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Coverage of MediShield extended to three areas

The Ministry of Health (MOH) has announced the extension of areas covered by MediShield Life to three areas on Wednesday (7 Nov): 

One, direct ED-CH admissions, or direct admissions from emergency departments of public hospitals to community hospitals;

Two, parenteral nutrition (PN) bags and consumables for patients on long-term PN due to chronic intestinal failure; and

Three, surgical interventions for two rare congenital conditions – trisomy 18 and alobar holoprosencephaly.

ED-CH admissions

Since 15 July this year, ED-CH admissions will depend on whether emergency departments of public hospitals have concluded that patients are in "a stable condition with a clear diagnosis," on top of "requiring a period of medical, nursing and/or rehabilitation care" from which, through "direct admission, the patient can benefit.

Qualifying cases include those such as "urinary tract infection, non-surgical wound care requiring inpatient medical care, or inpatient rehabilitation to improve patients’ ability to perform daily activities."

"Previously, MediShield Life covered community hospital stays only for patients transferred from an acute hospital after an acute inpatient stay," according to MOH.

Under MediShield Life, patients may claim up to $350 per day for ED-CH admissions, "which is the prevailing inpatient limit for community hospitals," added the Ministry.

Long-Term Parenteral Nutrition

In cases where patients suffer from intestinal failure, parenteral nutrition -- or intravenous provision of nutrition which bypasses the digestive system -- "may be required for the long term," which will result in astronomical medical expenses on the patients' part, according to MOH.

The extension of the MediShield Life criteria will cover long-term PN -- which encompasses 90 days or longer -- starting this month, subject to certain clinical criteria.

Patients who meet the eligibility criteria may "claim up to $1,700 per month from MediShield Life and withdraw up to $200 per month from MediSave for PN bags and consumables necessary for the administration of PN," said MOH.

Surgical Interventions for Trisomy 18 and Alobar Holoprosencephaly

Two rare congenital conditions -- Trisomy 18 and alobar holoprosencephaly -- which were potentially fatal previously are now included under the extension of the MediShield Life policies starting this month, as "more recent international studies have shown that surgical interventions can now improve the quality of life and survival of patients," according to MOH.

However, the coverage will be subject "to the prevailing surgical claim limits."

No MediShield Life premium adjustments, but a review will be conducted "by end-2020"

Regarding MediShield Life premiums, MOH revealed that while "there will be no premium adjustments at this point," the ministry will conduct "a review of premiums" in two years' time, "by end-2020," adding that "actual claims experience and healthcare cost inflation as well as possible future enhancements" will be factored in during the process of reviewing the insurance premiums.

However, MOH added: "Any patient who cannot afford their bills after subsidies, MediShield Life and MediSave, can apply for MediFund.

"No Singaporean will be denied appropriate healthcare due to the inability to pay," concluded the ministry in its press release.

MediShield Life, a basic health insurance plan administered by the Central Provident Fund (CPF) Board, is designed to cover large hospital bills and selected costly outpatient treatments such as dialysis and chemotherapy for cancer.

The insurance plan reduces the need for patients to use up their MediSave, or to pay out of pocket in cash for such large hospital expenses.