The policyholder went for a knee operation and paid $5,967. He was only reimbursed $128.
If he had remained in Medishield, his co-payments would be less than $2,000 (covering the Deductible and the coinsurance of 15%). The premium for Medishield would have been much lower than the Private Shield.
Why pay more for a Private Shield, and have to bear a higher Deductible and Coinsurance?
I believe you have made a mistake in saying his co-payments would be less than $2,000 under Medishield. There is a pro-ration rate of 35% for Private Day Surgery. Hence, he will already foot $3878 before we even consider the co-payments. After we subtract the $1500 deductible, the assessable amount is $588. He has to foot $5378 even before we factor in Surgical Operations event limits, Ward limits and the 20% co-insurance for claimable amounts below $3000.
I understand that you may have something against private medical insurance, but to deter the public from considering such options through misrepresentation is unfair.
While I cannot dispute the validity of this newspaper article, I can only say that this is an isolated case with AIA. It is unfair to generalise it across all private insurers, including IncomeShield.
To wjsim If you are insured for Medishield, you should go for the ankle operation in a restructured hospital. There is no need to use Private Day Surgery.
I only want people to be informed about an alternative that pays less and cover more. The insurance agents wants to sell Private Shield which gives them commission. So, my advice is to present the other side.
The agent can still try to convince the customer to buy Private Shield. They have plenty of ooportunity to do so.
Yes. If he had gone to a restructured hospital, I don't think his bill will be $5967. I just had to highlight the confusion that might be caused in other readers thinking that under Medishield, their co-pay will be less than $2000 for an operation at Gleneagles.
Thank you for the clarification.
The commission for health plans are relatively low to other products. Without incentives, few agents would even mention the product.
Many clients think that buying Plan B or Plan A paying higher premiums mean higher claims. That's not necessarily true.
Plan B and Plan A has higher claim limits, that's true, but they also have higher deductibles and co-insurance. You can get a meaningful Plan A claim only if you're incur tens of thousands of dollars of hospitalisation bills, and after many thousands of dollars in co-payment first.
Personally, I think that a basic Medishield is a necessity for all, and a Plan B is good enough if you can afford more for higher claim limits. Plan A is luxury for those who plan to stay in Class A and the first ten thousand dollars on the bill is not a problem.
Yes, our agents should be more transparent & less greedy!!!For years my wife & I were sweet-talk into paying for Incomeshield & Incomeshield Plus Rider unnecessarily!!! Luckily, we heed Mr Tan's advice to switch to Medishield & now we pay less annual premium & nil cash for the Rider!!!!We are always grateful to Mr Tan!!!
The point is for private shields you should opt for the plan that is what you will need. If you want to go to a private hospital, you should opt for the highest plan. It's also a good choice especially for young people. You really don't know whether you will end up using a private doctor 10, 20 years in the future. Today public hospitals are reasonably good. But who can guarantee that they will be just as good and efficient 20 years later when the population starts to age and the burden on public hospitals may be much higher. The fact is we don't know. Hence, by paying just a few dollars more from one's medisave a month to buy the highest private shield plan, a young person does not have to face the problem of being underinsured when he needs private hospital later.
Sometimes, I'm a little and fatigued in this type of issues. Victims, or percieved-victims, are simply interested in complaining and ranting without regard to the other side of story, and accusing all agents of being fraudsters and all insurance companies cheating.
I should them ask all of them feeling so, go lodge a police report. In fact, easier, pickup the phone and 999. You don't complain in internet blogs or forums when you're robbed or raped, do you? Call the police.
The policyholder went for a knee operation and paid $5,967. He was only reimbursed $128.
ReplyDeleteIf he had remained in Medishield, his co-payments would be less than $2,000 (covering the Deductible and the coinsurance of 15%). The premium for Medishield would have been much lower than the Private Shield.
Why pay more for a Private Shield, and have to bear a higher Deductible and Coinsurance?
Mr Tan,
ReplyDeleteI believe you have made a mistake in saying his co-payments would be less than $2,000 under Medishield. There is a pro-ration rate of 35% for Private Day Surgery. Hence, he will already foot $3878 before we even consider the co-payments. After we subtract the $1500 deductible, the assessable amount is $588. He has to foot $5378 even before we factor in Surgical Operations event limits, Ward limits and the 20% co-insurance for claimable amounts below $3000.
I understand that you may have something against private medical insurance, but to deter the public from considering such options through misrepresentation is unfair.
While I cannot dispute the validity of this newspaper article, I can only say that this is an isolated case with AIA. It is unfair to generalise it across all private insurers, including IncomeShield.
http://ask-us.cpf.gov.sg/Home/Hybrid/themes/CPF/Uploads/Healthcare/General%20Information%20on%20MSH.pdf
To wjsim
ReplyDeleteIf you are insured for Medishield, you should go for the ankle operation in a restructured hospital. There is no need to use Private Day Surgery.
I only want people to be informed about an alternative that pays less and cover more. The insurance agents wants to sell Private Shield which gives them commission. So, my advice is to present the other side.
The agent can still try to convince the customer to buy Private Shield. They have plenty of ooportunity to do so.
Yes. If he had gone to a restructured hospital, I don't think his bill will be $5967. I just had to highlight the confusion that might be caused in other readers thinking that under Medishield, their co-pay will be less than $2000 for an operation at Gleneagles.
ReplyDeleteThank you for the clarification.
The commission for health plans are relatively low to other products. Without incentives, few agents would even mention the product.
Many clients think that buying Plan B or Plan A paying higher premiums mean higher claims. That's not necessarily true.
ReplyDeletePlan B and Plan A has higher claim limits, that's true, but they also have higher deductibles and co-insurance. You can get a meaningful Plan A claim only if you're incur tens of thousands of dollars of hospitalisation bills, and after many thousands of dollars in co-payment first.
Personally, I think that a basic Medishield is a necessity for all, and a Plan B is good enough if you can afford more for higher claim limits. Plan A is luxury for those who plan to stay in Class A and the first ten thousand dollars on the bill is not a problem.
Yes, our agents should be more transparent & less greedy!!!For years my wife & I were sweet-talk into paying for Incomeshield & Incomeshield Plus Rider unnecessarily!!! Luckily, we heed Mr Tan's advice to switch to Medishield & now we pay less annual premium & nil cash for the Rider!!!!We are always grateful to Mr Tan!!!
ReplyDeleteThe point is for private shields you should opt for the plan that is what you will need. If you want to go to a private hospital, you should opt for the highest plan. It's also a good choice especially for young people. You really don't know whether you will end up using a private doctor 10, 20 years in the future. Today public hospitals are reasonably good. But who can guarantee that they will be just as good and efficient 20 years later when the population starts to age and the burden on public hospitals may be much higher. The fact is we don't know. Hence, by paying just a few dollars more from one's medisave a month to buy the highest private shield plan, a young person does not have to face the problem of being underinsured when he needs private hospital later.
ReplyDeleteSometimes, I'm a little and fatigued in this type of issues. Victims, or percieved-victims, are simply interested in complaining and ranting without regard to the other side of story, and accusing all agents of being fraudsters and all insurance companies cheating.
ReplyDeleteI should them ask all of them feeling so, go lodge a police report. In fact, easier, pickup the phone and 999. You don't complain in internet blogs or forums when you're robbed or raped, do you? Call the police.