Is the MediFund criteria a secret?

By S Y Lee and Leong Sze Hian

We refer to media reports about the time saving benefits offered for staff of SingHealth by the One Medifund scheme.

The medical healthcare group also shared that the new system has saved patients many trips shuttling between health institutions, medical social workers and pharmacies.

All subsidised patients who can’t pay can apply for MediFund?

According to the Ministry of Health’s web site – Patients who fulfill all of the following requirements may apply for Medifund assistance:

  • is Singapore citizen
  • is a subsidised patient
  • has received treatment from a Medifund-approved institution
  • Patient and family have difficulty affording the medical bill despite heavy government subsidies, MediShield and Medisave

“Every Medifund-approved institution has a Medifund Committee to consider and approve applications, and decide on the appropriate quantum of assistance to provide. The actual amount of assistance provided will depend on the patient’s financial and social circumstances, as well as the size of the medical bill incurred.”

In our volunteer work doing financial counselling over the last decade or so, we have come across hundreds of cases whereby patients were unable to get help from MediFund when they could not pay for their medical bills at public health institutions.

MediFund criteria?

So, what is the criteria for approving MediFund?

We don’t seem to be able to find much information on this. From what we have been able to gather, the criteria may be along the following lines:-

  • You get greater help if you contribute regularly to Medisave and are members of MediShield – “To encourage a greater sense of personal responsibility, Medifund will provide greater support to those who have contributed regularly to Medisave and who are covered by MediShield, but despite these have run into difficulties”
  • You cannot be a Class A or B1 patient (which means that you cannot be referred for treatment by a private clinic as then you would not be eligible for Class C or B2 treatment). It does not matter that you may have ended up in B1 because there were no beds available or you couldn’t wait for months as a subsidised patient to get a diagnostic test, operation or treatment.
  • You cannot be staying in a private property. It does not matter whether you are staying in a private property because the owner is kind enough to let you stay when you have no money and no assets yourself.
  • All your immediate family members (for example if the patient is the father, this means the wife and all the children) must have exhausted all their Medisave account balances, subject to the Medisave eligibility and withdrawal limits
  • You must not have more than a few thousand dollars in your bank accounts . The last we heard about this amount was around $4,000.
  • Certain medical treatments and drugs are not eligible for MediFund, or only 50% assistance
  • B2 treatment may not be eligible for 100% assistance

“A flexible and compassionate approach towards applicants”?

Instead of saying “They (MediFund Committee Members) are familiar with the needs and problems faced by lower-income Singaporeans, and will adopt a flexible and compassionate approach towards applicants” – why can’t the basic criteria for MediFund be disclosed to the public?

We also understand that the MediFund quantum allocated to each MediFund-approved institution is different – which they may have to allocate accordingly to last the whole year?

99% MediFund success rate?

The MediFund applications success rate of 99% and over 500,000 approved applications in a year may be quite meaningless, unless we know the patients (not applications) rejection rate, as well as those who may be told that they don’t even need to apply because they don’t meet one of the basic eligibility criteria.