Finance
Pregnancy Complications & MediShield Life: What the new coverage means for Singaporean women
As of April and June 2019, two new important benefits will be added to MediShield Life that aim to make childbirth and pregnancy more affordable. Read on to see how these changes may affect you.
Financial relief is coming soon to women who are at risk of having childbirth complications. Starting in April, MediShield Life will cover 24 pregnancy and childbirth complications. According to Edwin Tong, the Senior Minister of State for Health, as many as 4,000 patients per year will benefit from these changes.
In this article, we investigate what this news means for expectant mothers and how it could impact them financially.
What Conditions Will Be Covered & How Common Are They?
A total of 24 pregnancy-related conditions will now be covered under MediShield Life. These conditions include some common complications such as still-births, medically necessary abortions, gestational diabetes mellitus, ectopic pregnancy, haemorrhage and uterine rupture.
Currently, it is predicted that these additional coverages can benefit up to 4,000 women per year, but as more women over 40 are becoming pregnant, the number of women affected by pregnancy complications can increase. This is because women over 40 are at a higher risk of pregnancy complications and may thus see more ectopic pregnancies, miscarriages, gestational diabetes and high blood pressure.
For instance, preeclampsia, one of the newly covered conditions, affects 4-5% of women and is more common among either very young women or women over 40. Thus, this coverage may come just in time to keep pace with the emerging pregnancy trends.
Additionally, as of June, MediShield Life will also extend subsidised screening under the Screen For Life programme for women with a history of gestational diabetes. These women will no longer have to take the online diabetes risk assessment tool and they will be automatically eligible for subsidised cardiovascular risk screening as well.
This is relevant to expecting mothers because gestational diabetes only occurs during pregnancy and can increase the risk of getting Type 2 diabetes later in life.
Do Integrated Shield Plans Offer Coverage for These Conditions?
Approximately 68% of Singaporeans have an Integrated Shield Plan as a complement to Medishield Life. Unfortunately, Integrated Shield Plans do not offer coverage for all of the complications that will now be covered under MediShield Life.
In some cases, pregnancy complications coverage will only include a few of the most life-threatening conditions, while other insurers will provide coverage for 12-13 of the 24 complications. Furthermore, insurers also have a waiting period of 10 months before you can claim under this benefit.
This means that if women want to receive coverage for benefits that are not covered by their IP, they will have to either pay out of pocket or settle for a C1 or B2 Ward.
How Will The New Coverage Affect Your Hospital Bill?
While most women will see further financial relief after the new benefits are added, others may still see high childbirth costs. Thanks to a combination of Medisave maternity packages, government subsidies and MediShield Life, women experiencing childbirth complications who are staying in B2 or C Wards may see their hospital bills heavily reduced.
With the new MediShield Life coverage, pregnancy complications will be covered under the inpatient hospitalisation benefit, which means that women can claim up to S$700 per day for the cost of normal Ward hospitalisation stays and up to S$1,200 per day for ICU hospitalisation costs.
This is in addition to the existing Medisave Maternity Package (MMP), which offers withdrawal limits of up to $450 per day for daily hospital charges, S$750 for vaginal delivery and S$2,140 for Caesarean delivery along with an S$900 limit of pre-delivery expenses.
Singaporean female citizens or permanent residents staying in Ward types B2+, B2 or C also qualify for subsidies, which can be up to 80% of their total bill.
If, according to the Health Ministry, 80% of women who stayed in B2/C Wards paid less than S$500 out of pocket for pregnancy complications before this coverage, this means that for some women out of pocket costs could be completely reduced.
However, women who stay at B1 or A1 Wards or private hospitals may still pay a significant amount in out of pocket costs. Women who give birth in a B1 or A1 Ward can expect to pay on average between S$3,769 and S$8,208 for an uncomplicated normal delivery.
Private hospital costs tend to be up to 2 times greater. However, complicated childbirth can increase your hospital bill up to S$17,220, bringing your out-of pocket-costs to several thousand dollars even after you use your Medisave withdrawals.
Thus, women may need to make a difficult choice if they want to opt for a lower Ward during their delivery in order to save money. However, if you are adamant about staying in an A/B1 ward but are unable to pay the bill out of pocket, you can consider taking out a personal loan to finance this expense.
While this may increase your total bill due to f the cost of interest, you may have a more comfortable experience than if you had to stay in a hospital ward you’re not comfortable. Furthermore, personal loans charge lower interest rates than credit cards, making them better for a large expense that you are unable to repay within one month.
How to Reduce Pregnancy Complications
Medical complications are not always avoidable, but there are several things you can do to reduce the risk of a problematic pregnancy. The first is to stay as healthy as possible during your pregnancy. You should not smoke, drink or do drugs. You should also aim to maintain a healthy and balanced diet and stay active.
Women who have certain conditions should speak to their doctor when they become pregnant to see if there need to be changed to medication or lifestyle. You should also do what you can to reduce high blood pressure and try to avoid getting sick.
Pregnancy is a complicated matter and every woman has different experiences. However, staying as healthy as possible can at least reduce the risk of complications and make you and your baby’s life that much better.
This was first published at Value Champion’s website, “Pregnancy Complications & MediShield Life: What the New Coverage Means for Singaporean Women“.
Finance
CPF Special, MediSave, and Retirement accounts’ interest rate rises to 4.14% for Q4 2024
The Central Provident Fund (CPF) Board and Housing and Development Board (HDB) announced that the interest rate for CPF Special, MediSave, and Retirement accounts will increase to 4.14% in Q4 2024, up from 4.08%. The 4% floor rate will be extended for another year, providing members with stability amid a volatile interest environment, the announcement stated.
SINGAPORE: In a joint announcement on Friday (20 September), the Central Provident Fund (CPF) Board and the Housing and Development Board (HDB) revealed that the interest rate for CPF Special, MediSave, and Retirement accounts will rise to 4.14% for the fourth quarter of 2024, up from 4.08% in the previous quarter.
This increase, effective from October to December, comes as the pegged rate exceeds the established floor rate of 4%.
Finance
US taxation authority to pursue wealthy tax evaders with advanced AI tools
The Internal Revenue Service (IRS) of United States has announced a comprehensive initiative aimed at aggressively pursuing individuals and entities that owe substantial amounts in overdue taxes.
Under the initiative, 1,600 millionaires and 75 large business partnerships are the primary focus of the IRS’s intensified “compliance efforts.”
WASHINGTON, UNITED STATES: The Internal Revenue Service (IRS) announced last Friday (8 Sept), that it is embarking on an ambitious mission to aggressively target 1,600 millionaires and 75 large business partnerships that collectively owe hundreds of millions of dollars in overdue taxes.
IRS Commissioner Daniel Werfel revealed that with increased federal funding and the aid of cutting-edge artificial intelligence tools, the agency is poised to take robust action against affluent individuals who have been accused of evading their tax obligations.
During a call with reporters to provide a preview of the announcement, Commissioner Werfel expressed his frustration at the contrast between individuals who dutifully pay their taxes on time and those wealthy filers who, in his words, have “cut corners” when it comes to fulfilling their tax responsibilities.
“If you pay your taxes on time it should be particularly frustrating when you see that wealthy filers are not,” he said.
The IRS’s latest initiative targets 1,600 millionaires, each of whom owes a minimum of US$250,000 in back taxes, along with 75 large business partnerships boasting average assets of approximately US$10 billion.
These entities are now under the spotlight of the IRS’s renewed “compliance efforts.”
Werfel emphasised that a substantial hiring campaign and the implementation of artificial intelligence research tools, developed both by IRS personnel and contractors, will play pivotal roles in identifying and pursuing wealthy tax evaders.
This proactive approach by the IRS aims to highlight positive outcomes resulting from the increased funding it has received under President Joe Biden’s Democratic administration.
Notably, this move comes amid efforts by Republican members of Congress to reassess and potentially reduce the agency’s funding allocation.
IRS has introduced an extensive programme aimed at revitalisng fairness within the tax system
The IRS announced the groundbreaking move aimed at enhancing tax compliance and fairness, with a particular focus on high-income earners, partnerships, large corporations, and promoters who may be abusing the nation’s tax laws.
This initiative follows the allocation of funding under the Inflation Reduction Act (IRA) and a comprehensive review of enforcement strategies.
The new effort, which builds on the groundwork laid following last August’s IRA funding, will place increased attention on individuals with higher incomes and partnerships, both of which have experienced significant drops in audit rates over the past decade.
These changes will be facilitated through the implementation of advanced technology and Artificial Intelligence (AI) tools, empowering IRS compliance teams to more effectively detect tax evasion, identify emerging compliance challenges, and improve the selection of audit cases to prevent unnecessary “no-change” audits that burden taxpayers.
As part of the effort, the IRS will also ensure audit rates do not increase for those earning less than $400,000 a year.
Additionally, the agency will introduce new safeguards to protect those claiming the Earned Income Tax Credit (EITC).
The EITC is intended to assist workers with modest incomes, and despite recent years seeing high audit rates for EITC recipients, audit rates for individuals with higher incomes, partnerships, and those with complex tax situations have plummeted.
The IRS will also take measures to prevent unscrupulous tax preparers from exploiting individuals claiming these vital tax credits.
This move underscores the IRS’s commitment to fostering a fair and equitable tax system, ensuring that all taxpayers, regardless of income or complexity, are held to the same standards of compliance and accountability.
The initiative reflects a comprehensive approach to addressing disparities in tax enforcement and strengthening the integrity of the tax system for the benefit of all Americans.
“This new compliance push makes good on the promise of the Inflation Reduction Act to ensure the IRS holds our wealthiest filers accountable to pay the full amount of what they owe.
“The years of underfunding that predated the Inflation Reduction Act led to the lowest audit rate of wealthy filers in our history. I am committed to reversing this trend, making sure that new funding will mean more effective compliance efforts on the wealthy, while middle- and low-income filers will continue to see no change in historically low pre-IRA audit rates for years to come,”
“The nation relies on the IRS to collect funding for every critical government mission, from keeping our skies safe, our food safe and our homeland safe. It’s critical that the agency addresses fundamental gaps in tax compliance that have grown during the last decade,” Werfel said.
Major expansion in high-income/high wealth and partnership compliance work
Prioritisation of high-income cases: Under the High Wealth, High Balance Due Taxpayer Field Initiative, the IRS is intensifying efforts to address taxpayers with total positive income exceeding US$1 million and recognised tax debts of more than US$250,000.
Building on prior successes, which resulted in the collection of US$38 million from over 175 high-income earners, the IRS is allocating additional resources to focus on these high-end collection cases in Fiscal Year 2024.
The agency is proactively reaching out to approximately 1,600 taxpayers in this category who collectively owe substantial sums in taxes.
Expansion of pilot focused on largest partnerships leveraging Artificial Intelligence (AI): Recognising the complexity of tax issues in large partnerships, the IRS is expanding its Large Partnership Compliance (LPC) programme.
Leveraging cutting-edge Artificial Intelligence (AI) technology, the IRS is collaborating with experts in data science and tax enforcement to identify potential compliance risks in partnership tax, general income tax, accounting, and international tax.
By the end of the month, the IRS will initiate examinations of 75 of the largest partnerships in the United States, encompassing diverse industries such as hedge funds, real estate investment partnerships, publicly traded partnerships, large law firms, and more. These partnerships each possess assets exceeding US$10 billion on average.
Greater focus on partnership issues through compliance letters: The IRS has identified ongoing discrepancies in balance sheets within partnerships with assets exceeding US$10 million, indicating potential non-compliance.
Many taxpayers filing partnership returns are reporting discrepancies in the millions of dollars between year-end and year-beginning balances, often without attaching required explanations.
This effort aims to address balance sheet discrepancies swiftly, with an initial mailing of around 500 partnership notices set to begin in early October.
Depending on the response, the IRS will incorporate these cases into the audit process for further examination.
Priority areas for targeted compliance work in FY 2024
The IRS has launched numerous compliance efforts to address serious issues being seen. Some of these, like abusive micro-captive insurance arrangements and syndicated conservation easement abuses, have received extensive public attention. But much more work continues behind the scenes on other issues.
Among some of the additional priority areas the IRS will be focused on that will touch the wealthy evaders include:
Expanded work on digital assets: The IRS is continuing its expansion of efforts related to digital assets, encompassing initiatives such as the John Doe summons and the recent release of proposed broker reporting regulations.
The IRS’s Virtual Currency Compliance Campaign, which aims to ensure compliance with tax obligations related to digital currencies, will persist in the coming months.
An initial review has indicated a potential non-compliance rate of 75% among taxpayers identified through record production from digital currency exchanges.
The IRS anticipates the development of additional digital asset cases for further compliance efforts in early Fiscal Year 2024.
More scrutiny on FBAR violations: High-income taxpayers across various segments have been utilising foreign bank accounts to avoid disclosure and related tax obligations.
US individuals with a financial interest in foreign financial accounts exceeding US$10,000 at any point in the year are required to file a Report of Foreign Bank and Financial Accounts (FBAR).
The IRS’s analysis of multi-year filing patterns has revealed hundreds of potential FBAR non-filers with average account balances exceeding US$1.4 million. In response, the IRS plans to audit the most egregious potential non-filer FBAR cases in Fiscal Year 2024.
Labour brokers: The IRS has identified instances in which construction contractors are making payments to apparent subcontractors via Form 1099-MISC/1099-NEC, yet these subcontractors are, in fact, “shell” companies lacking a legitimate business relationship with the contractor.
Funds paid to these shell companies are routed through Money Service Businesses or accounts associated with the shell company before being returned to the original contractor. This scheme has been observed in states like Texas and Florida.
The IRS is expanding its attention in this area, conducting civil audits and launching criminal investigations to address non-compliance.
This effort is aimed at improving overall compliance, ensuring proper employment tax withholding for vulnerable workers, and creating a fairer playing field for contractors adhering to the rules.
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