When in Singapore, healthcare can be quite costly. This is also why many working adults invest in medical and hospitalisation insurance the moment they can afford it. Whenever we fall sick, most of us would tap on our private insurance or dip into our Medisave accounts for minor outpatient treatments and general doctor visits.
What happens then if we don’t have the backing of private health insurance – especially when it comes to major hospitalisations and serious medical situations? Fortunately, every citizen has a safety net with the MediShield Life health insurance scheme. To provide more comprehensive protection, the government is planning to increase premiums for MediShield Life against rising healthcare costs in Singapore.
An expert committee is put together to review measures like higher claim limits for surgeries, hospital stays, dialysis and even new cell therapies. However, to fund these enhancements, Singaporeans may have to dig deeper into their Medisave accounts. It’s a fine balance between making the premiums affordable and covering each citizen well.
More than ever before, we need to understand what this national insurance covers and excludes, especially since our monthly CPF contributions to Medisave are paying for it.
Guide to MediShield Life in Singapore 2024
- What is MediShield Life?
- MediShield Life Updates (2024)?
- Am I eligible for MediShield Life?
- MediShield Life coverage & benefits
- MediShield Life exclusions
- What is deductible in MediShield Life?
- What is co-insurance?
- How to make a MediShield Life claim?
- Does MediShield Life cover pre-existing conditions?
- MediShield Life premiums
- Can I get MediShield Life subsidies?
- What is an Integrated Shield Plan? Difference between an IP plan vs MediShield Life
1. What is MediShield Life?
Have you been told that you’ll go bankrupt if you fall seriously ill and don’t have medical insurance? Guess what, even if you’ve never spoken to an insurance agent or purchased a single insurance policy in your life, you are covered by the government-purchased medical insurance, MediShield Life.
MediShield Life is a basic medical insurance plan in which all Singaporeans and Permanent Residents (PRs) are automatically enrolled. It works in the same way as other types of health insurance. You can make a claim for certain types of medical bills, including hospitalisation and certain types of outpatient treatment.
The catch is that it is a very basic plan and there are strict limits on how much you can claim and what is covered.
For instance, if you get hospitalised, your MediShield Life payouts will only be able to cover the cost of Class C or Class B2 wards at public hospitals.
To give you an idea of the price difference, here are the median hospital bills from MOH for a complex knee joint replacement surgery at the various wards:
| Ward class | Total hospital bill |
| Public hospital: Ward C | $6,436 (subsidised) |
| Public hospital: Ward B2 | $7,753 (subsidised) |
| Public hospital: Ward B1 | $21,586 |
| Public hospital: Ward A | $24,899 |
| Private hospital | $10,220 – $14,400 |
For public hospitals alone, the moment you upgrade from Class B2/C to Class B1/A, prices more than triple. Big difference!
So if you want to stay in a higher class ward or go to a private hospital, MediShield Life won’t be enough. You’ll need to supplement your plan with an Integrated Shield plan (more on that below) for higher coverage, and/or top up the remainder in cash or Medisave.
2. MediShield Life Updates (2024)
Healthcare costs keep rising, so MediShield Life faces regular reviews to keep up. In 2024, major enhancements are on the cards based on recommendations by an expert council:
- Increasing claim limits significantly for surgical procedures and hospital stays
- E.g. Claims for angioplasty with ICU stay may need to double
- Raising outpatient claim limits for treatments like kidney dialysis
- Exploring coverage for new ground-breaking cell, tissue and gene therapies
- However, strict criteria on clinical effectiveness and cost-effectiveness will apply
To fund these expanded benefits, MediShield Life premiums look set for a fairly substantial increase. However, the government aims to ensure premiums remain fully payable by MediSave through various subsidies and top-up assistance.
Singaporeans may also have to utilise more of their MediSave for smaller medical bills like outpatient treatments typically costing a few hundred dollars or less. The government will ensure no one loses their MediShield Life coverage because they can’t afford it, including:
- premium subsidies for lower-to-middle income households,
- transitional subsidies to phase in the new premiums gradually over 4 years
- additional support for those still unable to pay after subsidies
Amidst the changes, the authorities are also clamping down on errant doctors making inappropriate MediShield claims:
- 29 cases involving $400k+ in wrongful claims uncovered since Oct 2022
- New enforcement actions from warnings to claim submission suspension
- Development of claims rules to guide proper billing practices
The goal? To ensure MediShield Life can keep providing affordable protection against large hospital bills for all Singaporeans.
3. Am I eligible for MediShield Life?
MediShield Life automatically grants all Singapore citizens and PRs lifetime protection.
If you are a PR, it’s important to note that the amount of subsidies you receive at public hospitals will be lower than what Singapore citizens receive. This is likely to result in your having to pay higher out-of-pocket charges.
You cannot opt out of MediShield Life, and have to continue paying the premiums over your lifetime—unless you live overseas and have no intention of returning. Then you can apply to opt-out.
You enjoy lifetime coverage regardless of any pre-existing medical conditions.
4. MediShield Life Coverage & Benefits
Here’s a quick look at the current MediShield Life benefits (i.e. how much you can claim). Table taken from the Ministry of Health:
| MediShield Life Coverage (Inpatient) | Claim Limits |
| Daily Ward and Treatment Charges | |
| Normal Ward | $800/day |
| Intensive Care Unit Ward | $2,200/day |
| Psychiatric (up to 60 days/year) | $160/day |
| Community Hospital (Rehabilitative) | $350/day |
| Community Hospital (Sub-Acute) | $430/day |
| Inpatient Palliative Care Service (General) | $250/day |
| Inpatient Palliative Care Service (Specialised) | $350/day |
If you’re getting hospitalised for surgery, there’s a comprehensive table of surgical procedures on the Ministry of Health‘s website that you can refer to. Find your exact surgery from that table, and then you will be able to match the cost of it here:
| MediShield Life Coverage (Inpatient) | Claim Limits |
| Surgical Procedures | |
| Table 1 A/B/C (less complex procedures) | A $240, B $340, C $340 |
| Table 2 A/B/C | A $580, B $760, C $760 |
| Table 3 A/B/C | A $1,060, B $1,160, C $1,280 |
| Table 4 A/B/C | A $1,540, B $1,580, C $1,640 |
| Table 5 A/B/C | A $1,800, B $2,180, C $2,180 |
| Table 6 A/B/C | A $2,360, B $2,360, C $2,360 |
| Table 7 A/B/C (more complex procedures) | A $2,600, B $2,600, C $2,600 |
| Implants | $7,000/treatment |
| Radiosurgery | $10,000/treatment |
| Continuation of Autologous Bone Marrow Transplant Treatment for Multiple Myeloma | $6,000/treatment |
Finally, if you’re going to the hospital for treatment as an outpatient (not getting hospitalised there), here are the benefits and claim limits:
| MediShield Life Coverage (Outpatient) | Claim Limits |
| Outpatient Treatment | |
| Chemotherapy for Cancer | $3,000/month |
| Radiotherapy for Cancer | |
| External (Except Hemi-Body) | $300/treatment |
| Brachytherapy | $500/treatment |
| Hemi-Body | $900/treatment |
| Stereotactic | $1,800/treatment |
| Kidney Dialysis | $1,100/month |
| Immunosuppressants for Organ Transplant | $550/month |
| Erythropoietin for Chronic Kidney Failure | $200/month |
| Long-term Parenteral Nutrition | $1,700/month |
Extra $3,600/year for Cancer Outpatient Costs from April 2023
Speaking of cancer outpatient treatments, there was much talk about the low MediSave withdrawal limit ($600/year) for cancer patients to use for cancer-related MRI, CT, and other scans. View MediSave withdrawal limits here.
While the MediSave withdrawal limit won’t be increased, cancer patients will be able to claim an additional $3,600/year for scans as part of their cancer treatment from April 2023. Radiotherapy cancer patients will be able to claim from the MediShield Life radiotherapy section, too.
Approved Outpatient Cancer Drugs
Another important thing to note about claiming for cancer from MediShield Life is that the outpatient cancer drugs that you use in cancer treatment have to be in the official MediShield Life Cancer Drug List to be claimable.
To see if your cancer drug is claimable and subsidised under MediShield Life, check this Ministry of Health Drug Subsidies List.
What are the claim limits for MediShield Life? You can claim up to $150,000 per policy year, but there’s no cap on how much you can claim in your entire lifetime.
| MediShield Life Maximum Claim Limit | |
| Per Policy Year | $150,000 |
| Lifetime | No Limit |
5. MediShield Life exclusions
You can’t use MediShield Life to pay for:
- Ambulance fees
- Cosmetic surgery
- Dental work (except due to accidental injuries)
- Vaccination
- Infertility, sub-fertility, assisted conception or any contraceptive operation
- Sex change operations, including their related complications
- Maternity charges (including Caesarean operations) or abortions, including their related complications, except treatments for serious complications related to pregnancy and childbirth
- Treatment for injuries arising from the insured’s criminal act
- Treatment of injuries arising directly or indirectly from nuclear fallout, war and related risk
- Treatment of injuries arising from direct participation in civil commotion, riot or strike
- Expenses incurred after the 7th calendar day from being certified to be medically fit for discharge from inpatient treatment and assessed to have a feasible discharge option by a medical practitioner
- Surgical interventions, including related complications, for the following rare congenital conditions which are severe and fatal by nature: Trisomy 13, Bilateral Renal Agenesis, Bart’s Hydrops and Anencephaly
- Optional items which are outside the scope of treatment
- Overseas medical treatment
- Private nursing charges
- Purchase of kidney dialysis machines, iron-lung and other special appliances
- Treatment which has received reimbursement from Workmen’s Compensation and other forms of insurance coverage
6. What is deductible in MediShield Life?
So, you might have read that there is a “deductible” for MediShield Life. The “deductible” is the amount of money you have to pay before you can make your first MediShield Life claim each year. This sum depends on which ward you stay in.
| MediShield Life Deductible | ||
| Age 80 and under | Age 81 and over | |
| Ward Class C | $1,500 | $2,000 |
| Ward Class B2 and above | $2,000 | $3,000 |
| Day surgery | $1,500 | $2,000 |
| Outpatient Treatments | – | – |
You will only have to pay the deductible once a year, even if you make multiple claims in that year.
Example:
You get hospitalised twice in a year, and in both cases, you get warded in a Class B2 ward. Your first medical bill is $8,000 and the second is $4,000, adding up to a total of $12,000.
Being under 81 years old, you would thus pay a deductible of $2,000 after your first hospital visit. As deductibles are only payable once a policy year, you would not have to pay any deductible when claiming your second visit.
7. What is co-insurance?
The deductible isn’t the only money you need to fork out to make a MediShield Life claim.
You will also have to pay co-insurance, which is calculated as a percentage of the amount you’re trying to claim. While the deductible is charged only once a policy year, co-insurance must be paid each time you make a claim.
The amount of co-insurance you must pay varies according to the size of your bill.
| Amount being claimed | Co-insurance |
| $0 to $5,000 | 10% |
| $5,001 to $10,000 | 5% |
| > $10,000 | 3% |
Example: Let’s take the example in the previous section, where you incurred two hospital bills worth $8,000 and $4,000 respectively, and paid a deductible of $2,000 after the first hospital visit.
After paying your deductible, you’ve still got $10,000 worth of expenses.
After the first hospital visit, which cost $8,000, you paid a deductible of $2,000. You would then submit a claim for $6,000. The co-insurance portion for that sum is 10% of the first $3,000 and 5% of the next $3000, so you would pay $450 and claim the remaining $5,550.
For the second hospital visit, there is no deductible, so you can submit a claim for the entire bill of $4,000. The co-insurance portion is 5% for the first $2,000 and 3% for the next $2,000 so you would pay co-insurance of $160, and then receive $3,840 worth of MediShield Life payouts.
In this scenario, your total medical bill of $12,000 is broken down as follows:
| MediShield Life payout | $9,390 |
| Deductible (paid by you) | $2,000 |
| Co-insurance (paid by you) | $610 |
| Total medical bills | $12,000 |
As you can see, to cover your medical bills totalling $12,000, you would have to fork out $2,610, and the rest would be paid by MediShield.
8. How to make a MediShield Life claim?
The claims process differs depending on whether you have purchased an Integrated Shield Plan (i.e. A private health insurance policy that works in tandem with MediShield Life), or whether you will be relying solely on MediShield Life.
If you don’t have an Integrated Shield Plan…
You’re probably wishing you had an Integrated Shield Plan right now. The good news, if we can call it that, is that the paperwork for your MediShield Life claim will be handled by the staff at your hospital or other healthcare provider.
Once you are admitted, inform the staff that you wish to make a MediShield Life claim to pay part of your bills. The medical institution will submit your claim on your behalf after receiving your authorisation.
The MediShield Life payouts will be computed based on the relevant benefits and claim limits, taking into account the deductible. You can then use your Medisave or cash to pay for the co-payment amount.
The MediShield Life payout will be released to the medical institutions by the CPF Board after the claim has been processed.
If you have an Integrated Shield Plan (IP)…
Contact your insurer or agent immediately when you know you’re going to be admitted to a hospital. Inform the hospital staff that you wish to pay your bill using your IP.
MediShield Life is included in all IPs. IPs comprise 2 components—the MediShield Life components are run by the CPF board and the additional private insurance coverage component is run by the insurance company.
Your insurer will process your claim and send payment to the hospital or other medical institution on your behalf. They will also handle the documentation for your MediShield Life claim, and the portion of your bill paid by MediShield Life will automatically be sent to the medical institution.
Whether you have an IP or not, any sums on your bill that cannot be covered by MediShield Life or your IP will be dutifully billed to you.
9. Does MediShield Life cover pre-existing conditions?
Unlike most health insurance, MediShield Life covers all pre-existing medical conditions. If you joined MediShield Life with one of the below pre-existing conditions (e.g. in the case of PRs) you will need to pay 30% additional premiums for 10 years.
| Pre-Existing Conditions | Some Examples… |
| Cancer | Lung cancer, colorectal cancer, breast cancer, stomach cancer |
| Blood disorders | Aplastic anaemia, thalassemia major |
| Degenerative diseases | Parkinson’s disease, muscular dystrophy, amyotrophic lateral sclerosis (ALS) |
| Heart or other circulatory system diseases | Heart attack, coronary artery disease, chronic ischaemic heart disease |
| Cerebrovascular diseases | Stroke |
| Respiratory diseases | Chronic obstructive pulmonary disease |
| Liver diseases | Alcoholic liver disease, chronic hepatitis, fibrosis or cirrhosis of the liver |
| Autoimmune / Immune System diseases | Systemic lupus erythematosus, HIV, AIDS |
| Renal diseases | Chronic renal disease, chronic renal failure, chronic nephritic syndrome |
| Serious congenital conditions | Congenital heart disease, congenital renal disease biliary atresia |
| Psychiatric conditions | Schizophrenia |
| Chronic conditions with serious complications | Hypertensive heart disease, hypertensive kidney disease, diabetes with kidney complications, diabetes with eye complications |
After 10 years, your premiums go back to normal. Additional premiums are Medisave-payable.
10. MediShield Life Premiums
Of course, somebody’s got to pay for MediShield Life. You will have to pay MediShield Life premiums annually, and these premiums will rise as you age. The premiums in the table below apply for policy start or renewal dates on or after 1 Jan 2024 and are before any subsidies:
| Age Next Birthday | Annual MediShield Life Premiums |
| 1-20 | $147.71 |
| 21-30 | $254.67 |
| 31-40 | $397.29 |
| 41-50 | $534.81 |
| 51-60 | $814.95 |
| 61-65 | $1,039.07 |
| 66-70 | $1,120.56 |
| 71-73 | $1,217.34 |
| 74-75 | $1,344.67 |
| 76-78 | $1,558.60 |
| 79-80 | $1,619.72 |
| 81-83 | $1,706.31 |
| 84-85 | $1,971.17 |
| 86-88 | $2,062.85 |
| 89-90 | $2,062.85 |
| >90 | $2,093.41 |
The good news is that you can pay 100% of your MediShield Life premiums using Medisave.
Your premiums will be automatically deducted from your Medisave account if you have enough. Or, your immediate family members may pay your premium using their Medisave.
11. Can I get MediShield Life premium subsidies?
Yes, there are MediShield Life premium subsidies for lower, middle, and upper income groups. You can get discounted premiums ranging from 15% to 50%, depending on your income level.
Here are the MediShield Life subsidy for lower-income families ($0 to $1,200 household monthly income per person):
| Age Next Birthday | Lower-Income
$0 – $1,200 |
Lower-Middle-Income
$1,201 – $2,000 |
Upper-Middle-Income
$2,001 – $2,800 |
| 1 – 40 | 25% | 20% | 15% |
| 41 – 60 | 30% | 25% | 20% |
| 61 – 75 | 35% | 30% | 25% |
| 76 – 85 | 40% | 35% | 30% |
| 86 – 90 | 45% | 40% | 35% |
| > 90 | 50% | 45% | 40% |
In addition, to receive any subsidies at all, you must live in a residence with an annual value of $13,000 or less. If you live in a residence with an annual value of between $13,001 and $21,000, your subsidy rates will be cut by 10%.
What is a property’s annual value? In layman’s terms, it’s the basic rental price and income your house can fetch if you rent it out.
Oh yes, and those who are part of the Pioneer Generation (born before 31 Dec 1949, and became a Singapore citizen before 31 Dec 1986) get 40% to 60% in MediShield Life premium subsidies from age 66 onwards.
Meanwhile, the Merdeka Generation gets a 5% premium subsidy from age 60 to 75, and a 10% subsidy from age 76 onwards.
12. What is an Integrated Shield Plan? Difference between IP Plan vs MediShield Life
You’ve already heard that you can’t rely solely on MediShield Life because of how basic it is.
But the solution is pretty easy: Upgrade your coverage is to opt for an Integrated Shield Plan (IP), which can be paid for with Medisave. There are 7 insurers that provide IPs in Singapore.
Integrated Shield plans comprise the MediShield Life base plan + additional private insurance provided by the insurance company. So there’s no duplicate here.
One of the biggest benefits of getting an IP is having being covered for staying in private hospitals or upgrading to Class B1 and A wards. This also gives you the chance to choose your doctor, with the possibility of shorter queues and wait times. You can also buy riders for your IP to receive even greater coverage.
The downside is obviously that you’ll be paying higher premiums if you have an IP, and there may be a cash portion that cannot be paid using Medisave. These premiums may be affordable when you’re young, but they’ll rise as you age and can eventually get quite hefty.
For more details, check out our Integrated Shield plan comparison.
Keeping MediShield Life Affordable and Sustainable
With new medical conditions and treatments, the upgrades to MediShield Life promise to offer better coverage. While it may cost more, we can be assured that everyone gets the basic medical care they deserve. Premiums will stay affordable with ample coverage for all Singaporeans through government subsidies and Medisave.
For those who can spare extra cash, we encourage you to invest in a good private insurance policy to cover the gaps Medishield can’t or simply offer the option of better quality treatment when the situation arises.
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