Is Integrated Shield Plan necessary in Singapore?

All in all, an integrated shield plan provides everyone with an opportunity to get lifelong protection against large medical bills. At this time, an integrated shield plan is a private health insurance scheme that is run by an insurance company. Accordingly, all Singapore Residents are eligible to submit the health insurance application. Given that relatively wide target audience, let’s find out whether you should purchase an integrated shield plan.

One Minute Summary:

An integrated shield plan caters to a wider group of consumers who wish to acquire better health insurance coverage for themselves.
By and large, by choosing the right integrated shield plan, it will likely reduce the out of pocket cost that you need to pay for your medical bill.
Before you purchase an integrated shield plan, be sure to take into account the cost of insurance over time. In effect, this ensures that you can afford to keep the health insurance scheme over the required time period.

Part 1: What is an Integrated Shield Plan (“Main IP”)

Basically, an integrated shield plan is a private health insurance scheme that provides reimbursement for hospital bills and selected outpatient treatments. At the present time, there are seven insurers that provide the private health insurance coverage. For this purpose, you may select a suitable plan from one of the following four broad scope of coverage:

Standard Integrated Shield Plan (for Public Hospitals, Class B1 ward)
Class B1 Plans (for Public Hospitals)
Class A Plans (for Public Hospitals)
Private Hospital Plans (in a Standard Room)

Summing up, by selecting a suitable plan that meets your health insurance needs, it reduces the out of pocket expenses that you need to pay in your medical bill. In effect, this assures you that you can focus on recovery and not worry about the bills.

Part 2: Target Audience

Generally, an integrated shield plan appeals to the following groups of consumer:

Singaporeans or Permanent Residents who prefer to seek unsubsidised inpatient treatment, i.e. Class B2+/B1/A ward in public hospitals, private hospitals;
Singaporeans or Permanent Residents who prefer to seek unsubsidised outpatient treatment or day surgery treatments in public or private hospitals;
Permanent Residents who prefer to reduce their out of pocket expenses in Class B2/C ward in public hospitals;
Singaporeans and Permanent Residents who prefer to include health insurance coverage for pre- and post-hospitalisation bill in public or private hospitals;
Foreigners who prefer to reduce their out of pocket expenses in public or private hospitals in Singapore.

In the next few sections, I will elaborate in detail on how each group of consumers may benefit from getting an integrated shield plan.

Part 3: Singapore Citizens

Part 3.1: Existing Health Insurance Scheme – MediShield Life

On the whole, MediShield Life covers all Singapore Citizens from birth following birth registration. As our nation’s health insurance scheme, MediShield Life provides cover against large subsidised bills incurred for hospitalisations in Class B2/C wards in public hospitals. Additionally, MediShield Life also helps to pay for selected costly outpatient treatments. Under those circumstances, the cost that you will need to pay will be limited to the deductible and co-insurance. Moreover, you will also need to pay any pre- and post-hospitalisation bill.

With this in mind, if you wish to enhance MediShield Life’s cover and reduce your out of pocket cost, then you may consider getting an integrated shield plan.

Part 3.2: Case Study 1 – Lower Abdomen, Removal of Appendix (Simple) in Class A Ward in Public Hospital

To illustrate, let’s look at the claim computation for Lower Abdomen, Removal of Appendix (Simple). As can be seen, if you choose to stay in Class A ward in a public hospital, then MediShield Life will cover about 10% of the medical bill only. In other words, you may expect to fork out cash for about 90% of the medical bill. To this end, we can conclude that MediShield Life may be insufficient to meet your health insurance needs.

In order to overcome this limitation, you may purchase an integrated shield plan (“Main IP”) that covers Class A ward in public hospitals. Under those circumstances, the Main IP will take 100% of the medical bill into account for its claim computation (i.e. 100% pro-ration factor). In effect, you will pay about 48% of the medical bill – which is a much smaller amount than the earlier case. Therefore, we can conclude that an integrated shield plan provides better coverage than MediShield Life.

MediShield Life vs Integrated Shield Plan: Case Study for Claim Computation - Singapore Citizen — MediShield Life vs Integrated Shield Plan: Case Study for Claim Computation – Singapore Citizen

Part 4: Permanent Residents (“PRs”)

Part 4.1: Existing Health Insurance Scheme – MediShield Life

Similar to a Singaporean, MediShield Life also covers all Permanent Residents from the day they attain residency. Although MediShield Life also covers PRs against large subsidised bills incurred for hospitalisations in Class B2/C wards in public hospitals, there is a caveat to the coverage. To point out, even if you choose to stay in Class C ward in a public hospital, a pro-ration factor will still apply. As a result, a Permanent Resident enjoys lesser health insurance coverage as compared to a Singapore Citizen.

With this in mind, if you wish to enhance MediShield Life’s cover and reduce your out of pocket cost, then you may consider getting an integrated shield plan.

MediShield Life vs Integrated Shield Plan: Case Study for Claim Computation - Singapore Permanent Resident — MediShield Life vs Integrated Shield Plan: Case Study for Claim Computation – Singapore Permanent Resident

Part 4.2: Case Study 2 – Lower Abdomen, Removal of Appendix (Simple) in Class C Ward in Public Hospital

To illustrate, let’s look at the claim computation for Lower Abdomen, Removal of Appendix (Simple). As can be seen, even if you choose to stay in Class C ward in a public hospital, MediShield Life will still apply a 44% pro-ration factor. In other words, MediShield Life will only take 44% of the medical bill into account for its claim computation. Under those circumstances, you can see that you will need to fork out cash for about X% of the medical bill. Hence, we can conclude that MediShield Life may be insufficient to meet your health insurance needs.

In order to overcome this limitation, you may purchase an integrated shield plan (“Main IP”) that covers Class C ward in public hospitals. Under those circumstances, the Main IP will take 100% of the medical bill into account for its claim computation (i.e. 100% pro-ration factor). In effect, you will pay about 26% of the medical bill – which is a much smaller amount than the earlier case. Therefore, we can conclude that an integrated shield plan works as intended.

Part 5: Foreigners with a Valid Pass

Generally, most (if not all) foreigners with a valid work pass will be covered by their company’s corporate insurance scheme. That being said, the corporate health insurance’s coverage may not be sufficient to cater to a large medical bill. This is because after all, most companies work with a limited budget. As a result, there exists a limitation on how much insurance coverage it can cater to all of its employees. With this in mind, if you intend to enhance your health insurance coverage, then you may consider getting an integrated shield plan.

In like manner, your corporate insurance scheme may not cover your spouse and children. Accordingly, if you wish to protect against large medical bills, then you may consider getting an integrated shield plan for your family members as well.

Part 6: Pre- and Post-Hospitalisation

As I have noted in my post on What is MediShield Life, our nation’s health insurance scheme does not cover pre- and post-hospitalisation bills. To put it another way, MediShield Life does not cover any bills that occur prior to your hospital stay. By the same token, it does not cover any bills that occur after you are discharged. Hence, you will need to fork out your own money for these consultations.

By comparison, most of the integrated shield plans include coverage for pre- and post-hospitalisation. Therefore, you can be assured of an extended coverage.

Part 7: In the Event of an Emergency

In addition to the cases that I have mentioned above, there is another reason to consider getting a Main IP; that is to cater for an emergency need. For this purpose, let’s review this incident that was reported by The Straits Times:

Patient could not get place in SGH, hit with $78k bill – The Straits Times, 11 October 2017

Mr Thomas Lukose suffered a heart attack while he was at work at Gleneagles Hospital.
Obviously, he was taken to the hospital’s emergency department for immediate treatment.
Following that, his family wanted to transfer Mr Thomas to National Heart Centre Singapore. This is because his insurance covers him for subsidised care only.
However, National Heart Centre Singapore did not have any spare bed in its intensive care unit at that time. As a result, Mr Thomas could not be transferred immediately.
Two days later, National Heart Centre Singapore offered a bed to Mr Thomas. Despite that, his condition made it risky for the transfer to take place.
Under those circumstances, the cardiothoracic surgeon from Gleneagles Hospital had to operate on Mr Thomas promptly.
In sum, the hospital billed $78,000 to Mr Thomas for his medical treatment.

All in all, here are some points to consider based on this incident:

Let’s assume that Mr Thomas purchased a health insurance plan that caters to subsidised care only. This is because it has always been Mr Thomas’s preference to seek subsidised care only. With this in mind, there is no insurance gap and the health insurance plan fulfils Mr Thomas’s needs completely.
However, Mr Thomas failed to take into account that in the event of an emergency, his health insurance plan may not provide sufficient insurance coverage. If he had bought a health insurance plan that includes coverage for private hospital, then he won’t be left in a financial distress.
Obviously, it will be more expensive to purchase a health insurance plan that includes coverage for private hospital. This is opposed to purchasing a health insurance plan that covers subsidised care only. With this intention in mind, we will need to know Mr Thomas’s budget and affordability.

Part 8: Cost of Insurance

Evidently, the arguments that I have listed above converges towards the idea that it is beneficial to get an integrated shield plan. After all, a Main IP does provide better insurance coverage as compared to MediShield Life. But before you submit an insurance application, you should also look into your budget and long-term affordability. Summing up, here are two blog posts that I have written to highlight the cost associated with an integrated shield plan:

Part 9: Is Integrated Shield Plan necessary?

To conclude, an integrated shield plan caters to a wider group of consumers who wish to acquire better health insurance coverage for themselves. For instance, the Main IP is able to cover your pre- and post-hospitalisation bill. Similarly, if you prefer to seek treatment in a private healthcare facility, then you are able to purchase an IP that provides such scope of coverage. Summing up, by choosing an integrated shield plan that matches your healthcare needs, it reduces the out of pocket cost that you need to pay for your medical bill.

That being said, a private health insurance plan tends to be more expensive than MediShield Life or your corporate insurance scheme. As a result, you should also consider your budget and long-term affordability. Finally, it is important to realise that the insurer may change the benefits and cost associated with an IP. Therefore, you should not be completely reliant on an integrated shield plan to meet all of your healthcare needs.

First Published: 13 March 2019
Last Updated: 30 April 2024

PZL Blog | Singapore

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