Understanding Health Insurance Coverage for Private Hospitals in Singapore

Perhaps your insurance agent has told you that you are fully covered for private healthcare. But what does that really mean?

Does that mean you wouldn't have to fork out a cent after getting treated at a private hospital? How would the bill payment work out?

Firstly – yes, depending on your insurance policy, you definitely could be paying zero for a private hospital bill.

Knowing that you're covered for private healthcare would be a huge load off your back. You can rest easy, knowing that in the event of an unexpected illness or accident, you'd be receiving prompt and quality treatment in a private, comfortable environment – free from any worries about the bill.

So what does it mean to have full coverage for private healthcare? It would mean you have all of the following:

1. You have an Integrated Shield Plan

Your Integrated Shield Plan is what would cover and pay for the bulk of your private hospital bill. It comprises of two parts – the basic MediShield Life and an additional private insurance portion managed by your private insurer. As you are a Singaporean or Permanent Resident, you are automatically under MediShield Life – a national healthcare scheme run by the Central Provident Fund (CPF) Board.

To put it simply, your Integrated Shield Plan is an extension of your MediShield Life plan. The private insurance plan that you have purchased from your insurance agent is integrated into your existing MediShield Life plan to offer additional benefits and higher medical coverage, including private healthcare.

2. You selected a 'Private Hospitals as Charged' plan

When choosing an Integrated Shield Plan, you picked one that covers for private healthcare 'as charged'. It means that your insurance policy does not restrict claims to a sub-limit. In other words, you are allowed to submit the entire hospital bill for insurance claim without any restrictions.

3. You pay annually for an additional rider

While an Integrated Shield Plan would cover the bulk of your hospital bill, there are the deductible (the first $3,500 of the bill) and co-insurance (10% of the remaining bill) portions of the bill, which a patient would be expected to pay. However, you would not be required to pay for these compulsory cash payable portions as you have subscribed to a rider.

A rider is a monthly or annual cash premium add-on that reimburses the deductible and co-insurance portions of your medical bill so you are covered from the first dollar!

The bottomline is that you own an Integrated Shield Plan covered for 'Private Hospitals as Charged' as well as an additional rider, all of which entitle you to claim 90 – 100% of your private hospital bill! Your Integrated Shield Plan will pay for bulk of your hospital bill while the rider will cover the deductible and co-insurance portions of your bill.

It's important to understand your health insurance coverage so you can get the best value from it. Check with your insurance agent to clarify if your Integrated Shield Plan covers you fully for private hospitalisation.