Should I downgrade my Raffles Shield plan coverage? This is what we think

A brief recap on MediShield Life and the Integrated Shield (IP) plans offered by Raffles Health Insurance.

MediShield Life (MSHL) – A mandatory basic health insurance, MSHL provides universal coverage for all Singapore citizens and Permanent Residents (PRs), and is administered by the CPF Board.

Integrated Shield (IP) plans – Consider IP plans if you would like to receive treatment at higher ward types or private hospitals. IP plans will also provide annual policy limits higher than that of MSHL. IP plans are offered by seven private insurers with Raffles Health Insurance being the only health insurance company in Singapore to be backed by a medical group. Raffles Health Insurance is one of the seven private insurers to offer IP plans.

In this article, we study the different Raffles Shield plans and riders to determine if you should pay for the highest-tiered Private plan, and share alternatives to get private hospital coverage at lower premiums.

What do the different hospital ward classes mean:

Class A ward – Single bed, air-conditioned room with attached bathroom and television.

Class B1 ward – 4 to 5 bedder air-conditioned room with shared attached bathroom and television.

Class B2 ward – 6 bedder room with shared bathroom (bathroom may not be attached to room). Ward may be air-conditioned or fan ventilated.

#1 Difference in benefits between Raffles Shield Private and Raffles Shield A

Is there really a significant difference in coverage and benefits between Raffles Shield Private and Shield A plans? Here are the five main differences between the two plans.

Annual policy limit for panel providers, and ward entitlement - A major difference between Shield Private and Shield A plan is the annual policy limit and ward entitlement benefit. With Raffles Shield Private, individuals have a ward entitlement for private hospitals and an annual policy limit of up to $1,500,000 if they seek treatment at panel or extended panel providers or an annual limit of $600,000 for non-panel providers. Raffles Shield A plan however provides coverage for Class A wards at public hospitals and has an annual policy limit of $600,000.

[💡 If you do not plan to visit panel providers for treatment then the annual limit for Shield A and Private plans are actually the same at $600,000 per policy year. List of panel providers for Raffles Shield can be found here.]

Inpatient psychiatric treatment – Raffles Shield Private offers a higher benefit of $8,000 per year as compared to Raffles Shield A’s $6,000 per year. This includes post-hospitalisation psychiatric treatment.

Living donor organ transplant – The living donor organ transplant benefit gives up to $60,000 for Raffles Shield Private as compared to Shield A’s $40,000 benefit. In the event that the insured is the living donor donating an organ, a 24-month waiting period for recipient will apply.

Congenital abnormalities benefit for insured’s biological child – A benefit only applicable to females, Raffles Shield Private offers a $30,000 per lifetime benefit as compared to Shield A’s $20,000 per lifetime benefit. The benefit per child is also different with Shield Private plan offering $5,000 per child as compared to Shield A’s $4,000 per child.

Final expense benefit– Raffles Shield Private provides a $5,000 final expense benefit, as compared to Shield A’s $4,000 final expense benefit.

^{List of differences and similarities are for illustration purposes only. Please refer to your policy wording for more information. Information retrieved on 22 November 2024.}

Premiums for Raffles Shield Private and Raffles Shield A

#2 Do I need riders for my Raffles Shield plan?

Integrated Shield plan riders are intended to enhance your hospitalisation coverage by offering additional benefits. The three IP riders available for Raffles Shield plans are:

To reduce co-payment and deductible: Key Rider

The addition of Key Rider will reduce the co-payment needed from 10% to 5%. This will also be capped at $3,000 per policy year for pre-authorised treatment under the extended panel. Note that there will be no cap on co-payment for treatments that are not pre-authorised.

Key Rider will also remove the annual deductible required, and offer additional benefit for Cancer Drug Treatments that are not on the Cancer Drug List (CDL).

To enhance your coverage: Premier Rider

The addition of Premier Rider will increase your monthly Cancer Drug Treatments on the CDL limits to 2 times the MediShield Life (MSHL) limit. Non-CDL Cancer Drug Treatments will also have a $20,000 annual limit for drug classes A to E.

Premier Rider will also offer additional benefits such as immediate family accommodation, post-hospitalisation follow-up Traditional Chinese Medicine (TCM) treatment, post-hospitalisation home care, emergency outpatient due to accident, and ambulance services.

[💡 Post-Hospitalisation Follow-Up TCM Treatment for Raffles Premier rider includes Physician’s consultations, herbal medication, acupressure, acupuncture, cupping and moxibustion. Benefit is given if treatment is done within 180 days at TCM clinics at Raffles Hospitals or Government Restructured Hospitals only. There is no per visit cap for this benefit.]

For higher cancer treatment coverage: Raffles Cancer Guard Rider

Cancer coverage with MediShield Life (MSHL) is limited to $200 - $9,600 per month for drugs on the Cancer Drug List (CDL). Cancer drug services claims are also limited to $3,600 per annum with no coverage given for non-CDL treatments.

Raffles Cancer Guard Rider enhances this coverage by offering up to 18 times the MSHL limit for Cancer Drug Treatments on the CDL. This allows you to get up to 23 times the MSHL limit when you add Raffles Cancer Guard Rider and Premier Rider to your Raffles Shield Private or Shield A + Raffles Hospital Option plan.

You will also receive up to $250,000 per year for non-CDL Cancer Drug Treatments with the addition of Raffles Cancer Guard Rider.

An illustration for Raffles Shield Private with riders

How can I get private hospital coverage at lower premiums?

Option 1: Downgrade from Raffles Shield Private to Shield A and add a Raffles Hospital Option

Want access to private hospitals but at a lower cost? If you are comfortable with the idea of only seeking treatment at Raffles Hospital and public hospitals, then downgrade from Raffles Shield Private plan to Shield A and add the Raffles Hospital Option. By doing so, you will still have access to private hospital facilities at Raffles Hospital but will pay less premiums as compared to a Shield Private plan. (Note that medical underwriting may be required for the addition of Raffles Hospital Option.)

Premiums for Raffles Shield Private vs Raffles Shield A + Raffles Hospital Option

Option 2: Add the high deductible option to reduce your premiums

If you want coverage for all Private Hospitals, and do not want to be limited to Raffles Hospital or public hospitals only, then add the high deductible option to your Raffles Shield plan. This will increase your deductible to $10,000 per policy year for all ward types and ages, in exchange for 30% cheaper premiums.

Premiums for Raffles Shield Private without high deductible option vs Raffles Shield Private with high deductible option

Do note that you will not be able to add the High Deductible option if you have Key Rider added to your Raffles Shield plan.

Have a question? Speak to us about your shield plans here:

Read also,

A Guide to assessing your Enhanced IncomeShield plan

Assess your Singlife Shield plan with this one guide

My Integrated Shield plan premium is increasing; would lowering the cost of my hospital insurance compromise my coverage?

Is private hospital insurance really necessary?

Answering commonly asked questions about Integrated Shield Plans

What is hospital cash benefit, and why will I need this?

^{Information obtained from:}

^{https://www.moh.gov.sg/managing-expenses/schemes-and-subsidies/medishield-life/medishield-life-benefits#Cancer-Drug-List}

^{https://www.raffleshealthinsurance.com/products/raffles-shield/learn-more/raffles-shield-plans/}

^{https://www.raffleshealthinsurance.com/wp-content/uploads/2021/03/Raffles-Shield-Product-Summary-1-April-2024-Finalv1-1.pdf}

^{https://www.raffleshealthinsurance.com/products/raffles-shield/learn-more/raffles-cancer-guard/}

^{Information retrieved on 22 November 2024.}

^Disclaimer:

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