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Key Points
Context of the Review
- Since its inception in 2015, the MediShield Life scheme has undergone several enhancements to improve coverage while maintaining affordability and sustainability.
- The 2024 Review aims to ensure that MediShield Life remains relevant as a national health insurance scheme amidst rising medical costs and changing healthcare delivery models.
Impetus for the 2024 Review
The Council identified three key factors driving the need for review:
- Rising Medical Bills: Current claim limits are insufficient, covering just under 80% of subsidized bills, necessitating an increase to better protect patients from large medical expenses.
- Shift in Healthcare Delivery: There is a growing trend towards outpatient and home-based care, requiring MediShield Life to expand its coverage beyond inpatient settings.
- Advancements in Medical Technology: New, high-cost therapies are emerging, which should be covered by insurance if they are clinically and cost-effective.
Recommendations for Changes to Scheme Benefits
- Increase Claim Limits:
- Daily claim limits for the first two days in normal wards will increase from $1,000 to $1,630.
- ICU daily claim limits will rise from $2,200 to $5,140.
- Policy year claim limit will increase from $150,000 to $200,000.
- Outpatient Coverage Enhancements:
- Significant increases in claim limits for outpatient treatments, such as:
- Kidney dialysis limits will rise from $1,100 to $1,750 per month.
- Introduction of coverage for new outpatient treatments, including repetitive Transcranial Magnetic Stimulation (rTMS) for mental health conditions.
- Significant increases in claim limits for outpatient treatments, such as:
- Coverage for New High-Cost Treatments:
- Expansion of coverage to include Cell, Tissue, and Gene Therapy Products (CTGTPs), which are expected to become more mainstream.
Financial Adjustments and Support Measures
- Premium Adjustments: To support the increased claim limits and new benefits, premiums will need to be adjusted. The Council recommends:
- A cap on premium increases to no more than 35%.
- Phasing in premium increases evenly across the cycle.
- Enhanced premium subsidies for lower- to middle-income households.
- Incentives for Healthy Lifestyles: The Council suggests introducing premium discounts for policyholders who engage in healthy living practices, promoting preventive health measures.
Insights from Public Engagement
The Council engaged over 300 stakeholders through focus groups and discussions, highlighting concerns about healthcare affordability and the need for better coverage.
Conclusion
The proposed changes aim to improve financial protection for Singaporeans facing large medical bills and ensure that MediShield Life remains a sustainable and effective health insurance scheme. You can access the previous document about Annex A – MediShield Life 2024 Review Press Release. For more details, please check the document below:
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