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Medical insurance terminated despite deduction of Medisave

By Eugene Cheng

My mother, a old and retired widow, used to be covered under Medishield like most other Singaporeans. When the Private Medical Insurance (PMI) scheme was introduced, my mother opted for it in view of the greater coverage offered while allowing the entire premium to be paid for using her Medisave. She saw that it was important that her medical fees for major surgeries be covered as the larger bills will be the ones that will burden her most.

Last year in March 2013, Medishield was revised to provide better medical coverage for all Singapore citizens and Permanent Residents. NTUC Income decided to follow suit, revising its (PMI) IncomeShield plans. They claimed that the changes to the benefits and premiums are aimed at keeping pace with customer needs and rising medical costs.

They migrated all IncomeShield M plans to Standard IncomeShield. My mother’s MA Plan was auto-migrated to A Plan. This auto-migration caused her annual premium payment for this coverage to increase from $514 to $868, a 69% increase. While there was an increased coverage that came with the new plan, the amount of $868 was above the Medisave limit of $800. This meant that my mother has to fork out $68 in cash.

This was not what my mother intended. She has been retired, involuntarily, for the past ten years and widowed for the past 32. She has no cash or Ordinary Account savings and relies solely on my income (I am her only child) for her living expenses. What she wanted was the highest possible coverage using the least possible cash for those reasons. Policy holders who do not wish to be migrated can either opt out or opt to downgrade the plan to a lower-premium plan if they are aware of the auto-migration.

NTUC Income claims that they have sent my mother a few letters, one, the renewal notice and two payment reminders in October 2013 which we did not receive. They claimed they also sent an SMS on 29 Oct 13.

I keep all financial statements, letters and bills dating back to 2010. I found none of those letters in my records. My history of SMSes in my phone from March 2010 yielded nothing from NTUC Income except birthday greetings addressed to my mother, whose contact number is registered under my phone.

NTUC Income claims that due to the non-response (due to non-receipt), they had to terminate my mother’s coverage. When we finally did receive one letter, it was the termination letter dated 22 Nov 13. This letter was received shortly before my mother was due for an early Dec 13 operation for a wrist injury she sustained in a fall. This termination of coverage took place despite the fact that $800 was deducted from my mother’s Medisave on 23 Sep 13.

This amount is more than sufficient to cover the lower-premium B Plan. However, NTUC Income chose to terminate rather than keep her on a lower-coverage plan.

This termination led to my mother having to go to the hospital during her surgery recuperation period to pay for and obtain a medical report for $80. This, we were told, is mandatory for consideration of reinstatement of the policy.

I wrote to NTUC Income repeatedly, asking 6 times over two and a half months, trying to find out and understand the rationale for terminating her policy rather than to downgrade her policy to Plan B and avoiding the termination and the costs incurred by us. My question has not been answered and all I have been told repeatedly is the policy that is in place rather than why this policy was chosen over the simpler downgrading of the policy that could be met with the premium payment that my mother had already made. They claimed that it is not possible to auto-downgrade her plan without her explicit consent but I find it puzzling why they find that it is alright to auto-migrate her or terminate her coverage with her consent but yet cannot do the auto-downgrade based on the $800 that she has already paid.

While I can understand if they choose to terminate a person's coverage who specifically chose a plan and failed to pay the premium, I feel that not even taking the initiative to downgrade a person's coverage due to non-response to a auto-migration exercise simply gives me the feeling they are taking this opportunity to do "spring-cleaning" of policy holders, hoping to catch any policy holder off guard.

I am not writing to rant but rather I hope this issue can be highlighted to readers and make them aware of the risks we take when we choose PMI over Medishield. Hopefully Medishield Life can help address some of these issues by moving people back to the scheme administered by CPF Board. As you can see, private insurers will not hesitate to terminate the coverage of high-risk groups such as the elderly as soon as they find good reasons to do so.

TOC has written to NTUC on 2nd July and has not received a response about Eugene's case. The letter has been edited prior to publishing.