How this affects IP riders

What are these changes?

MOH recently released guidelines requiring all insurers to incorporate two features in new Integrated Shield Plan (IP) riders. Moving forward, new rider policyholders will:

Why is this necessary?

CO-PAYMENT CAP

A co-payment cap will be applied during the policy year if treatment is sought from one of the insurer’s preferred healthcare providers or if the treatment has been pre-authorised.

The minimum co-payment cap insurers can apply is S$3,000.

Pay 5% of the bills or the co-payment cap, whichever is lower

IF TREATMENT IS SOUGHT FROM THE INSURER’S PREFERRED HEALTHCARE PROVIDER OR

HAS BEEN PRE-AUTHORISED

IF TREATMENT IS NEITHER SOUGHT FROM THE INSURER’S PREFERRED

HEALTHCARE PROVIDER NOR PRE-AUTHORISED

CO-PAYMENT

Need to pay, out-of-pocket, at least 5% of their hospitalisation/outpatient treatment/day surgery bills.1

1 Net of any rider cash benefit payouts.2 Assuming co-payment cap of S$3,000.

This is part of collective efforts to ensure that healthcare and health

insurance remain available and affordable in Singapore.

FOR FULL COVER IP RIDERS PURCHASED FROM 8 MARCH 2018 TO 31 MARCH

2019 (BOTH DATES INCLUSIVE)

Policyholder will continue to enjoy the current cover. We will continue to monitor and proactively manage our claims experience. Should any change be required, we will reach out to inform our policyholders at

least 31 days before it takes effect.

FOR FULL COVER IP RIDERS PURCHASED BEFORE 8 MARCH 2018

FOR IP RIDERS PURCHASED FROM 1 APRIL 2019

How will this affect new IP riders’ coverage?

Case illustrations after implementation2

When will this be implemented?

Pay 5% of the bills, with no cap

DEDUCTIBLE

CO-INSURANCE

S$3,500

(10% X (S$200,000 - S$3,500))

ASSUMING JOHN’S MEDICAL BILL AMOUNTED TO

OUT-OF-POCKET PAYMENT(5% CO-PAYMENT)

DEDUCTIBLE

CO-I

NSUR

ANCE

IP + MEDISHIELD LIFE PAYOUT

S$200,000

S$19,650

S$23,150(S$3,500 + S$19,650)CO-INSURANCE

TOTAL DEDUCTIBLE &

TREATMENT WITH NON-PREFERRED PROVIDER & NO PRE-AUTHORISATION

S$10,000TOTAL OUT OF POCKET

S$13,150

(5% X S$200,000)

(S$23,150 - S$10,000)

RIDER PAYOUT(TOTAL DEDUCTIBLE & CO-INSURANCE - OUT OF POCKET)

TREATMENT WITH PREFERRED PROVIDER OR WITH PRE-AUTHORISATION

S$3,000TOTAL OUT OF POCKET

S$20,150

(5% OUT OF POCKET PAYMENT CAPPED AT S$3,000)

(S$23,150 - S$3,000)

RIDER PAYOUT(TOTAL DEDUCTIBLE & CO-INSURANCE - OUT OF POCKET)

DEDUCTIBLE

CO-I

NSUR

ANCE

IP + MEDISHIELD LIFE PAYOUT

OUT-OF-POCKET PAYMENT(5% CO-PAYMENTCAPPED AT S$3000)

The rider must be transitioned to the new IP rider from the first renewal

from 1 April 2021.

All insurers must offer the new IP rider with co-payment

by 1 April 2019.