Tan Kin Lian's Blog: Means Testing

Tuesday, September 15, 2009

Means Testing

Someone asked if a high income person can still use the subsidised wards (B2 and C).

The answer is "yes". They will be given a lower rate of subsidy. Currently, the subsidy varies from 80% to 65% for class C and from 65% to 50% for class B. See the explanation here.

Basic Medishield should be sufficient to cover the cost of the subsidised bill, even though the rate of subsidy is lower for a high income person. Even if it does not cover the full amount, the difference is quite small.

Most retirees and elderly people have a low or no income and should qualify for a higher of subsidy anyway.

8 comments:

Lion Investor said...: Means testing has the effect of almost doubling the bill for some people. The drop in subsidy might seem a little (from 80% to 65% of the bill) but essentially if you pay 20% of x and now you pay 35% of x, your bill size will have almost doubled.

If you fall into the higher income class, your claim under Medisave will be affected. The excess that you are paying will not be claimable.

Taken from MOH FAQ:
As most patients are not affected by means-testing and will continue to enjoy full subsidies of 65% at Class B2 and 80% at Class C, most patients’ claims from MediShield will also not be affected by means-testing.

However, as MediShield premiums are the same for all insured members in the same age group, MediShield payouts are therefore similar for all insured members, regardless of subsidy status.

To ensure a fair payout across all MediShield insured members for the same treatment received, Class B2 or C patients who are affected by means-testing will have their claims adjusted such that it would be similar to that of patients receiving maximum subsidy.

Should you be affected by means-testing, you may wish to consider applying for an increased coverage under a Medisave-Approved Integrated Shield Plan. Integrated Shield Plans are offered by the following participating insurers: AIA, Aviva, Great Eastern, NTUC Income and Prudential.; September 15, 2009 1:54 PM
Anonymous said...: Hello Mr Tan,

MEANs Testing for some S'poreans mean a hefty 75% increase in out-of-pocket medical hospital expenses. Why? Because before MEANs Testing was implemented, all S'poreans can get 80% subsidy for ward C bed, but after MEANs Testing, higher income S'poreans get only 65%. So 35%/20% = 175% (paying 75% more).

I know why the govt implemented MEANs Testing. Because the govt wants to grow the PR population significantly and also want PRs to enjoy subsidies like S'poreans. SO the only way to do this without increasing national healthcare budget is to REDUCE subsidy for S'poreans.

Under MEANs Testing, PRs of lower income get up to 15%-points more subsidy than S'poreans of higher income. Why should that be the case? Given how easy it is for a foreigner to obtain S'pore PR, subsidy for PRs should NOT be higher than that for S'poreans, regardless of income.; September 15, 2009 2:39 PM
jamesneo said...: Hi Mr Tan or any readeres can anybody enlighten me if means testing is the average household income or income of patient which is what i get from the file . From my experience in outpatient it seem to be average houshild income but is it different for hospitalization?; September 15, 2009 4:09 PM
Tan Kin Lian said...: Hello 2:39 PM

Yes, it is large increase on a small base, but it represents 15% of the total bill, and is still a 35% discount from class A. Anyway, the increase of 15% are for people at high income, so they can afford it. Anyway, if you are covered under Medishield, the increase will be paid by Medishield.; September 16, 2009 11:25 AM
Anonymous said...: The so-called 'fortunate' are those who get to foot the co-insurance of MediShield after which Medishield Insurance need not pay one single cent. If I am correct, any patient is quickly discharged from hospital so I think most of us end up paying the deductible after which bill is fully settled. Of course, as we enter the older age group, we pay hefty premiums for MediShield. The latest trend is quality of life over quantity of life. I wonder, when I age, if I will end up paying for quality of life as well as MediShield?; September 16, 2009 1:38 PM
Lion Investor said...: Note that the for those affected by Means testing, the increase in bill will not be paid by Medishield. You will have to pay for the excess. Refer to my earlier comment.; September 17, 2009 10:59 AM
Tan Kin Lian said...: To Lion Invetor,
Thank you for your clarification that the additional charge in B2 (for those affected by means testing) will not be covered by Medishield. I stand corrected.; September 17, 2009 11:52 AM
Anonymous said...: Mr Tan (11.25am),

The base is irrelevant. It is the quantum of the out-of-pocket expenses (up to 75% hike) that is the pain.

The lowest subsidy of 65% kicks in at income of $5,200 and above. How can one drawing $5,200 be considered "high income"???; September 17, 2009 3:50 PM