Disappointed with the new integrated shield riders? This is what we think

In our previous article "All you need to know about the new integrated shield riders", we highlighted the new integrated shield plan rider changes and share how this may affect you as a policyholder.

To recap, here are the three main changes that were made to integrated shield plan riders:

1. There is a minimum of 5% co-payment necessary even with a rider
2. Introduction of panel and non-panel providers with the payable out of pocket expenses differing between the two
3. Removal of hospital cash benefit

If you are disappointed with the level of coverage offered by new integrated shield riders and wonder if it is still possible to receive the same level of coverage as old integrated shield riders, this is our advice to you.

#1 There is no affordable way around the minimum 5 per cent co-payment required

As mentioned in our previous article, full riders that require zero co-payment have resulted in doctors overcharging or providing unnecessary treatment, and patients making more claims for treatments that may not be necessary. Riders with a minimum of 5 per cent co-payments was therefore introduced to manage healthcare costs in the long run and ensure that individuals are more conscious about their treatments and claims.¹ With these revisions meant to deter individuals from misusing and abusing the healthcare system, there is no affordable way around this 5 per cent co-payment.

While alternatives such as an international health plan can fully cover hospitalisation cost with zero co-payment required, the annual premiums of these plans do not come cheap. Therefore for Singaporeans and Permanent Residents who already have access to MediShield Life and Integrated Shield Plans, we do not recommend getting overlapping health coverage. Instead, we suggest choosing panel treatments whenever possible as this will help to keep your out of pocket expenses low. Panel treatments will cap your co-payment amount to a maximum of $3,000 per policy year.

#2 Choose panel treatment whenever possible

The new integrated shield plan riders requires at least 5 per cent co-payment for your hospital bill, with this capped at $3,000 per policy year for panel treatments. However, there will be no cap on this 5% co-payment should you choose to seek treatment at a non-panel clinic. As such, we recommend seeking treatment at panel clinics so as to incur a lower out of pocket expense. However if you insist on choosing a clinic or hospital that is non-panel, then you must either be prepared for the higher out of pocket expenses or consider supplementing your hospitalisation coverage with an International Health plan.

(See "Are Integrated Shield Plans Necessary?")

#3 Foreigners living in Singapore can consider International Health plans for full coverage with zero co-payment

As mentioned in our previous point, while an International Health plan can offer full coverage with zero co-payment, the annual premiums of these plans tend to be higher. Therefore, we mainly recommend these plans for two groups of individuals: foreigners living in Singapore and Singaporeans who spend a significant portion of their time overseas. This is because all Singaporeans and Permanent Residents (PRs) by default, have coverage from MediShield Life. This thus makes International Health plans less ideal for this group of individuals, especially if they do not live or work overseas and spend the majority of their time in Singapore.

However, this is not the case for foreigners living in Singapore as they do not have the default MediShield Life hospitalisation coverage. Moreover, they may have different considerations when looking for health coverage. One such consideration may be the portability of their health plans. International Health plans offers worldwide coverage* and are portable. This allows them to bring their International Health plans along should they move or relocate to another country in future. Therefore, for foreigners living in Singapore, we recommend getting an international health plan instead of MediShield Life for health coverage in Singapore.

Comparing International Health Plan vs Integrated Shield Plan for foreigners

Profile: Age 45 foreigner non-smoker male for private ward hospitalisation coverage.

^{*Area of coverage can be chosen for ASEAN, Asia, Worldwide excluding USA and Worldwide including USA.}

^{Prices shown are accurate as of 16 June 2021. Changes subjected to insurer’s discretion.}

To find out more about International Health plans, you may read our article here: 3 Reasons An International Health Plan Is For You.

#4 Hospitalisation cash benefit serves as income replacement in the event that you are hospitalised and unable to work

Lastly, the removal of hospitalisation cash benefit in Integrated Shield Plan riders means that you would no longer be able to receive a daily cash benefit for choosing to stay at a ward lower than what your plan entitles.

Hospitalisation cash benefit serves as an income replacement in the event that you are hospitalised and unable to work. With the removal of hospitalisation cash benefit in integrated shield plans, you will no longer receive income replacement when you are hospitalised. While employees can get paid hospitalisation leave, this will only be given for 60 days. Anything in excess of 60 days will then likely have to be taken as unpaid leave. With a hospitalisation cash benefit, this allows you to continue receiving some income from your plans even if you are hospitalised beyond 60 days.

Alternatively, individuals who are self-employed would also benefit from a hospitalisation cash benefit as they would not have any income if they do not work. While employees still have a 60 day hospitalisation leave as "buffer", the self-employed do not have such a “buffer” if they are hospitalised or on hospitalisation leave for a prolonged period. With hospitalisation cash benefit this allows those who are self-employed to receive income replacement for every day that they are hospitalised, up to the benefit limits of the plan.

If you are interested in getting a hospitalisation cash benefit, then plans such as Hospital CashPlus, Hospital Income Protect, and International Health may be suitable. In our next article "Cover Your "Missing" Hospitalisation Cash Benefits With These 3 Plans", we elaborate on three plans that will cover for this missing Hospitalisation daily benefit.

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_{¹Source: https://www.moh.gov.sg/docs/librariesprovider5/pressroom/current-issues/cos-2018-media-factsheet---keeping-healthcare-costs-sustainable-for-all-singaporeans.pdf}