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Health & Insurance

Healthcare in Singapore

The Southeast Asian city-state is well known for its medical quality standards and the affordable plans for public healthcare in Singapore. Unfortunately, many expats are not eligible for these schemes. Still, we’ll explain how healthcare in Singapore works and which options temporary residents have.

 

If you are going to relocate to Singapore, you needn’t worry about your health. Healthcare in Singapore boasts excellent quality standards, both in the public and private sector. The system of public healthcare in Singapore consists of several government schemes for citizens and permanent residents. These schemes reimburse a substantial part of medical bills. Nonetheless, most participants still need to cover some costs from their own pocket — or via supplementary insurance.

Government healthcare in Singapore is subsidized and organized by the CPF, the Central Provident Fund Board, and the Ministry of Health. The CPF is an integral part of Singapore’s social security in general. Its provisions for public healthcare in Singapore include the four insurance plans described below.

Medisave: Saving Up for Medical Costs

Established in 1984, Medisave is the oldest component of public healthcare in Singapore. Every Singaporean and permanent resident employee needs to put away an annual 8 to 10.5% of their income. The money is collected in a dedicated savings account, where it accrues tax-free interest. The exact percentage depends on the person’s age. Contributions are lowest for those under 35 and highest for the 50+ age group.

Also, those who earn less than 1,500 SGD per month contribute to Medisave at special rates. The self-employed pay into the plan according to their net income. You can accumulate up to 49,800 SGD in your Medisave account — this limit is called the Basic Healthcare Sum (BHS). Any overflow goes into different CPF funds, e.g. your Retirement Account.

Singaporean citizens and permanent residents can use their Medisave money to pay for specific medical costs at all public healthcare institutions, as well as approved private hospitals and clinics. Those costs mainly include bills for inpatient hospital care, day surgery, psychiatric treatment, specific chronic diseases (e.g. diabetes, asthma, or depression), therapies for people with cancer or HIV-positive patients, childbirth, and selected health screenings. For a complete and up-to-date list of treatments covered by the Medisave scheme, see the CPF website.

However, there are certain daily, monthly, or yearly withdrawal limits on Medisave healthcare in Singapore. All fees exceeding those limits must be paid for by other means. Your immediate family members (parents, spouse, and children) can provide for you from their account, but the limits apply to these contributions as well.   

Medishield Life: Assistance for Larger Medical Bills

To help those with serious illnesses, whose Medisave account may not be nearly enough to account for their bills, the government founded another plan for healthcare in Singapore. Introduced in late 2015 and replacing the previous Medishield scheme, Medishield Life works as a so-called “catastrophic illness insurance scheme” that makes provisions for hospitalization, surgery, and selected outpatient treatment. Every citizen or permanent resident is automatically insured via Medishield Life unless they choose to opt out of the program.

Participants pay annual premiums according to their age group: only 50 SGD for those under 21, but up to 1,190 SGD for patients aged 86 to 90 (as of 2016). These premiums can be taken from your or your family’s Medisave account. However, even if you have Medishield Life healthcare in Singapore, you still pay a yearly deductible sum before you get any reimbursements. There will also be co-payments on each fee.

Again, you can take the co-payments from your Medisave account as long as you don’t meet the withdrawal limit for particular conditions. Then you must pay the rest in cash. Private insurance companies in Singapore offer a top-up for Medishield Life coverage: the Integrated Shield Plan is a private insurance in addition to your Medishield Life plan, meaning you can take advantage of better hospital wards and private sector care, which would otherwise not be covered with just Medishield Life.

ElderShield: Supporting You through Your Later Years

The third pillar of government-subsidized healthcare in Singapore is called ElderShield. As the name implies, this insurance schemes assists elderly patients with severe long-term disabilities. Singaporean citizens and permanent residents are automatically enrolled at the age of 40 but have the option to opt out and join at a later date if they want. From the age of entry to the age of 65, those insured via ElderShield pay a fixed yearly premium. This is higher the older an insured person is at the age of entry to ensure people pay a similar amount overall. For example, a 40-year-old Singaporean woman who joined the scheme after September 2007 will pay an annual lump sum of 217.76 SGD for the next 26 years. The premiums for men are usually lower, due to their lower life expectancy.

If ElderShield participants become severely disabled in old age — i.e. they need help with tasks such as washing, dressing, or feeding themselves — the program assists with nursing care. They get monthly cash payouts of 400 SGD for up to six years to cover some of the related costs. There are three government-approved insurance providers in Singapore that offer ElderShield plans: Aviva, Great Eastern, and NTUC Income. If you want bonus coverage with higher payouts or a longer period of time, you have to buy so-called ElderShield supplements from one of these three companies.

Medifund: Ensuring Healthcare Remains Affordable for Citizens

Last but not least, a further healthcare scheme in Singapore caters to the needs of the poor and the elderly. Singaporean citizens who cannot afford their medical bills can apply for financial assistance under Medifund, Medifund Junior, or Medifund Silver. Medifund Junior is aimed at helping children in needy families, while Medifund Silver is aimed at elderly people in need of financial assistance. They receive treatment only at accredited facilities. There they have to talk to a Medical Social Worker about government aid.

The reimbursement they get is decided on a case-to-case basis. It normally depends on their health issues, their medical bills, and their social and financial situation. Medifund explicitly includes citizens only. Even permanent residents without citizenship are not eligible for this program.

Again, it needs to be emphasized that expats with temporary passes — e.g. residence/work permits for foreign employees — have no access to public healthcare in Singapore. We will tell you more about insurance options for expatriates in the second part of this guide.

 

We do our best to keep this article up to date. However, we cannot guarantee that the information provided is always current or complete. 

InterNations Expat Magazine