Have you ever had a migraine, then struggled to pry the top off a child-proof bottle of aspirin? Yeah, what you need is right in front of you, but you can’t get at it. That’s how Singaporeans are starting to feel about Medisave: Our impressive healthcare plan, that’s about as accessible as a buried submarine. In this article, we look at how it could be extended:
What is Medisave?
Medisave is a nationwide healthcare plan. Part of your CPF contributions go here, and Medisave grows at 4% per annum. Two common examples of how it works:
You can claim up to $450 a day if you’re hospitalized (inclusive of $50 for doctor’s attendance). Any amount above that, you pay yourself. For day surgeries, you can claim up to $300.
Note that in order to claim hospitalization fees, you need to have been in the hospital for at least eight hours.
Medisave works on a co-payment basis. For example, say you have regular outpatient treatments for diabetes:
During an outpatient treatment, you’d pay the first $30 of your bill, and then the remaining 15%. The rest is covered by your Medisave (if there’s enough money in there). There’s a withdrawal limit of $400 per year.
For major surgeries, Medisave claim limits range between $250 to $7,550. Check out this chart. The hospital will tell you which table of operations you’re under.
There are other uses of Medisave (e.g. maternity fees, psychiatric treatment). But for the most part, it covers:
- Hospital Ward Fees
- Doctor’s Attendance Fees
- Most surgical procedures
- Some medicines and implants
If that seems like a lot, here’s a quick reminder: Your body’s ultimately a bag of soft, squishy bits, held together by skin and fluid. One malfunction, and you’ll break down faster than a Proton in third gear. Medisave doesn’t really cover as much as it should.
How about adding:
1. A Wider Range of Dental Services
Medisave does cover some dental procedures. Mainly wisdom tooth extraction, and implant surgery.
But of all the medical coverage we need, dental is the most universal. Gum disease is way more common than, say, a brain tumor or hernia.
But without delving into the science of dentistry (for which I’m as qualified as the average toaster repair man), I’ll just say toothaches affect productivity, and are common.
But with dental visits costing from $15 – $50 (depends where you go), people tend to hold off. Low income earners, the elderly, students, etc. are especially prone to ignoring dentistry; right up till the last minute. And then they’re looking at more expensive treatments, like root canals or something.
But that can be prevented by regular dental visits, which happen just twice a year. Surely it’s not too hard for Medisave to cover that?
No one’s going to wipe out a huge chunk of Medisave on biannual $15 – $50 visits. And by encouraging it, we’ll prevent some people from needing expensive dental surgery later.
2. A Wider Range of Medical Equipment
Medisave doesn’t cover certain medical equipment, such as wheelchairs, crutches, hearing aids, etc. A nurse I spoke to, who declined to be named, suggested: “If it’s outside your body, it’s probably not covered. Medisave tends to cover things like implants.”
I spoke to Mr. Harry Quek, a 73 year old retiree, who had to buy his own hearing aid:
“I asked if I could use Medisave, but they told me for hearing aids, no, cannot. I had to use a different special assistance fund.
But my family’s income exceeded the requirement; my son said we were over by $300. So I didn’t get the assistance, I had to buy the hearing aid without help. Mine cost around $1,200, and for a retiree like me that’s too much. I almost wanted to tell my son, ‘Nevermind, I will go without.’”
I understand that we don’t want to overdraw on our Medisave. But refusing someone a hearing aid to save his money? That’s like refusing to eat so you won’t run out of groceries. The whole point of healthcare is to provide for medical needs; not to grow itself like a huge, useless tumour.
3. Home Based Hospice and Palliative Care
This one is already in the news.
Home based hospice care is usually for elderly patients, who are receiving care at home. Home palliative care is for terminal patients, who choose to spend the rest of their time at home rather than the hospital.
Medisave currently provides for the latter: a $1,500 withdrawal cap, per patient, per lifetime. Because apparently, a terminally ill person has reason to maintain a big Medisave account.
Anyway, home based hospice care and home palliative care have practically the same requirements. Both should benefit from Medisave payouts. Humane and practical reasons are also in favour of this: Patients should be where they feel most comfortable, and hospitals are in need of more room.
But if Medisave covers hospital ward fees, but not home based care… you see where this is going. Some people will then choose to stay in the hospital longer, because they want to use Medisave rather than their own cash.
Amongst all the suggestions made, I’m most expecting this one to get a pass.
4. All Screening and Tests
Medisave does cover some tests and screenings. I don’t know which of the billion odd tests are or are not covered, and to what extent. For example, some X-rays are covered, but many blood tests aren’t. You’ll have to ask at the hospital.
Frankly, all the screenings and tests should be covered. This is main reason low income earners and the elderly avoid hospitals, even if they’re coughing up their organs.
What if they get sent for 10 different tests, and don’t get hospitalized? Suddenly they’re facing down a $200+ bill, not covered by Medisave. I mean, my last visit to a cardiologist had a barrage of tests, amounting to almost $800, and none of it was claimable.
Mr. Lawrence Fong, who recovered from a heart attack three years back, is especially ticked off by that:
“My Medisave is very big, let me tell you. Last time I checked it was almost $30,000. But every time I go for a heart check-up, after I do this test and that test, I end up paying almost $150. Does Medisave help at all? What’s the use of having $30,000 if I cannot use one cent?
I feel like a sick man, who is so stupid to save up for a nice funeral instead of paying the doctor.”
The reluctance to get tested means problems go unnoticed, and grow. That leads to bigger problems down the road, and then Medisave really does get wiped out.
For a summary of Medisave Withdrawal Limits, you can go here.
What else should Medisave cover? Comment and let us know!
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