Tuesday, March 08, 2011

Remove uncertain component of means testing in MediShield use

Printed in Straits Times Forum Page, 8 March 2011

MANY elderly people opt to be insured under basic MediShield to cover their medical expenses at an affordable premium ('Stumped by low MediShield payout' by Ms Goh Poh Kheng; yesterday). They accept treatment in a subsidised ward and must pay the deductible and co-insurance of 20 per cent from their Medisave accounts.

They should not be subject to the further uncertainty caused by the pro-ration of the bill due to means testing.


The Ministry of Health should allow patients to pay a slightly higher premium to be excluded from this pro-ration formula. This will allow for greater transparency and give them more certainty on the coverage under basic MediShield.


Many people are now advised to transfer to a private Shield plan to obtain higher coverage. However, the premium for such a plan can be much costlier and the co-payments, in the event of a claim, can also be higher.


This will be outside the financial means of many elderly patients, who need to conserve their Medisave for their old-age needs. Private Shield plans should be only for those who are well-off.


I hope the ministry will consider making basic MediShield the default plan for the large number of seniors who cannot afford to use their Medisave for higher insurance premiums and co-payments.


Tan Kin Lian

12 comments:

Vincent Sear said...

I'm baffled by means testing reduction of Medishield claims. Medishield is insurance, not welfare. It's funded by premiums individually billed and paid for benefits in case of medical contingencies, not dispensary of public money for those who need medical care but can't afford.

stevenskloke said...

Mr Tan,
My understanding of Medishield is co insurance, and obviously that is proven wrong with the pro-ration element.

Do you any idea when this element was introduced ? Im very sure that it wasnt hinted at when I bought this.

Thanks

yujuan said...

Have the feeling of being cheated
when CPF Board encouraged us to take up Private Shield Plans with NTUC Income years ago, and then this means testing thing implemented now.
Is it possible to switch back now?

Garrett said...

I'm afraid it is already too late to make noise. The first reports of means testing appeared over more than a year ago, and yet nothing was mentioned. This is why I have said from the beginning that private shield plan is still the way to go. The premiums are not unreasonably high especially if one budget for medical premium expenses during retirement, and medishield cannot be relied on. Mr Tan, I think you should admit your mistake on this. Not all insurance products are bad. If you claim to provide advice in the best interest of your readers, you would publish this comment.

Vincent Sear said...

I repeat, Medishield is insurance, not welfare. All covered are paying premiums. The only reason for premium increase is claim experience or class upgrading.

There shouldn't be such thing as means testing on insurance claims. It's just like saying, despite you've paid insurance premiums for years on car, there's no claim or discounted claim just because you're rich enough to afford it.

Insurance in general (except life) is on indemnity basis. That is, you can't claim more than you've lost or spent. Insurance reimburse you and shouldn't profit you.

Medishield is insurance with co-insurance and deductible. That's to ensure the patient has to pay something and discourage frivolous hospitalisation or unnecessary prolonging of hospitalisation.

However, how can there be such thing as means testing on insurance claims? Just because you can afford the bills independently, insurance don't pay out or discount payout? Then whyfore pay insurance premiums?

Tan Kin Lian said...

Garrett
You can give your views without passing judgement on my views, or putting words in my mouth.

If you want your views to be published, you should express your own views and not pass pass the unwarranted judgement on other people's views - especially if you have a vested interest as an insurance agent (but I am not sure if this is the case).

My view still remain the same - that basic Medishield is suitable for most people, and that those who are well off can buy Private Shield.

The pro-ration due to means testing is just another component of co-payment (although it is complicated) but it does not detract from my underlying view.

stevenskloke said...

The pro-ration due to means testing is just another component of co-payment (although it is complicated) but it does not detract from my underlying view.....

Your views still dont address the concern of the cover. Can I take it that we are to accept pro ration as part of the policy cover in Medishield. Is this also how a private shield will work, despite the higher premiums.

Thanks in advance.

Vincent Sear said...

Private shields are actually good for people able and willing to afford Class A/B. We can't just assume everybody wants Class C though it's the most subsidised.

There's lower deductible on Medishield than private shield but there's also high upper claim limits. People who want and can afford Class A/B usually have Medisave maxed up across S$30k or with cash enough to spare. So the higher deductible won't be a problem, where the higher claim limits would be very beneficial.

There shouldn't be such thing as Medishield is best or private shield is best. It depends on personal circumstances and expectations. Medishield is basic, yes, but not absolute solution too for those who prefer private or Class A/B. One or two serious hospitalisation with surgery would have wiped out basic Medishield claim limits and leave the patient uninsured and uninsurable.

Wilfred said...

Hi Mr. Tan,

Your personal views are well respected by many individuals. Thus, it carries significant weight and thus many laymen will take what you say very seriously and even act on it in accordance to your advice.

Tan Kin Lian said...

I hope that many elderly people, who are not well off, take my advice and stick with basic Medishield.

There are quite a few cases where they upgrade to private shield. pay a higher premium and co-payment and suffer the stress of having the claim rejected due to some reason or another - usually alleged non-disclosure. It is better to avoid the stress. See the examples in my website, called "rejected claims".

There is also the point about the low limit in basic Medishield. If the elderly goes to subsidised wards, the limit in basic Medishield is more than adequate in most cases. The cases where the limits are breached are due to getting into higher class wards.

Insurance agents exaggerate these cases to get people to buy private shield. They are free to express their views elsewhere, but not in my blog.

Those well off are free to do what they like with their money. They don't have to justify their action to me. Those who disagree with my views are also free to express their views in their blogs or elsewhere.

This blog is not the place for insurance agents to advertise their views.

michael13 said...

The difference between the basic Medishield and Private Shield is not only about the costs, but also involving the advantages for a right of choosing their preferred doctors/specialists for treatment of illnesses/diseases. Under some circumstances, the judgements and skills of specialists determine the ultimate speedy recovery of the patients.

In Singapore, either in Private or Restructure Hospitals like SGH, TTSH or NUH, etc.. Many past cases shown evidences that in reality, although they are all named 'Specialists', the outcome of the related treatments could be a vast difference.

There is a saying: "Discipline weighs ounce but regret weighs ton". I believe that any sensible people are not prepared to take risks of NOT having a chance to choose their preferred doctors/specialists for much more effective treatments because of costs' factor.

Vincent Sear said...

I agree with TKL. Many older folks with little or no Medisave during their primes should stick with basic Medishield. Exception is of course, they have children willing to pay higher premiums for them.

Blog Archive