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After extensive consultations with workers,
employers, insurers and the public, the Ministry of Health (MOH) is finalising
its MediShield reform plan for implementation on Jul 1, 2005. |
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The key objective of the reform is to protect
Singaporeans against the financial burden of large hospital bills, at least at
the Class B2/C level. |
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This will be achieved by returning MediShield to
its original intent of only covering major Class B2/C hospital bills but
covering them adequately. Due to inadequate adjustments over the years, the
current MediShield has severe limitations. |
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First, MediShield payouts for patients with large
hospital bills have shrunk to about 40% of total bills, landing the patients
with a high effective co-payment of about 60%. For a hospital bill of say
$10,000, this means a co-payment of about $6,000 by the patient which may not
be affordable to many. |
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Second, MediShield has been in operational deficit
since 2002. Its premium collections no longer cover the payouts. This is not
sustainable for long. |
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Reforming MediShield requires adjustments in three
areas. |
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First, increase the MediShield payouts by
adjusting the MediShield claim limits and co-insurance rate. This will
minimise co-payments by patients and ease their financial burden. |
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Second, restore the financial viability of
MediShield by adjusting premium rates. |
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Third, return MediShield to its original purpose
of providing catastrophic medical insurance by adjusting the MediShield
deductible levels. |
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Achieving an optimal reform package requires
policyholders to make trade-offs, balancing their wishes for higher benefits
against the contrasting desire for affordable premiums. For example, better
MediShield payouts must mean higher premiums. Lower premiums would mean higher
MediShield deductibles. |
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After extensive public consultations, MOH thinks
that an optimal reform package is to half the current effective co-payment by
patients, from 60% of the hospital bill to about 30%. |
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Increasing MediShield Payouts |
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To halve the patients' share of the major hospital
bills, MediShield claim limits, which determine the payouts to policyholders,
will be raised substantially: |
- Lifetime claim limits from $120,000 to
$200,000;
- Annual claim limits from $30,000 to $50,000;
- Daily claim limits for normal hospital stays
from $150 to $250, and for ICU stays from $300 to $500;
- Claim limits for surgical procedures from
the current range of $120~$900 to $150~$1,100; and
- Claim limits for surgical implants from
$1,500 to $2,500
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At the same time, the co-insurance rate (the
portion of the claim amount that the policyholder is responsible for paying
after the deductible is met) will be reduced from the current 20% to 10% for
amounts above $5,000. This ensures higher payouts for large bills. |
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More..... |
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Source:
Ministry of Health Press Release 26 Jan
2005 |
MediShield reform plan takes effect from 1 July 2005 
