One of the rites of passage to become a functioning adult is to get health insurance.
And many have said that one of the key insurance policies you need to get is the Integrated Shield Plan (IP).
But is it really necessary?
Find out right here!
Disclaimer: The Information provided by Seedly does not constitute an offer or solicitation to buy or sell any insurance product(s). It does not take into account the specific objectives or particular needs of any person. We strongly advise you to seek advice from a licensed insurance professional before purchasing any insurance products and/or services.
TL;DR: Are Integrated Shield Plans Necessary? Comparing Medical Cost Without IPs
| Plan Type | MediShield Life Only (Class C Ward) | MediShield Life Only (Class B1 Ward) | Integrated Shield Plan (Class B1) W/O Rider | Integrated Shield Plan (Class B1) With Rider |
| Annual Premium (Ages 21 – 30) | $252.34 (MediSave) | $252.34 (MediSave) | $300 (MediSave) + $238 (Cash) | $300 (MediSave) + $356 (Cash) |
| Hospital Bill (Coronary Artery Bypass Graft) | $6,528 | $35,834 | $35,834 | $35,834 |
| Claim Computation Amount | $6,528 | $15,408 (43% of bill) | $35,834 (100% of bill) | $35,834 (100% of bill) |
| Less Deductible (Aged <80) | $1,500 | $2,000 | $2,500 | $2,500 (Covered by Rider) |
| Claimable Amount (Less Deductible) | $5,028 | $13,408 | $33,334 | $33,334 |
| Less Co-Payment After Deductible (Up to 10%) | $426 | $652 | $3,333 | $1,667 |
| Total Bill Paid By Insured | $5,454 | $14,060 | $5,833 | $1,667 |
Source: MOH Fee Benchmarks and Bill Amount Information, MOH and Income
*Figures include GST and are based on the median of actual transacted fees across the medical institutions for each bill component, from 1 January 2021 to 31 December 2021. They therefore provide an estimate of fees but do not necessarily sum up to the total bill amount. Figures in this table will be updated annually.
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- Important Insurance Terms to Understand About Integrated Shield Plans
- MediShield Life Explained
- What is Integrated Shield Plan?
- MediShield Life vs Integrated Shield Plans: Claims and Amount Payable
- MediShield Life vs Private Integrated Shield Plan: Pro-Ration
- Integrated Shield Plan Compared for 2023
- Integrated Shield Plan Premium Costs
- Conclusion
Important Insurance Terms to Understand About Integrated Shield Plans
But first some context.
You will need to know these important health insurance terms before you purchase an IP. They are Deductibles, Co-Insurance/Co-Payment, and the Pro Ration Factor.
Deductibles represent a fixed amount that you are required to pay towards your medical expenses before your insurance provider starts covering any benefits under the IP policy. The purpose of deductibles is to keep the cost of hospitalisation plans reasonable by shifting some of the financial responsibility to the insured individual. Typically, deductibles are calculated on an annual basis, which means that all qualifying expenses incurred within a policy year contribute towards meeting the deductible amount. But, certain plans may have deductibles applied on a per disability basis.
Co-Insurance/Co-Payment, as outlined in your insurance policy, refers to a predetermined percentage (typically ranging from 5% to 10%, depending on the inclusion of additional coverage options) of the overall medical expenses that you are responsible for paying after meeting the deductible. The purpose of co-insurance is to discourage excessive utilisation of healthcare services. Certain policy riders may offer benefits such as reduced co-insurance and deductibles.
A Pro-Ration Factor is an extra fee (represented as a percentage in the benefits schedule) that you are obligated to pay if you are admitted to a hospital or ward that exceeds the coverage level of your current insurance plan. For example, let’s say you were admitted to a private hospital due to an emergency. But, if you only have MediShield Life which only covers C and B2 Class wards in a public hospital, you will be required to pay the Pro-Ration Factor as an additional charge.
MediShield Life Explained
Speaking of MediShield Life, let me explain this policy as it is vital to the understanding of IPs.
MediShield Life is a basic health insurance plan, which all Singaporean Citizens (SCs) and Singaporean Permanent Residents (SPRs) are automatically enrolled in.
It helps you to pay for large medical bills and even certain types of outpatient treatment like dialysis or chemotherapy.
At a glance, MediShield Life offers:
- Better protection and higher payouts, so you pay less MediSave or cash
- Lifetime protection including coverage of pre-existing conditions.
What Am I Covered Under MediShield Life?
MediShield Life mainly serves as basic health insurance to help Singaporeans defray medical costs.
For instance, its payouts would mostly cover the cost of Class B2 or C wards of public hospitals and subsidised outpatient treatments and day surgeries in public healthcare institutions.
MediShield Life covers both inpatient and outpatient treatments, with its benefits as follows (applicable for admissions or treatments received on or after 1 April 2023):
| Inpatient/Day Surgery | Claim Limits | ||
|---|---|---|---|
| Daily Ward and Treatment Charges(1) | |||
| - Normal ward | $800 per day* | ||
| - Intensive care unit ward | $2,200 per day* | ||
| * An additional claim limit of $200 per day applies for the first two inpatient days | |||
| - Psychiatric (up to 60 days per policy year) | $160 per day | ||
| - Community hospital (Rehabilitative)(2) | $350 per day | ||
| - Community hospital (Sub-acute)(2) | $430 per day | ||
| - Inpatient palliative care service (general) | $250 per day | ||
| - Inpatient palliative care service (specialised) | $350 per day | ||
| Surgical proceduresSurgical procedures | A | B | C |
| - Table 1 A/B/C (less complex procedures) | $240 | $340 | $340 |
| - Table 2 A/B/C | $580 | $760 | $760 |
| - Table 3 A/B/C | $1,060 | $1,160 | $1,280 |
| - Table 4 A/B/C | $1,540 | $1,580 | $1,640 |
| - Table 5 A/B/C | $1,800 | $2,180 | $2,180 |
| - Table 6 A/B/C | $2,360 | $2,360 | $2,360 |
| - Table 7 A/B/C | $2,600 | $2,600 | $2,600 |
| Implants | $7,000 per treatment | ||
| Radiosurgery, including Proton Beam Therapy – Category 4(3) | $10,000 per treatment course | ||
| Continuation of autologous bone marrow transplant treatment for multiple myeloma | $6,000 per treatment | ||
Source: Ministry of Health (MOH)
(1) Includes meal charges, prescriptions, professional charges, investigations and other miscellaneous charges
(2) Claimable only upon referral from a hospital after an inpatient admission or from a public hospital’s emergency department for further medical treatment.
(3) Refer to the MOH website for approved indications for use of Proton Beam Therapy
| Outpatient Treatment | Claim Limits |
|---|---|
| Cancer drug treatment(1) | $200 - $9,600 per month, depending on cancer drug treatment1 |
| Cancer drug services | $3,600 per year |
| Radiotherapy for cancer | ç |
| - External (except Hemi-body) | $300 per treatment |
| - Brachytherapy | $500 per treatment |
| - Hemi-body | $900 per treatment |
| - Stereotactic | $1,800 per treatment |
| - Proton Beam Therapy - Category 1 | $300 per treatment |
| - Proton Beam Therapy - Category 2 | $500 per treatment |
| - Proton Beam Therapy - Category 3 | $1,800 per treatment |
| Kidney Dialysis | $1,100 per month |
| Immunosuppressants for organ transplant | $550 per month |
| Erythropoietin for chronic kidney failure | $200 per month |
| Long-term parenteral nutrition | $1,700 per month |
Source: MOH
(1)Refer to the Cancer Drug List on the MOH website for the applicable claim limit.
However, some might prefer to reduce out-of-pocket expenses when the need arises and enjoy greater flexibility in terms of:
- The types of hospital ward you can stay in
- The types of treatment
- Annual coverage limits.
For reference here is a comparison of the types of facilities you can expect from a Public/Restructured hospital [Singapore General Hospital (SGH)] and a private hospital (Mount Elizabeth Hospital):
| Ward Type & Description | Rates* |
| Standard Ward Type C Up to 8 beds in a room |
From $37 per day |
| Standard Ward Type B2 Up to 6 beds in a room semi-automated electric bed |
From $57 per day |
| Standard Ward Type B1 4 beds in a room attached bath room and toilet television semi-automated electric bed choice of meals. |
From $268.92 per day |
| Standard Ward Type A Single room attached bath room and toilet toiletries television telephone fully automated electric bed choice of meals sleeper unit for accompanying adult |
From $540.00 per day |
| Private Ward Free WiFi Lodger bed cum sofa In-room safe Writing desk In-room telephone Bath and Toiletries Ensuite bathroom Luxury toiletries with plush towels and slippers Hairdryer Entertainment Flat-screen TV Daily copy of the local newspaper Food and Beverage 5 nourishing meals per day Daily meals for 1 companion Complimentary Services 24-hour in-house security Daily housekeeping 24-hour nursing services |
From $790 per day |
*NOTE: Updated as of 1 Jan 2023.
So if you want the optionality and better facilities, you may want to opt for an IP as an add-on to enhance your medical coverage.
How Do I Pay for the Premiums of MediShield Life?
The premiums of MediShield Life are fully payable via MediSave.
Family members such as spouse, parent, child, sibling or grandchild with sufficient MediSave balance can also pay for your MediShield Life coverage.
There are also discounts for MediShield premiums for to lower- to middle-income families with household monthly income per person of $2,800 and below (applicable for renewals from 1 September 2019), and living in residences with an Annual Value of $21,000 and below.
Eligible SCs can receive subsidies of up to 50% on their premiums. However, SPRs will only receive half the subsidy rate applicable to citizens.
The rates are as follows:
*For those living in residences with AV of $13,000 or less.
Those with an Annual Value between $13,001 to $21,000 will receive 10 percentage points less than these subsidy rates.
Those living in residences with an Annual Value of above $21,000 will not receive these subsidies.
If you own more than one property, you do not qualify for this subsidy.
What is Integrated Shield Plan?
An IP essentially has two components:
When you sign up for an IP you are paying for the MediShield Life component and an additional private insurance coverage component ‘top up’.
Note: If you are paying for an IP you will still receive subsidies on your MediShield Life premiums if you are eligible for them.
Depending on the type of IP that is chosen, the protection can be enhanced to provide coverage for areas such as hospitalisation benefits, claim limits and coverage for private hospitals and public hospitals (A or B1 wards).
When you purchase an IP, you are already covered by MediShield Life. The insurer that you bought the IP from will be the single point of contact. They will act on the CPF Board’s behalf for premium collection and claims disbursement for the MediShield Life component of your Integrated Shield plan.
But with the increase in coverage, one can expect the premiums for IP to be much higher as compared to MediShield Life.
What Am I Covered Under an Integrated Shield Plan?
Here’s a quick overview of the differences between MediShield Life and an IP:
| MediShield Life | Integrated Shield Plan | |
|---|---|---|
| Coverage For | Public hospital (B2 or C wards) | Private Hospitals |
| Ward Choice | Public Hospital B2 or C ward | Private Hospitals Public Hospital -A ward -B1 ward -B2 ward -C ward |
| Policy Annual Claim Limit | Up to $150,000 | Up to $2,000,000 |
| Amount Payable | Deductibles, co-insurance, expenses that exceed the coverage limit | Deductibles, co-insurance, expenses that exceed the coverage limit |
| Additional Coverage | - | Includes coverage for areas such as pre- and post-hospitalisation treatment, and emergency overseas treatment |
| P | - | Includes coverage for areas such as pre- and post-hospitalisation treatment, and emergency overseas treatment |
Also, do note that cancer drugs have their own policy year limit as follows:
However, while MediShield Life covers pre-existing conditions, IP policies might only be accepted if the individual is healthy.
This is depending on the insurer, and applications might be either modified or rejected if an individual has pre-existing conditions.
As such, it is recommended to not switch plans if your current plan covers your pre-existing condition.
How Do I Pay for the Premiums of Integrated Shield Plans?
There are Additional Withdrawal Limits (AWLs) for using MediSave to pay for IPs.
MediSave Withdrawal Limit for Integrated Shield Plan
The AWLs is as follows:
- $300 if you are 40 years old or younger on your next birthday.
- $600 if you are 41 to 70 years old on your next birthday.
- $900 if you are 71 years or older on your next birthday
Each insured person can only have one Integrated Shield Plan paid with MediSave.
MediShield Life vs Integrated Shield Plans: Claims and Amount Payable
In addition to the difference in premium amounts, there is a difference between what you can claim and the amount you have to pay in the end:
P.S. The diagram provided is purely for explanatory purposes. Note that pro-ration will be implemented for private hospital bills or public/restructured hospital bills in class A or B1 wards under MediShield Life with benefits sized for class B2 or C ward bills.
Generally, you will pay the least out of pocket if you purchased an IP with a rider, and chose treatment from a panel doctor. This out of pocket amount that you will pay will also vary according to your choice of insurer.
As MediShield Life mainly serves as basic health insurance to help Singaporeans defray subsidised medical costs i.e. treatment at Class B2 or C wards of public hospitals and subsidised outpatient treatments and day surgeries in public healthcare institutions.
MediShield Life vs Private Integrated Shield Plan: Pro-Ration
The non-subsidised bills are pro-rated before the claims under MediShield Life are computed as follows:
| Pro-ration Factors for MediShield Life Claim | ||
| Ward Class / Subsidy Status | Singapore Citizen | Permanent Resident |
| Class C | 100% | 44% |
| Class B2 | 100% | 58% |
| Class B2+ | 70% | 47% |
| Class B1 | 43% | 38% |
| Class A | 35% | 35% |
| Private Hospital | 25% | 25% |
| Community Hospital (Subsidised) | 100% | 50% |
| Community Hospital (Non-subsidised) | 50% | 50% |
| Inpatient Palliative Care Service (Subsidised) | 100% | 50% |
| Inpatient Palliative Care Service (Non-subsidised) | 50% | 50% |
| Short Stay Ward (Subsidised) | 100% | 58% |
| Short Stay Ward (Non-subsidised) | 35% | 35% |
| Day Surgery (Subsidised) | 100% | 58% |
| Day Surgery (Public Hospital Non-subsidised) | 35% | 35% |
| Day Surgery (Private Hospital) | 25% | 25% |
| Outpatient Treatment (Subsidised)1 | 100% | 67% |
| Outpatient Treatment (Non-subsidised)1, 2 | 50% | 50% |
| 1 Continuation of Autologous Bone Marrow Transplant for Multiple Myeloma will follow the outpatient pro-ration factors
2 Non-subsidised bills for outpatient cancer treatments and home parenteral nutrition will be pro-rated. Bills for dialysis-related treatments and immunosuppressants will not be pro-rated. |
||
Source: MOH
Simply put, MediShield life will cover a larger percentage of your bill if you stay in a lower class ward.
That’s not all.
If you only have MediShield Life, you will need to pay a deductible and co-insurance as follows:
To add here’s an example from MOH of how MediShield Life’s claims are computed and how much you might have to pay in the end if you opt for a subsidised ward:
However, if you opt for an unsubsidised ward (Class B1 and above) you will have to pay more as MediSheld Life’s benefits are catered towards class B2 and C wards.
Check out this example provided by MOH for a clearer picture of what this looks like:
Do note that the deductible will only have to be paid once per policy year. So if you suay suay (Hokkien unlucky) have to visit the hospital again the same year, you will not need to pay the deductible again.
You can actually purchase different tiers of IPs for broader coverage starting with the standard IP which covers B1 wards without pro-ration. Next, you can opt for an A class IP that includes coverage for A wards, and there is even a top-tier option that covers private hospitals. But do note that deductibles and co-insurance still apply.
These IPs offer additional coverage specifically for stays in Class A or B1 wards in restructured hospitals, as well as private hospitals. Additionally, there are riders available to cover the cost of deductibles (the fixed amount you need to pay before your insurance coverage starts) and co-insurance (the percentage you are responsible for after your insurance coverage starts). With a co-pay rider, you can minimise the co-insurance payment to as low as 5%.
But it is important to note that your hospital bill will balloon if you opt for a high class public hospital (B1 or A ward) or private hospital.
Integrated Shield Plan Comparison 2023
To illustrate the price difference, I will be looking at the example of a Coronary Artery Bypass Graft as heart disease is one of the top causes of death in Singapore:
| Plan Type | MediShield Life Only (Class C Ward) | MediShield Life Only (Class B1 Ward) | Integrated Shield Plan (Class B1) W/O Rider | Integrated Shield Plan (Class B1) With Rider |
| Annual Premium (Ages 21 – 30) | $252.34 (MediSave) | $252.34 (MediSave) | $300 (MediSave) + $238 (Cash) | $300 (MediSave) + $356 (Cash) |
| Hospital Bill (Coronary Artery Bypass Graft)* | $6,528 | $35,834 | $35,834 | $35,834 |
| Claim Computation Amount | $6,528 | $15,408 (43% of bill) | $35,834 (100% of bill) | $35,834 (100% of bill) |
| Less Deductible (Aged <80) | $1,500 | $2,000 | $2,500 | $2,500 (Covered by Rider) |
| Claimable Amount (Less Deductible) | $5,028 | $13,408 | $33,334 | $33,334 |
| Less Co-Payment After Deductible (Up to 10%) | $426 | $652 | $3,333 | $1,667 |
| Total Bill Paid By Insured | $5,454 | $14,060 | $5,833 | $1,667 |
Source: MOH Fee Benchmarks and Bill Amount Information, MOH and Income
*Figures include GST and are based on the median of actual transacted fees across the medical institutions for each bill component, from 1 January 2021 to 31 December 2021. They therefore provide an estimate of fees but do not necessarily sum up to the total bill amount. Figures in this table will be updated annually.
Integrated Shield Plan Premium Increase
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