Integrated Shield Plans (Health Insurance) in Singapore: Guide for 2020

By now, you must’ve heard about the Integrated Shield Plan.

It has different names – shield plan, hospitalisation insurance, private health/medical insurance, etc.

But do you really know what is it and how it works?

In this page, you’ll find out everything about it.

So, read on!


This page is part of the Health Insurance 3-Part Series:


Too Long; Didn’t Read

But First, What is MediShield Life?

In Singapore, the cost of healthcare is getting expensive. In fact, it’s increasing at 10% per year – multiples of the general inflation rate.

As a result, the average hospital bill has increased significantly.

If we were to zoom into cancer, which is one of the most common critical illnesses in Singapore, it poses a bigger issue.

Every day, 38 are diagnosed. And the lifetime risk of getting cancer is 1 in every 4-5 Singaporeans.

The cost to treat it can be very high. The treatment of late-stage cancer can cost $100,000 to $200,000 yearly.

cancer treatment cost singapore

These statistics show the importance of health insurance to protect against huge medical bills.

Fortunately in Singapore, all Citizens and Permanent Residents are automatically covered under MediShield Life.

It is a basic medical insurance to mainly cover inpatient and outpatient treatments.

MediShield Life is one of the few national healthcare schemes. Its counterparts are ElderShield and CareShield Life – both provide long term care support in the form of monthly payouts if one were unable to perform 3 out of 6 Basic Activity of Living (ADLs).

What is an Integrated Shield Plan (IP)?

As MediShield Life provides the most basic of hospitalisation insurance, it does come with limitations.

On its own, those who wish to have a more comprehensive cover are unable to do so.

And that’s when the Integrated Shield Plan (IP) comes in.

It is a private health insurance plan that can be purchased on top of MediShield Life (integrated with it). This ultimately provides additional benefits and more options to cater to your specific needs.

Which Insurance Companies Provide Integrated Shield Plans?

Currently, there are only 7 companies that offer shield plans:

  • AIA
  • Aviva
  • AXA
  • Great Eastern Life
  • NTUC Income
  • Prudential Assurance
  • Raffles Health Insurance

Take note that you can only be insured under 1 insurance provider.

Therefore, if you’re thinking of replacing or switching your existing IP plan, it can have a detrimental effect, especially when you have pre-existing conditions. Speak to a financial advisor first.

How to Check Whether You Have an Integrated Shield Plan

To check whether you’ve upgraded before, follow these steps:

  1. Go to https://www.cpf.gov.sg/
  2. Log in using your SingPass
  3. Click on “My Messages”
  4. Scroll to “Healthcare”
  5. Look at the MediShield Life/Integrated Shield Plan section

If you have an IP, you would see something like this:

how to check for integrated shield plan

Note: It doesn’t give any details on what plan you’re or whether you have a rider attached. That information has to be gotten from the insurance company. Drop a call to them directly if you wish to know the details.

How Does the Integrated Shield Plan Work

This is an overview of how both the MediShield Life and the Integrated Shield Plan work together:

how integrated shield plans work

In an Integrated Shield Plan, there are 3 components:

  • MediShield Life
  • “Basic” Upgrade
  • Rider

Note: The “basic” upgrade and the rider components form the Additional Private Insurance Coverage.

Much have been said on MediShield Life here, so I won’t touch on it in detail again.

Here’s a short summary of it:

  • Claim limits
  • Basic cover with no pre/post hospitalisation coverage, etc
  • Pegged to B2/C class wards
  • Premiums fully payable by MediSave

If you realised, MediShield Life is included when you purchase an IP plan.

Does it mean that there will be duplicate coverage or you’re paying double the premiums?

No.

It just means that the private insurance company handles that MediShield Life component for you, and they will be the single point of contact.

So that’s MediShield Life.

Let me break down the other 2 components – the “basic” upgrade and the rider.

The “Basic” Upgrade of an Integrated Shield Plan

Here are the various options you can upgrade to:

  • Private
  • Government A1
  • B1
  • Standard

So let’s say you decide to upgrade to be covered under private hospitals, and you chose to go to a government hospital, there’s no issue.

However, if you’re only covered for government hospitals and go to a private hospital, you’ll still need to fork out a substantial amount as the “basic” upgrade only covers a proportion of the bill at the private hospital (pro-ration factor).

That’s why most people go for the private option but in the end, it’s still up to your needs and budget.

Furthermore, if in the future you find the premiums too costly, you can always reduce your coverage to government hospitals and pay lesser premiums. It’s not a problem to downgrade.

However, if you were to start with government hospitals and want to upgrade in the future, a whole new round of health underwriting will take place again.

And if new medical conditions developed prior to the upgrade, there’s a possibility that you may not be able to enjoy the higher level of cover.

Main Benefits

1) Get your preferred type of ward

An upgrade allows you to choose what type of wards you want to be covered. It’ll mean that you’re not limited to B2/C class wards which are 5-9 bedders.

If you prefer the private space to recover when the need arises, having that option is valuable.

Not only that, you can choose your preferred hospital or specialist.

2) Higher claim limits

In MediShield Life, there is a cap to how much you can claim for inpatient and outpatient treatments, and you’ll need to fork out the excess.

If you upgrade, the eligible treatments including surgeries are usually “as charged” (still subject to deductible and co-insurance).

This provides you with the peace of mind that large bills will be greatly taken care of.

3) Pre and post hospital treatments

MediShield Life does not cover this aspect, but IP plans do.

Pre-hospital treatments include certain consultations and diagnostic costs that were incurred before you were hospitalised. They have to be related to the reason why you were warded.

Post-hospital treatments include follow up treatments that are needed for you to recover.

The length of period for pre and post hospital treatments may vary from company to company.

These are the 3 reasons why people apply for IP plans, but there are other additional benefits too.

Premiums

Similarly to MediShield Life, the premiums increase with each age-band. However, the “basic” upgrade of an IP may not be fully payable by MediSave as there are withdrawal limits.

The premiums you’d pay for the “basic” upgrade are on top of what you’re paying for MediShield Life. The withdrawal limit only applies to the additional premium of the private insurance component, and does not include the premiums of MediShield Life.

Here are the yearly Additional Withdraw Limits (AWL):

  • $300 if your age next birthday is 40 years old or younger
  • $600 if your age next birthday is 41 to 70 years old
  • $900 if your age next birthday is 71 years or older

EXAMPLE
If you’re 35 years old and the premium for the “basic” upgrade component is $350, you can pay $300 from MediSave and the remaining of $50 will be in cash. If the premium is $250, then it can be fully payable by MediSave.

But in IP plans, there’s still something called the deductible and co-insurance.

Deductible and Co-insurance Apply

What is a Deductible?

If a claim arises, the deductible is a fixed amount that you would need to pay once each policy year. The amount depends on which type of ward you stayed in. The purpose of this is to filter out smaller claims to make the overall premiums of the plan affordable.

Here are the deductibles (for age 80 years and below next birthday):

  • Class C ward – $1,500
  • Class B2/B2+ ward – $2,000
  • Class B1 ward – $2,500
  • Class A ward – $3,500
  • Private – $3,500

What is Co-insurance?

Co-insurance is a percentage of the of claimable amount. You’ll need to pay the co-insurance on top of the deductible. The co-insurance is at 10% for IPs.

Illustration:

Bill$100,000
Deductible (Private Ward)$3,500
$96,500
Co-insurance (10%)$9,650

So with a “basic” upgrade, you’ll still need to fork out $13,150 ($3,500+$9,650) out of a bill of $100,000. The rest of the amount, $86,850, can be claimed.

The deductible and co-insurance can still be a big amount to pay out-of-pocket, and that’s when the rider component comes in …

The Rider of an Integrated Shield Plan

The rider allows you to get the most comprehensive medical insurance coverage.

You must have the “basic” upgrade to be able to add on the rider. And both must come from the same insurance company.

Main Benefits

The main reason why most add on the rider is because they want to reduce out-of-pocket expenses (caused by the deductible and co-insurance).

The secondary reason is that having the rider gives even more benefits.

The Old “Full” Rider

(You can skip this section if you’re not interested in the past)

If you’ve applied for an IP plan with a “full” rider in the past (before 8 March 2018), it would’ve meant that you’re able to cover the full bill, including the deductible and co-insurance, thus, eliminating out-of-pocket expenses.

However, there were 2 implications – over-consumption and over-charging.

One was able to claim for anything, and for the full amount, leading to more claims and bigger claim sizes. At the same time, hospitals may over-charge knowing that the patient is under a “full” rider.

This led to a drastic increase in healthcare costs. Insurance companies had to pay out more and it became unsustainable. That’s why insurance companies made many upward revisions to their premiums over the years.

IF YOU REALISED BY NOW
The premiums of IP plans which cover private hospitals and with the “full” rider, have been substantially increased till the point that it may not be feasible to stay on that level of coverage now. Several “value” options may be available. But you should speak to a financial advisor first.

That’s when the industry-wide change came in.

The New Rider (With 5% Co-Payment)

Because of the recent industry changes, the old “full” riders are not available anymore.

As for those who purchased the old riders from 8 March 2018 up to 31 March 2019, they WILL need to transit to the new riders from 1 Apr 2021.

These new riders can still substantially cover the deductible but you’ll need to co-pay 5% of the bill. Most insurers have the co-payment capped at $3,000/year (terms and conditions apply).

Generally, to fulfil these conditions, you’ll need to obtain pre-approvals/authorisation, and preferably select specialists from the insurance company’s panel. The exact conditions differ from company to company.

The new riders still make a lot of sense because they protect you from needing to pay for larger out-of-pocket expenses, and their premiums are relatively cheaper than the old riders.

Premiums

Premiums for the riders are only payable using cash. Likewise, they increase with each age-band.

Can Foreigners Purchase These Shield Plans?

There may be only 2 options available if you wish to get a private medical insurance as a foreigner.

International health insurance and local health insurance.

The pros with international is well, you’re covered for other countries. However, the premiums that you pay tend to be much higher. In comparison to a local health insurance like the IP, the premiums are affordable but the coverage is meant to be in Singapore. So it ultimately depends on your needs.

If you’re a Singaporean or a PR, you’re able to get an IP for your dependents if they have valid passes in Singapore.

You may also use your MediSave to pay for such plans.

There may be slight differences administratively, but the core benefits still stay the same.

Company/Group Insurance vs Private Medical Plan

The question that’s asked the most:

“What if I’m Covered Under Company/Group Insurance?”

There are a few things to take note…

Firstly:

Can you foresee being with that company forever?

If you get your own private medical plan, you’ll be covered no matter what happens – either you fire your employer or your employer fires you. That also means that if along the way when minor medical conditions pop up, you can still be covered under your private plan.

The opposite is not the same.

If you’re just under the company insurance and medical conditions happen along the way, you may not get accepted into a private medical plan when you apply for it in the future.

Secondly:

Some medical benefits from the company insurance may not be sufficient and usually, they have a cap. If you go above that amount, you have to pay for the excess, however large that may be. Furthermore, the medical benefits may not be comprehensive.

Lastly:

You don’t own the policy, the company does. Whatever they want to do with it depends on them.

With a private plan, you own the policy. And with that, comes greater flexibility.

Protection Against Hospital Bills Solves 50% of the Problem

Covering the potential of paying for big hospital bills is one of the most fundamental aspects of financial planning.

Reason being: the hospital is the first place you’ll be at if an injury or illness were to happen.

But a hospital plan only covers half of the problem.

What if you’re back home and still unable to work because of a permanent disability or a critical illness?

Who’s going to pay for the daily expenses, commitments and future goals?

That’s why it’s equally important to have life insurance coverage to protect your income.

Do you think you have enough cover for death, total and permanent disability, and critical illness? Check out our life insurance coverage calculator now.

Finding the Best Integrated Shield Plan in Singapore

Hospitalisation and surgical costs are expensive in Singapore. And they’re getting higher every year.

Would you be able to cope financially if something adverse were to happen?

Sure, there is MediShield Life to aid, but is it enough for you?

What if you want a better and more extensive cover for your medical needs?

An integrated shield plan paired with a rider will give you the greatest peace of mind.

Get a comparison to find out the best integrated shield plans in Singapore now.

Abram Lim

With over 7 years of experience in the financial advisory industry, and previous stints in Citibank and UOB, Abram eagerly shares his knowledge by publishing research-backed articles. Learn more about Abram