Cancer Coverage Singapore: Should You Get Public or Private Health Coverage?

Singaporeans are used to hearing about the aspirational 5Cs: cash, condo, car, credit card, and club membership. But there’s another C that is much easier to get and one that we all do not want—Cancer.

I don’t mean to be all doom and gloom, but the stats are there. According to the Singapore Cancer Society, 1 in 4 Singapore residents is likely to get some form of cancer during their lifetime. 

It’s a sobering statistic, but we think it’s well worth pointing out to highlight the gravity of the situation. And cancer treatments are not cheap either.

The estimated treatment costs for late-stage cancer can range from S$100,000 to S$200,000 yearly (or S$8,400 – S$16,700 per month) … Who has that much money to pay?

That’s why getting comprehensive coverage for cancer is vital.

In this article, we’ll explore public and private coverage for cancer and what they cover to help you decide which is the best option for you.

 

Cancer coverage used to be easy

Under the previous system, MediShield Life (MSHL) covered up to S$3,000/month for all cancer drugs, and Integrated Shield Plans (IPs) often covered costs above this without a claim limit and required only a small co-payment.

If you’re not familiar with IPs, they are private insurance products that, according to the Ministry of Health, cover hospital bills and selected outpatient treatments at the Class B1 level in Singapore’s public hospitals.

They comprise 2 components: 

1. MediShield Life
2. Additional insurance coverage by a private insurance company that covers higher-class wards (B1 and above)

For more details, read our guide to Integrated Shield Plans.

If you bought an IP, you get the full benefits of MediShield Life and your private insurance. 

Unfortunately, the government implemented changes to the coverage of outpatient cancer treatment to “keep cancer treatments and insurance premiums affordable in the longer term”. This makes things a little tricky for us.

 

Implementation of the Cancer Drug List (CDL)

In 2022, the government introduced the Cancer Drug List, which specifies which cancer treatments are eligible for coverage. The CDL shows the claimable outpatient cancer treatments and the corresponding MediShield Life (MSHL) and Medisave (MSV) limits. 

Since 1 Apr 2023, the CDL has applied to Integrated Shield Plans too.

 

Implementation of MSHL Claim Limits

Another layer of rules that was implemented is the MSHL Claim Limits. 

Each drug on the CDL will have specific limits to how much you can claim from MediShield Life per month and MediSave withdrawal limits. These limits inform patients about the maximum amounts that can be claimed from their insurance and savings for each treatment. 

For example, for the drug Abemaciclib, you will be able to claim S$800 from MediShield Life and S$600 from MediSave.

Cancer Information				Clinical Indication	MediShield Life Claim Limit per Month	MediSave Withdrawal Limit per Month
Type: Breast cancer Active ingredient: Abemaciclib Dosage Form(s) and Strength(s): Abemaciclib tablet (50 mg, 100 mg, 150 mg) Subsidy Class: MAF Category: 4				Abemaciclib in combination with an aromatase inhibitor as initial endocrine-based therapy for HR positive, HER2 negative, advanced or metastatic breast cancer. Pre/perimenopausal women treated with this combination could also receive a luteinizing hormone-releasing hormone agonist according to local clinical practice.	S$800	S$600

Source: MOH

Note that the CDL does not apply to inpatient cancer drug treatments if you’re warded in the hospital, as these are covered under separate inpatient claim limits for MSHL and MediSave, along with other inpatient costs.

So, these changes mainly affect outpatient cancer treatments only.  

 

Can private cancer insurance coverage compensate low MSHL Claim Limits?

Private cancer insurance, by way of Integrated Shield Plans (IPs), can substantially increase your coverage. 

Using the same example above, the claim limit if you only have MediShield Life is S$800. But with an IP that covers private hospitals, your insurance coverage will increase by 5 times, and with the additional coverage from rider/booster, it will increase substantially by another 2 to 18 times, depending on your insurer.  

This means that for the drug Abemaciclib shown above, coverage will be between S$4,000 (no rider/booster) to S$18,400 (with rider/booster), which will comfortably cover cancer treatment costs. 

 

What are the premiums and coverage amounts for private healthcare?

You’ve probably come across a private insurer keen on selling you the IP. Here’s a quick overview of some top-tier shield plans*.

Insurer	Out-of-Pocket Annual Premium (for ages 21 to 30)	Monthly Claim Limit (CDL Drugs)	Monthly Claim Limit With Rider/Booster Purchased (CDL Drugs)
AIA HealthShield Gold Max A	S$291.80	5 times of MSHL limit	Additional 16 times of MSHL limit
Great Eastern GREAT SupremeHealth P Plus	S$226.15	5 times of MSHL limit	Additional 15 times of MSHL limit
HSBC Life Shield Plan A (Previously AXA)	S$211.40	5 times of MSHL limit	Additional 18 times of MSHL limit
NTUC Income Enhanced IncomeShield Preferred	S$211.38	5 times of MSHL Limit	Additional 10 times of MSHL limit
Prudential PRUShield Premier	S$241.43	5 times of MSHL Limit	Additional 15 times of MSHL limit
Singlife Shield Plan 1 (Previously Aviva)	S$236.33	5 times of MSHL Limit	N/A
Raffles Shield Private	S$223.61	4 times of MSHL Limit	Additional 2 times of MSHL limit

*Information correct as of 31 June 2024. Premiums are also expected to change at the discretion of insurers. 

Note that these premiums are only for those between the ages of 21 to 30. As we age, the premiums will increase as we are more prone to health risks.

Based on the numbers above, premiums may not be as high as you might think—especially when you consider that with a relatively small additional annual premium, you can substantially increase your monthly claim limits. 

For instance, with the NTUC Income Enhanced IncomeShield Preferred, you can enjoy 5 times the MSHL claim limit for CDL drugs by paying just S$211.38 in out-of-pocket expenses yearly (that’s just S$17.62 per month).

And by purchasing riders/boosters, you can enjoy a massive amount of coverage.

 

Should I get private healthcare or stick to public healthcare?

As we’ve seen above, don’t just rule out private healthcare because it’s the more expensive option—it could well be within your budget. 

And while insurance plans covering private healthcare first and foremost help with costs by increasing your claim limits, the benefits go beyond that. 

Private healthcare can enable you to access faster diagnoses, a broader range of treatments, personalised care with direct access to your oncologist, and less waiting time, which can significantly reduce your anxiety and improve your chances of a better outcome.

Regardless, it’s best to review your overall health and do your research before you decide on what’s the best healthcare coverage for you. If you end up choosing private healthcare, remember that you’ll always have the option to switch back to public healthcare at any time.

So review your insurance coverage, and if cash flow permits, make sure you and your family members are well protected with the best available insurance options locally.

 

If you know anyone who needs advice on healthcare, share this article with them!