MediShield Life claim limits to be reviewed more frequently, but have to stay: MOH

SINGAPORE — There have to be limits on the amount that patients can claim through MediShield Life, or there would be significant increases in premiums for all Singaporeans.

Making this point in Parliament on Tuesday (Jan 15), Senior Minister of State for Health Edwin Tong said that if claim limits were to be removed, Singaporeans would see their MediShield Life premiums increase “to the order of 30 per cent or more”.

However, the Ministry of Health (MOH) will review claim limits more frequently in future, he added.

After completing its current review, which began last year – the first since MediShield Life was enhanced in 2015 – the Government will review the claim limits once every three years, he said.

Mr Tong was responding to questions from Members of Parliament Tin Pei Ling, of Marine Parade Group Representation Constituency (GRC) and Murali Pillai, of Bukit Batok, on the national health insurance scheme, which is compulsory for all Singaporeans.

Both wanted to know what the MOH was doing to ensure that MediShield Life continued to offer adequate coverage for large medical bills.

Their questions followed a report in The Straits Times late last year about Mr Seow Ban Yam, an 83-year-old who underwent eye surgery and discovered that the insurance scheme had only disbursed S$4.50 to help foot his subsidised bill of S$4,477.

KEEPING UP WITH HEALTHCARE COSTS

When MediShield Life was enhanced in 2015, the claim limits were set at a level that would fully cover 9 out of 10 subsidised bills.

The latest available figures show that today, 8 in 10 subsidised bills remain fully within the MediShield Life claim limits, Mr Tong told Parliament, partly due to higher healthcare costs.

“We will review this, and adjust the limits as necessary,” he said.

“However, even at present rates, in respect of the bills which fall outside the claim limits, about half exceed the claim limits by S$230 or less.”

MR SEOW'S CASE

Explaining what had happened in Mr Seow’s case, Mr Tong recounted that the elderly patient had undergone a duct drainage procedure at the Singapore National Eye Centre (SNEC).

It was performed by a senior consultant in an operation that took three hours and was complex given his age, Mr Tong said.

“It is also not common for the procedure to be performed on both eyes at the same time, and this was only done for seven patients out of 42,000 procedures performed by SNEC that year,” he noted.

Mr Seow’s bill was about S$12,000 before subsidy.

Of this amount, the Government subsidised about S$7,500, leaving a balance of about S$4,500.

This was S$1,400 above the MediShield Life claim limit.

As a result, the insurable amount from his bill was only S$5.00, with MediShield Life covering 90 per cent, or S$4.50. Mr Seow paid the remaining amount using his MediSave.

Mr Tong noted that MOH has since asked SNEC to review its charges, and SNEC has decided to scale down its fees for this procedure and a number of other complex procedures with higher fees, from March 1.