MOH posted a reply to a letter written in the Straits Times forum about a  couple’s newborn being rejected from Medishield.

According to MOH, it was not a case of rejection but more of a deferment as the baby was still undergoing medical treatment at the point of application. The couple can apply again for the Medishield after they have obtained the relevant medical reports although the existing condition could probably be excluded.

While it is good to get a clarification from MOH, one wonders how many other people who had been deferred might have fallen under the radar if they had not gone on to seek a proper clarification like what the couple had done.

There was an article on the Straits Times forum yesterday written by a parent whose child was denied the Medishield plan by CPF.

It was unfortunate that CPF did not want to cover the child, and it seemed to go against the  Health Minister Khaw Boon Wan’s announcement that every newborn baby will have basic medical insurance coverage at birth.

There was an earlier case of a newborn with congenital defects being excluded, but from the reply it seemed to imply that at least they would still be covered by Medishield with an exclusion for the congenital defect.

This does not seem to be the case here.  Hopefully, MOH can shed some light on this issue.

When it comes to medical insurance for adults, the situation is much clearer. However, there are some things you should take note of. These points relate to the Medishield and private integrated shield plans.

1. When you apply for a medical plan, pre-existing conditions are automatically excluded (whether you are aware of it or not). The acid test comes at the point of claim since the doctor will be able to report on when the condition first developed. For example, if a tumor started growing one year ago (unknown to you) but you only applied for the medical insurance six months ago, then it won’t be covered.
2. Therefore, you should not wait until you develop a medical condition before you start looking for medical insurance. Switching plans should also be avoided unless really necessary.
3. If you are aware of a medical condition but fail to disclose it in your application, it is a form of non-disclosure. Once discovered, the insurer can choose to amend your policy to exclude that condition or even worse void your policy altogether.
4. There are certain medical conditions whereby an insurer will reject your application outright. This need not be serious conditions but can be (what might appear) a minor thing like being diagnosed with high cholesterol before the age of 35. The conditions that trigger this automatic decline will differ from insurer to insurer.
5. For people that fall into the above category (4), they can apply with a certain insurer under the moratorium option with no medical underwriting. This offers guaranteed acceptance into the plan no matter what their underlying condition is. Of course, the underlying conditions will still be excluded. However, it is important that such people are aware of this option and do not go and apply with other insurers as one of the conditions to take up the moratorium option is that they have NOT been rejected by any insurer before.

Free Child Upgrade Campaign: 11 May 2009 – 30 September 2009

From 11 May 2009 (Monday) last week, Incomeshield launched a new campaign: Free Upgrade for Children.

NTUC income will offer all children in Singapore a one-year free upgrade from MediShield to their Standard Incomeshield Plan B. This offer is available to all Singapore citizens and permanent residents aged 16 and below, who do not hold an integrated Shield plan by NTUC Income or other insurers.

This decision comes amidst growing a concern to help needy families affected by the economic downturn. Further, in periods like the present, where there is an ongoing flu pandemic, a health insurance policy like Incomeshield provides cover against a gamut of ailments and defrays the hospitalization expenses incurred on medical treatments.

Parents who wish to upgrade their children’s MediShield plan may do so between 11 May and 30 September.  Those whose children are on MediShield will continue paying the $33 yearly premium, and NTUC Income will absorb the $19 it costs to upgrade to Standard Incomeshield Plan B, which costs $52 a year. Those who want to upgrade their children to a higher plan than Plan B, we will give a $19 discount on the first year premium as well.

Another good news is that for NTUC members, instead of offering Standard Incomeshield Plan B, NTUC will offer their children an Enhanced Incomeshield Basic plan instead. The parents will only need to pay $33 and get an Enhanced Incomeshield Basic Plan worth $70 a year, this works out to a discount of $37. This $37 discount may be applied to other higher Enhanced Incomeshield Plans as well, with the offer similarly limited to a one-year term.

All children, on age next birthday must be aged 16 and below, policy submitted on 11 May onwards till 30 Sep 09 will be automatically given $19 discount. 

Some main points to highlight :

1) New Business only

Please note that this campaign is for new business only, any change of plans or adding riders will not be entitled to the discount.

2) Foreigners

The life to be assured must be Singaporean Citizens or Permanent Residents. Foreigners are not entitled to the discount.

Further Comments

This promotion by NTUC is essentially a discount of $19 for the first year (or $37 if you are a NTUC member) if your child takes up an integrated shield plan with NTUC. 

An integrated shield plan is essential for everyone and should be taken up as early as possible to ensure proper hospitalisation and surgery (H&S) insurance coverage for life.

Certain medical conditions developed later on in life might cause a person to become uninsurable – meaning insurance companies will reject an application for H&S cover.

While the discount by NTUC is a good incentive for people to buy a proper H&S plan for their children, do consider your circumstance carefully before taking up the Plan B that is being offered.

You should really take up a plan that is suitable for the kind of ward you intend to stay in if you are ever hospitalised. Should you take up a higher plan, you will still enjoy the $19 discount.

Starting from 1st January 2009, patients staying in B2 and C class wards in public hospitals will have to undergo means testing to determine the amount of subsidy they will get. This new rule will affect people (in the form of higher bills) earning more than $3200/month (or unemployed but staying in private property) and who opt to stay in C or B2 wards when they are hospitalised.

The means testing will be based on a person’s level of income filed with IRAS. Different income bands will receive a different amount of subsidy. If you do not wish to allow your income levels to be checked by the hospital, you can refuse it. However, that will mean you automatically get the lowest level of subsidy.

For those people who are not working, it will be based on the value of the property they are staying in. Those staying in a property with an annual value of $11k or less will continue to receive the full subsidy. This system does have some limitations. Some retirees who are staying in private houses are already thinking of declaring a tuition income of few hundred dollars a month in order to enjoy the full subsidy.

The current subsidy of class C wards is 80% while that of B2 wards is 65%. Through means testing, the level of subsidy can go down to as low as 65% for C and 50% for B2. (Note: The subsidies for PRs are 10% lower)

While the drop is percentage might seem little at only 15%, don’t let that number deceive you. It does not mean your bill will increase by only 15%.

For C ward, paying 35% of the unsubsidised  bill compared to paying 20% of the unsubsidised bill is an increase of 75% from the current bill size.

For B2, 50% compared to 35% is an increase of 43% in your bill size.

For more information on Means Testing, you can refer to the MOH FAQ on Means Testing.

One particular question addresses those people who are currently only on the basic Medishield plan.

Will my claim from MediShield be affected?

As most patients are not affected by means-testing and will continue to enjoy full subsidies of 65% at Class B2 and 80% at Class C, most patients’ claims from MediShield will also not be affected by means-testing.

However, as MediShield premiums are the same for all insured members in the same age group, MediShield payouts are therefore similar for all insured members, regardless of subsidy status.

To ensure a fair payout across all MediShield insured members for the same treatment received, Class B2 or C patients who are affected by means-testing will have their claims adjusted such that it would be similar to that of patients receiving maximum subsidy.

Should you be affected by means-testing, you may wish to consider applying for an increased coverage under a Medisave-Approved Integrated Shield Plan. Integrated Shield Plans are offered by the following participating insurers: AIA, Aviva, Great Eastern, NTUC Income and Prudential.

What this means is that if you are affected by means testing, will have to bear the cost of the increase yourself. If you wish to find out more about how private shield plans can help you in terms of providing for medical insurance coverage, feel free to  contact me for further details.

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