SINGAPORE — Compulsory enrolment in the ElderShield scheme and a lowering of the registration age to 30 from the current 40 are among the key recommendations made by the committee appointed to review the severe disability insurance to ensure that Singaporeans have sufficient coverage for their long-term care needs.

Lowering the enrolment age by 10 years will allow people to start contributions earlier, and in turn ensure that annual premiums are kept affordable, said the 14-member ElderShield review committee on Tuesday (Jan 30), at a media conference to give an interim update on its key proposals.

“ElderShield is meant as a key pillar of our national social safety net and we want people to start thinking about it (earlier)... They need to start to set aside some money as there is high risk that they may need some help (when they are older),” said committee chairman Chaly Mah.

About one in two Singaporeans who are healthy at the age of 65 are at risk of having a severe disability later on, but Singaporeans tend to “underestimate and under-appreciate” this risk.

According to the Health Ministry’s (MOH's) estimates, about three in 10 Singaporeans live 10 more years after they suffer a disability.

So in line with the principle of collective responsibility and supporting Singapore’s aim of being a caring and inclusive society, the committee recommends making the current opt-out scheme mandatory for Singaporeans once they hit the enrolment age, and to include those with pre-existing disabilities and conditions.

Its other proposal of lowering the scheme’s inclusion age also allows premiums to be spread out across a larger pool of policyholders.

ElderShield began in 2002, paying out S$300 or S$400 a month to policyholders who cannot independently perform at least three out of six activities of daily living — eating, bathing, dressing, transferring (from the chair to bed, for instance), going to the toilet, and walking or moving around. The payouts last for five or six years, depending on when policyholders joined the scheme.

Currently, all citizens and permanent residents with Medisave accounts are enrolled in ElderShield at the age of 40, unless they opt out.

Someone who joins ElderShield at the age of 40 pays S$175 (males) or S$218 (females) annually in premiums.

If the proposal for universal coverage is taken up, Singaporeans will not be allowed to opt out. Cost of premiums and payouts are also likely to go up, said Mr Mah, but he added that the committee is still in the process of reviewing the structure of premiums and payouts under the enhanced scheme.

From 2002 to end-2015, about S$2.6 billion was collected in premiums and around S$100 million was paid out in claims. The MOH did not share more recent figures on Tuesday for premiums collected, but said about S$114 million was paid out in claims from 2002 to end-2016.

The committee proposes that the Government offers support for lower-income Singaporeans and those with financial disabilities so that they do not lose ElderShield coverage.

It also recommends that the Government takes over as the single administrator of ElderShield, which is currently insured by one of three private insurers — Aviva, Great Eastern or NTUC Income.

“Government administration would also offer more flexibility for future scheme enhancements, while still ensuring that the scheme remains sustainable over the long-term,” said the committee.

The Health Ministry had said in July last year that they were studying this proposal.

However, the private insurers will still be able to offer supplementary plans.

The committee, which consulted over 800 Singaporeans over 26 focus group discussions, is also recommending improvements to claims processes, such as by expanding the pool of ElderShield assessors to include physiotherapists and occupational therapists. 

The current pool includes 126 general practitioners who conduct assessments in their clinics, and 14 who do house calls.

The committee, which will submit full recommendations to MOH by the middle of this year, is also mulling over a name change for the scheme.

In a Facebook post, Senior Minister of State for Health Chee Hong Tat said he welcomed the interim recommendations.

“The enhanced ElderShield will enable Singaporeans to pool our risks and resources in preparation for old age, when one faces higher risks of becoming severely disabled,” he said, adding that the insurance scheme is an important pillar of Singapore’s social safety net as its society ages.

He added that the Government will look at providing premiums subsidies to keep the premiums affordable for lower- and middle-income Singaporeans.

“This reflects our values in building an inclusive society, where we help and care for one another.”