What is Per Capita Household Income?

I already have an Integrated Shield Plan. How is MediShield Life relevant to me?

I am a pensioner retired from the civil service. Can I opt out of MediShield Life?

Per Capita Household Income is the total amount of income earned by a family staying under one roof, divided by the number of members of that family. So, if the total income earned by family members is $10,000, and there are four members in the family, then the Per Capita Household Income is $2,500.

Using Per Capita Household Income to calculate the need for subsidies will ensure that those who need help most will receive adequate support. This is because the amount they can spend on each family member will be lower if there are more family members.

Please refer to page 14 on Integrated Shield Plans (IP).

All Singaporeans will be covered by MediShield Life. If you are a pensioner, you will also be covered under MediShield Life. [Pensioners on Comprehensive Co-payment scheme will get 2% additional Medisave contribution. For those who are on older medical benefits schemes, which already provide better coverage than what MediShield Life will be providing, Government will pay for the premiums for this group so that these pensioners will be no worse off and will benefit from MediShield Life coverage. Public Service Division will be writing to pensioners with the details.]

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Examples of MediShield Life Benefits

Patient who had a heart attackExample

Mr Tan 60 years old

Hospitalised for 10 days in B2 Ward

Comparison of MediShield & MediShield Life Coverage

With MediShield Life, patients pay less

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MediShield Benefits (Now)

MediShield Life Benefits (New)

Bill after Government Subsidy $8,100

Maximum coverage based on hospitalisation and surgical claim limits

$6,050 $8,100

Deductible $2,000 for B2

Co-insuranceMediShield/MediShield Life PaysPatient Pays (Medisave/Cash)

$605$3,445 (43%)$4,655 (57%)

$455$5,645 (70%)$2,455 (30%)

5MediShield LifeBetter Protection. For All. For Life.

Patient who had a stroke

Mr Yee 48 years old

Example

Hospitalised for 10 days in B2 Ward and 4 days in ICU for stroke due to brain haemorrhage


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$8,100 $10,100

Deductible $2,000 for B2

Co-insuranceMediShield/MediShield Life PaysPatient Pays (Medisave/Cash)

$810$5,290 (52%)$4,810 (48%)

$550$7,547 (75%)$2,553 (25%)

With MediShield Life, patients pay less

6 MediShield LifeBetter Protection. For All. For Life.

Patient who had cancerExample 03

Mdm Kamla 63 years old

Underwent 4 cycles of chemotherapy treatment for cancer






$4,960 $6,120

Deductible $0 for outpatient treatment

Co-paymentMediShield/MediShield Life PaysPatient Pays (Medisave/Cash)

$1,840$4,960 (73%)$1,840 (27%)

$680$6,120 (90%)$680 (10%)



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MediShield Life Premiums and Subsidies

Age Next BirthdaySubsidies1 as Percentage of Premiums (for Singapore Citizens)

Lower-Income2 Lower-Middle-Income3 Upper-Middle-Income4

1 – 20

25% 20% 15%21 – 30

31 – 40

41 – 5030% 25% 20%

51 – 60

61 – 65

35% 30% 25%66 – 70

71 – 73

74 – 75

76 – 78

40% 35% 30%79 – 80

81 – 83

84 – 85

86 – 8845% 40% 35%

89 – 90

>90 50% 45% 40%

Age in 2015 Pioneer Generation Subsidies1 as Percentage of Premiums

66 - 69 40%

70 – 79 45% – 54%

80 – 89 55% – 59%

≥ 90 60%

1 (a) These subsidy rates are applicable to Singapore Citizens who live in residences with an Annual Value of $13,000 or less. Those with an Annual Value between $13,101 to $21,000 will receive 10 percentage points less than these subsidy rates. Those with an Annual Value of above $21,000 will not receive these subsidies;

(b) Permanent Residents receive half of the subsidy rates applicable to Singapore Citizens.2 Lower-income refers to individuals with monthly per capita household income of $1,100 or less3 Lower-middle-income refers to individuals with monthly per capita household income of $1,101 to $1,8004 Upper-middle-income refers to individuals with monthly per capita household income of $1,801 to $2,600

1 Pioneer Generation subsidies are applicable to all Pioneers, regardless of income level. The subsidy rates are subject to change every year to ensure the commitment for Pioneers are met.

Figure 1: Premium Subsidies for Lower- to Middle-Income (Non-Pioneer Generation)

Figure 2: Premium Subsidies for Pioneer Generation


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Age Next Birthday

Current Annual Medi-Shield

Premiums ($)

Medi-Shield

Life Annual

Premiums before

Subsidy ($)

2015 MediShield Life Premiums after Subsidy1

Lower-Income Lower-Middle-Income

Upper-Middle-Income High Income

Annual ($)

Monthly ($)

Annual ($)

Monthly ($)

Annual ($)

Monthly ($)

Annual ($)

Monthly ($)

1 – 20 50 130 60 5 61 5 62 5 66 6

21 – 30 66 195 82 7 84 7 86 7 92 8

31 – 40 105 310 131 11 134 11 137 11 146 12

41 – 50 220 435 237 20 241 20 246 20 263 22

51 – 60 345 630 364 30 371 31 377 31 402 34

61 – 65 455 755 462 39 470 39 477 40 515 43

66 – 70 540 815 530 44 546 46 554 46 595 50

71 – 73 560 885 563 47 572 48 581 48 625 52

74 – 75 646 975 634 53 653 54 663 55 712 59

76 – 78 775 1,130 678 57 735 61 778 65 846 71

79 – 80 865 1,175 705 59 764 64 823 69 927 77

81 – 83 1,123 1,250 750 63 813 68 875 73 1,148 96

84 – 85 1,150 1,430 858 72 930 77 1,001 83 1,206 101

86 – 88 1,190 1,500 825 69 900 75 975 81 1,252 104

89 – 90 1,190 1,500 825 69 900 75 975 81 1,252 104

>90 - 1,530 765 64 842 70 918 77 1,258 105

1 (a) Subsidies include premium subsidies for lower-to-middle income families and transitional subsidies for all Singapore Citizens. Premium subsidy rates in Figure 1 were used, and are applicable for those living in properties with an Annual Value of $13,000 or less. Those with an Annual Value of between $13,101 to $21,000 will receive 10 percentage points less than the subsidy rates in Figure 1. Those with an Annual Value of above $21,000 will not receive premium subsidies.

(b) Table applies to Singapore Citizens. For Permanent Residents, half of the relevant premium subsidy rates apply, but no transition subsidies apply.

* Premiums are subject to change depending on medical inflation and claims experience. Premiums are based on the indicative schedule of benefits and may be further revised. The Central Provident Fund Board will inform all policyholders of their payable MediShield Life premium (after any applicable subsidies) in writing, before premium deduction.

Figure 3: Current MediShield and MediShield Life Premiums in 2015

Age Next

Birthday

Current Annual Medi-Shield

Premiums ($)

Medi-Shield

Life Annual

Premiums before

Subsidy in 2019

($)

2019 MediShield Life Premiums after Subsidy1

Lower-Income Lower-Middle-Income

Upper-Middle-Income High Income

Annual ($)

Monthly ($)

Annual ($)

Monthly ($)

Annual ($)

Monthly ($)

Annual ($)

Monthly ($)

1 – 20 50 130 98 8 104 9 111 9 130 11

21 – 30 66 195 146 12 156 13 166 14 195 16

31 – 40 105 310 233 19 248 21 264 22 310 26

41 – 50 220 435 305 25 326 27 348 29 435 36

51 – 60 345 630 441 37 473 39 504 42 630 53

61 – 65 455 755 491 41 529 44 566 47 755 63

66 – 70 540 815 530 44 571 48 611 51 815 68

71 – 73 560 885 575 48 620 52 664 55 885 74

74 – 75 646 975 634 53 683 57 731 61 975 81

76 – 78 775 1,130 678 57 735 61 791 66 1,130 94

79 – 80 865 1,175 705 59 764 64 823 69 1,175 98

81 – 83 1,123 1,250 750 63 813 68 875 73 1,250 104

84 – 85 1,150 1,430 858 72 930 77 1,001 83 1,430 119

86 – 88 1,190 1,500 825 69 900 75 975 81 1,500 125

89 – 90 1,190 1,500 825 69 900 75 975 81 1,500 125

>90 - 1,530 765 64 842 70 918 77 1,530 128

1 (a) Subsidies include premium subsidies for lower-to-middle income families. Premium subsidy rates in Figure 1 were used, and are applicable for those living in properties with an Annual Value of $13,000 or less. Those with an Annual Value of between $13,101 to $21,000 will receive 10 percentage points less than the subsidy rates in Figure 1. Those with an Annual Value of above $21,000 will not receive premium subsidies.

(b) Table applies to Singapore Citizens. For Permanent Residents, half of the relevant premium subsidy rates apply, but no transition subsidies apply.


Figure 4: Current MediShield and MediShield Life Premiums (Non-Pioneer Generation) in 2019


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Age Current MediShield Annual Premiums ($)

MediShield Life Premiums2 ($)

Annual Premiums Before Subsidies

Annual Premiums With Pioneer Generation Subsidies

Monthly Premiums With Pioneer

Generation Subsidies

66 – 69 540 815 489 41

70 – 72 560 885 491 41

73 – 74 646 975 497 41

75 – 77 775 1,130 517 43

78 – 79 865 1,175 537 45

80 – 82 1,123 1,250 566 47

83 – 84 1,150 1,430 615 51

85 – 89 1,190 1,500 615 51

≥90 - 1,530 612 51

1 Premiums stated are for Pioneer’s age in 2015 and will change corresponding to his age. There will be additional premium of 30% if the Pioneer has pre-existing conditions.

2 Figures shown have not included Pioneer Generation Medisave top-ups, which range from $200–$800 depending on birth cohort and can further offset premiums. With the top-ups, Pioneers aged 80 and above in 2014 will not incur any payables, while Pioneers aged 79 and below in 2014 will pay less than current premiums. These assurances will also be valid in 2019.


Figure 5: MediShield Life Premiums in 2015 for Pioneer Generation Members1


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Premium Impact on Some Households

Lower-income nuclear family

Middle-income nuclear family

Mr and Mrs Koh (mid 30s) have 2 children (primary school).Mr Koh earns $2,000 a month.

He receives $180 a month in Medisave contributions.

Mr and Mrs Muthu (mid 30s) have 2 children.Mr Muthu earns $5,000 a month as a project manager.

They receive $450 a month in Medisave contributions.

Mrs Muthu is a housewife.

Coverage Total Premiums for Koh household

Current MediShield $26/month

MediShield Life (2015) $32/month with transitional subsidies

MediShield Life (2019) $55/month

Coverage Total Premiums for Muthu household




Premiums fully payable by Medisave

inflows


inflows


Middle-income extended family

Retired Pioneer Generation family

Mr and Mrs Zakir (mid 30s) have 2 children and care for 2 retired parents (early 60s).Mr and Mrs Zakir earn $8,000 a month as project managers.

They receive $720 altogether each month in Medisave contributions.

Mr and Mrs Ng (retirees, mid 70s) are part of the Pioneer Generation.

Coverage Total Premiums for Zakir household




Coverage Total Premiums for Ng household




inflows

Premiums are supported by Pioneer Generation Medisave Top-ups


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Integrated Shield Plans

Medisave can be used to pay for Integrated Shield Plan premiums.5 private insurers are approved by MOH to sell Integrated Shield Plans.

Not all insurance plans sold by these insurers are Integrated Shield Plans. Please check with your insurer if you are unsure whether your insurance plan is an Integrated Shield Plan.

Inte

grat

ed S

hiel

d Pl

an The top-up portion of an Integrated Shield Plan is managed by a private insurer and offers enhanced benefits e.g. additional coverage for Class A/B1 in public hospitals, or in private hospitals.

The basic MediShield portion of an Integrated Shield Plan is managed by the Central Provident Fund Board and is targeted to help with large hospitalisation expenses at the Class B2/C level in public hospitals. This will become MediShield Life in future.

EnhancedBenefits

Provided byPrivate Insurer

MediShield(MediShield

Life in Future)

All Integrated Shield Plan holders are covered by MediShield

A member of the OCBC Group


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Paying Premiums:

Making Claims:

More resources on Integrated Shield Plans are available at www.moh.gov.sg/integratedplans

PolicyholderPaysPremium

IntegratedShieldPlan

Insurer

Premium forEnhancedBenefits

provided byIntegratedShield Plan

Insurer

Premium forMediShield

Benefitsprovidedby CPFB

IntegratedShieldPlan

Insurer

Portion of ClaimPayable from

EnhancedBenefits

(IntegratedShield Plan

Insurer)

Portion of ClaimPayable fromMediShield

Benefitsprovided by CPFB

One SingleIntegrated

ShieldPlan

Premiumwith TWO

Parts

MediShieldPortion

Managedby CPFB

MediShieldPortion

Providedby CPFB to

Insurer

Submits Claim

Claim Settledby Insurer

How do MediShield Life and Integrated Shield Plans work together?

HOSPITAL


I already have an Integrated Shield Plan. How will MediShield Life benefit me?

Do I still need an Integrated Shield Plan?

Will I still be eligible for the premium subsidies?

If you are currently covered under an Integrated Shield Plan, you enjoy the combined benefits of MediShield, which is run by the Central Provident Fund board, and the enhanced benefits of the top-up portion, which is run by your private insurer. When implemented, MediShield Life will automatically replace the current MediShield portion in your Integrated Shield Plan. Hence, you need not worry about duplicate coverage between MediShield Life and your Integrated Shield Plan. As MediShield Life will cover all pre-existing conditions, all Integrated Shield Plan policyholders will also enjoy MediShield Life coverage for life, for any pre-existing conditions. This will apply even if your pre-existing condition is excluded from the top-up coverage by your private insurer. You will have peace of mind that you will continue to remain covered at the basic level, even if you have exclusions on your Integrated Shield Plan cover or you have to drop your Integrated Shield Plan cover.

MediShield Life will provide coverage for all Singaporeans with large hospitalisation expenses, regardless of which class ward they choose. The level of benefits is based on expenses in B2/C class wards in public hospitals. You will get the same level of benefits, pegged to the estimated B2/C class expenses, if you choose to stay in a B1/A class ward or in private hospitals. You can sign up for an Integrated Shield Plan if you want additional coverage of bills in these higher class wards or in private hospitals. However, premiums will be higher. Carefully consider your preferred ward class and premiums over the lifetime, and plan your insurance coverage accordingly.

Yes, for as long as you meet the eligibility criteria. Premium subsidies are provided to help the lower- to middle-income households with their MediShield Life premiums. Pioneer Generation subsidies are applicable for the rest of the Pioneer’s life.

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Frequently Asked Questions


For more information, visit www.medishieldlife.sg. July 2014 | All information in this booklet is correct at the time of printing.

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Documents

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applicable premium subsidies

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lifepremium subsidies

large bills

large hospital bills