Private healthcare is more affordable than you think. Your integrated shield plans can help pay for the cost of your private hospital stay at Mount Elizabeth Hospitals. Know your options.
An integrated shield plan (IP) is health insurance consisting of 2 parts:
MediShield Life which is the basic health insurance plan managed by the Central Provident Fund (CPF). MediShield Life premiums can be paid by MediSave.
Private health insurance which:
Your health should not have to wait. Learn more about integrated shield plans, so that if the unexpected happens, you can get treated promptly and just focus on your recovery.
Find out your coverage and bill size
You can also use our Hospital Bill Estimator to get an estimate of your out-of-pocket expenses for common surgical procedures.
The deductible is the basic amount you must pay for your bill before you make an insurance claim. The deductible is capped at a fixed sum. If the bill is less than the deductible, you will pay the full bill.
For example, if your bill size is $10,000 and your private hospitalisation deductible is fixed at $3,500 for your integrated shield plan, you must first pay $3,500 before making an insurance claim for the remaining $6,500.
Co-insurance is the amount you have to co-pay with your insurer after you have paid the deductible.
For each claim you submit, you will split the cost with your insurer. The co-insurance is expressed as a percentage of the claim and is typically 10% for integrated shield plan. Your insurer will foot the remaining bill.
For example, if your hospitalisation bill is $10,000 and your deductible is $3,500, your co-insurance will be 10% of $6,500, which is $650. This means you will pay a total of $4,150 (deductible and co-insurance) while your integrated shield plan will pay the rest of the bill.
Co-payment is the percentage, usually 5%, you have to pay towards your hospital bill when you submit an insurance claim.
If you have purchased a co-pay rider with your integrated shield plan, the rider will cover your deductibles and co-insurance to reduce your out-of-pocket expenses.
Depending on your rider plan, most insurers set the co-payment at 5% with a cap of $3,000 if you seek treatment from your insurer's preferred panel of doctors, and the treatment has been pre-authorised by your insurer.
This means you only need to pay up to $3,000 if your co-payment amount exceeds the cap. The remaining co-payment amount will be covered by your insurer.
For certain integrated shield plans under AIA, it is important to seek pre-authorisation from your insurer before your procedure. Without pre-authorisation, AIA will apply a pro-ration factor on your claim.
For example, if your claim is $10,000, your insurer will only cover 85% of the claim without pre-authorisation. You will need to pay for the remaining amount.
There are 2 types of limits for integrated shield plans:
Insurers have their preferred doctors whom they have selected to be on their panel. You may enjoy enhanced coverage and higher claim limits if you are treated by your insurer's panel doctors.
The extended panel refers to a doctor who is currently not on a certain insurer’s main panel, but is on the approved list of panel doctors of the other integrated shield plan providers. He/she can then apply and be approved by the insurer to be on the extended panel.
To qualify as an extended panel claim, a certificate of pre-authorisation must be issued, subject to the insurer’s acceptance. This allows consumers to have a wider pool of doctors to choose from.
Pre-authorisation is a service where your insurer agrees to cover your hospital admission or day surgery costs prior to the actual procedure. Pre-authorisation is based on your policy coverage, benefit entitlement and medical information provided by your doctor.
Where possible, you should always seek pre-authorisation before you begin treatment. This can ease the claim process and may allow you to enjoy a higher coverage.
Please allow sufficient time to process the pre-authorisation. Most insurers can provide pre-authorisation within a week.
Claims-based pricing is a way to adjust premiums for your riders based on the claims paid out to you by your insurer during the previous policy year.
With claims-based pricing, your rider premiums at each policy renewal may increase or decrease. You will receive a discount of 10% to 25% off your premium if no claims were made in the previous policy year.
If a claim was paid out, your premium may increase by 10% to 100% of the standard premiums before they return to the standard level in the next renewal. The increase is determined by each insurer and depends on factors such as:
A: Before admission, contact your insurance provider to check your plan's coverage for private hospitalisation.
During admission, our Business Office will get your consent for the Medical Claims Authorisation Forms (MCAF) and assist you in using your integrated shield plan.
Find out about more about using your health insurance.
A: Pre-authorisation is always recommended for planned treatments. It can ease the claim process and may help you enjoy higher coverage.
Find out more about using your health insurance.
A: An integrated shield plan consists of MediShield Life and additional private health insurance coverage.
MediShield Life is a basic health insurance plan that covers all Singapore citizens and permanent residents.
Additional private insurance covers treatment at private hospitals or Class A and B1 wards at public or restructured hospitals.
Note: The Additional Withdrawal Limits may be subject to change. Please visit the Ministry of Health website for the latest information.
Depending on the plan you purchased, integrated shield plans and riders can provide coverage for:
If you have an integrated shield plan and rider, you may be partially or even fully covered (for some existing policies) for treatment and single-room stay at private hospitals.
A: If you had purchased a full rider with your integrated shield plan, it covers the deductible and co-insurance components fully. You do not incur any out-of-pocket expenses.
Due to the Ministry of Health's requirements, insurers no longer offer full riders from 1 April 2019. You may only purchase co-pay riders with a minimum of 5% co-payment. With the exception of Prudential's PruExtra Premier Rider, all full rider plans purchased by existing policy holders have transitioned to co-pay riders upon policy renewal from 1 Apr 2021.
With a co-pay rider, your out-of-pocket expense is:
Your co-payment amount may be offset partially or fully by MediSave or your corporate insurance. Please check with your Human Resource department if you are covered under a corporate insurance.
For the latest policy changes, please check with your insurer.
Tip: Use our Hospital Bill Estimator to estimate your out-of-pocket expenses for common surgical procedures.
As part of the recent changes, insurers such as AIA, Great Eastern and Prudential have also introduced claims-based pricing for selected Integrated Shield Plans.
With claims-based pricing, your rider premiums at each policy renewal are adjusted based on your claims during the previous policy year. The adjustments differ across insurers.
For example, if the standard premium for a co-pay rider at 38 years old is $722 and a claim is made at a private hospital in 2021, your premium for the next policy year (2022) will increase by 1.5 times to $1,083. The adjusted premium will revert to the standard level in 2023.
Please check with your insurer to find out more about your plan and premiums.
Note: This scenario is based on the Great Eastern TotalCare Elite-P co-pay rider as of 1 April 2021, for a claim amount higher than $2,000.
Extended Panel is an initiative by the Multilateral Healthcare Insurance Committee (MHIC), which is appointed by the Ministry of Health (MOH), to allow integrated shield plan insurers to recognise each other’s panel doctors mutually. Under the Extended Panel, you may enjoy selected panel benefits when seeking pre-authorised treatments from specialists that are not on your insurer’s panel. If they are on other integrated shield plan insurer panels, follow your insurer fee schedule and meet their pre-authorisation terms. This initiative provides consumers with a wider choice of specialists and supports better continuity of care for patients.
To qualify for an Extended Panel claim, complete these steps before your planned treatment:
A: To find out if you have an integrated shield plan:
To find out the policy details of your integrated shield plan, please refer to your policy document or contact your insurer or financial advisor.
A: If you have an Integrated Shield Plan (IP) and a rider that provides coverage for private hospitals, you may be covered for treatment at our hospital.
Below is a list of private hospital plans and co-pay riders offered by various insurers:
Singlife with Aviva
Raffles Health Insurance
Please check with your insurer for your full policy details.
*These are old rider plans that are no longer offered by the insurers for new customers.
A: Your integrated shield plan can also serve as an emergency medical insurance if your visit to our Accident & Emergency (A&E) department warrants a hospital admission with a minimum stay of 8 hours.
If your integrated shield plan and rider cover private hospitals, you only need to pay a minimal amount for both your A&E outpatient bill and your inpatient treatment.
Some policies also cover the A&E outpatient treatment up to a certain limit and can be used as both accident health insurance and emergency health insurance. Contact your financial advisor to understand your full policy details.