MediShield Life coverage to expand with new outpatient and home care benefits

SINGAPORE: The Singapore government has moved forward with a significant expansion of the MediShield Life coverage, passing a bill in Parliament on Monday (11 November) to include new models of care beyond traditional healthcare premises.

This development follows recommendations from the MediShield Life Council aimed at strengthening protections for Singaporeans against large medical bills and providing greater access to new types of treatments.

The Bill, which seeks to amend the MediShield Life Scheme, proposes coverage for a broader range of outpatient treatments, including mental health services and community-based care, as well as home-care treatments.

Additionally, the bill will raise claim limits, giving patients more financial support.

Expanding MediShield Life coverage to include treatments beyond approved institutions with enhanced regulatory standards

The MediShield Life Scheme (Amendment) Bill is designed to expand the scheme’s scope, allowing for coverage of treatments provided outside approved medical institutions, provided these services are still delivered under proper regulatory standards.

The proposed changes redefine the MediShield Life framework, permitting treatments as long as they are provided by licensed and approved medical institutions, even if those services occur outside of traditional healthcare settings.

Minister of State for Health, Rahayu Mahzam, addressed Parliament, explaining that these updates would be supported by a “more robust governance framework” to ensure the continued appropriate use of MediShield Life Fund resources.

This will include stricter oversight of medical institutions through the suspension or revocation of approvals where necessary, aiming to prevent misuse of public funds.

As part of the proposed changes, medical institutions must possess valid licences under the Healthcare Services Act 2020 to be eligible for approval to offer services covered under the scheme.

A new concept of “claimable medical treatment or services” will be introduced to ensure the scheme only covers treatments and services within approved institutional frameworks.

The Bill also outlines provisions to enhance the administration of the scheme, such as offering demand notes via email and making information about MediShield Life premiums more accessible on the Ministry of Health’s website.

Amendments address the shift to outpatient, community, and home-based care

Madam Rahayu emphasised that the shift towards outpatient, community, and home-based care has necessitated these amendments.

The new framework will allow MediShield Life to keep pace with emerging healthcare delivery models while providing targeted approvals, suspensions, and revocations of medical treatments as needed.

She stressed the importance of these changes for the sustainability of the MediShield Life Fund, as any unpaid premiums could affect the scheme’s ability to meet future claims, ultimately resulting in higher premiums for other policyholders.

MPs express concerns over potential financial burden of MediShield Life changes

Parliamentary members also raised concerns about the potential financial burden these changes might place on Singaporeans.

The MediShield Life Council previously indicated that the premium increase could be as much as 35 per cent, phased in over three years from April 2025 to March 2028.

Some Members of Parliament (MPs) expressed concern that the introduction of a new outpatient deductible and increased inpatient deductibles could place a heavier financial burden on those with insufficient Medisave balances.

Ng Ling Ling, PAP MP for Ang Mo Kio GRC and East Coast GRC MP Jessica Tan voiced concerns that the changes could lead to higher out-of-pocket costs for patients, particularly those who rely on Medisave to fund their healthcare.

Giam calls for removal of Annual Value as a means-testing criterion for MediShield Life subsidies

Workers’ Party MP for Aljunied GRC Gerald Giam urged the government to consider removing the Annual Value (AV) as a means-testing criterion for MediShield Life premium subsidies, especially for retirees and low-income households.

He proposed that, at the very least, individuals with AVs above $25,000 should still be eligible to apply for subsidies, with a comprehensive and transparent assessment based on their individual circumstances.

He argued that this approach would allow the scheme to better target subsidies to those who truly lack the cash flow to meet their healthcare needs.

MP Tan further questioned whether the increased claim limits and expanded coverage would be enough to convince patients to give up their Integrated Shield Plans (IPs).

IPs, which provide additional coverage for stays in higher-class wards in public hospitals or in private hospitals, have seen uptake from many patients, despite some using subsidised care at public hospitals.

Rahayu assures financial assistance, including MediFund, for those struggling with medical bills

In response to these concerns, Madam Rahayu assured MPs that Singaporeans facing difficulty in paying their medical bills after subsidies and MediSave usage could apply for financial assistance, such as MediFund support.

She reiterated that government support measures will offset premium increases over the next three years, ensuring that no Singaporean is denied access to appropriate healthcare due to financial constraints.

Regarding the issue of means-testing and residential property annual values (AV), Madam Rahayu highlighted that the government regularly reviews eligibility criteria for subsidies and has recently raised AV thresholds.

Those in need of further assistance can appeal for more help, which will be assessed on a case-by-case basis.