Wednesday, March 09, 2011

Elderly person - not insured

Hi Mr Tan,
My mother is a housewife and she is 61 year old. She has no contribution to her cpf thus she does not have any medishield or medisave. Two years ago I try to get a medical insurance from NTUC for her but was rejected due to her high blood pressure and irregular heart rhythm. I having problems to get a suitable medical insurance for her as it either too expensive or they would normally reject for her case.

You can try to apply for basic Medishield with CPF and see if she can be accepted. If not, it is all right. I know of many elderly people who are not insured. If they are hospitalised, go to a subsidised ward (B2 or Cclass) as the bill is kept affordable.
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Spur said...

For those unable to get medical insurance, I urge them to only consider C Class wards. B2 may still be quite expensive --- certainly there is substantial price difference between C and B2.

E.g. A $2000 bill at C Class will translate to $3500 bill for B2, i.e. a 75% increase in price.

Spur said...

In the olden days, maybe 50 years ago, there were only 2 ward "classes" in Singapore hospitals -- either open wards or private rooms. Many countries around the world still practice this. And the price difference is perhaps 2X i.e. $5000 in open ward equals $10K in private room.

In Singapore the hospital setup has become commercial business, with complicated differentiation, market segmentation, and playing on economics of envy or fear (what you pay is what you get, low quality etc etc). The price difference in Singapore between C Class and A Class is quintuple (5X). A $5K C class bill equals $25K in A Class.

Maybe they will start using airline terminology in hospitals --- economy, business, 1st class, raffles class, premier-economy etc etc.

zhummmeng said...

In UK medical service and hospitalisation is still FREE.

yujuan said...

With means testing influencing Medishield payout, it may be better to do away with Medishield cover and rely on the C class wards to pay the bills.
The low Medishield claims highlighted in the ST Forum Letter
make us wary about relying on Medishield to cover us, provided there are sufficient C wards to cater to demand.

Spur said...

Medishield is still a GOOD PLAN, if you are under the following:-

1) Earn less then $3,200/mth.


2) Go only to C or B2 class wards in restructured hospitals.

If you earn over $4,500/mth you may need to consider private Shield plans, as the govt reduces C & B2 subsidies for those earning over $3,200 (on a sliding salary scale). The un-subsidised portion of C & B2 bills cannot be covered by Medishield. This is the result of many people complaining about insufficient C class beds. Govt wants to penalise richer people from going to C class wards.

That's why the recent complaint letter in ST. I suspect the patient was a retiree but stayed in high-end condo, or had some rather good rental income etc. Thus "failing" the means-testing and thus having to pay extra for his C class bills that is mostly not covered by Medishield.

E.g. If his stated bill was $2300, the actual bill if he didn't fail the means-test could be as low as $1314. (2300/0.35 X 0.2)

The first $1000 is deductible, so gotta pay from Medisave or cash. Of the remaining $314, eighty percent or $251 should be covered by Medishield, while the remaining $63 to be paid via Medisave or cash.

The 2nd bill of $2,200 should probably be $1,254 if he didn't fail the means-testing. Since he already paid the $1K deductible, for this 2nd bill, Medishield will cover $1,003 and the remaining 20% or $251 to be paid with Medisave or cash.

So if the patient did not fail the means-testing, his total C class bills of $1,314 + $1,254 = $2,568.

Of which he has to pay by Medisave or cash = $1000 + $63 + $251 = $1,314.

Medishield would pay the rest i.e. $2,568 - $1,314 = $1,254.
Payout ratio of about 46%.

The payout ratio is low becoz this case is not "catastrophic" enough, where the bills are quite low in the first place. The letter writer also clarified that there was no operation or complicated procedures. Otherwise the bill will be much bigger, and payout ratio from Medishield will be higher too.

Vincent Sear said...

The difference between Class C and B2 is that there's a toilet in your ward in Class B2 whereas there's only common corridor toilets in Class C shared between several wards. That's a practically useless and wasteful amenity. If serious enough to lie on a hospital bed, most patients cannot go to toilet themselves, as they're under IV drip. For those who can walk, what's the difference between walking to the corner of the ward or out to the corridor? Frankly I think, classes in government should be abolished. All single class of shared wards. Let the private hospitals have the private room wards for those rich enough to afford the privacy.

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