13.JAN.2017 6 MIN READ | 6 MIN READ

Many of us find it challenging to understand our health insurance coverage. But it is important that we know what it means, so we can make the most out of it. With health insurance, private healthcare can be more affordable than you think.

Last updated on 28 September 2021

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 could be paying $0 for a private hospital bill.

Knowing that you’re covered for private healthcare takes 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 medical coverage for private healthcare? It would mean all of the following:

1. You have an Integrated Shield Plan

Your Integrated Shield Plan is what covers and pays for the bulk of your private hospital bill. It comprises two parts:

  • MediShield Life
  • An additional private insurance portion managed by your private insurer

Integrated Shield Plan

As you are a Singaporean or Permanent Resident, you are automatically covered under MediShield Life – a national healthcare scheme run by the Central Provident Fund (CPF) Board.

Your Integrated Shield Plan is an extension of your MediShield Life plan. This private insurance plan that you have purchased from your insurance agent offers additional benefits and higher medical coverage, such as hospitalisation in a private hospital.

What are the benefits of an Integrated Shield Plan?

Depending on the plan and riders that you choose, your Integrated Shield Plan can provide these benefits:

  • Higher ward classes or stay at a private hospital
  • Higher annual claim limits
  • Claims for pre- and post-hospitalisation treatments
  • Choice of doctors
  • Shorter waiting time to see specialists

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 covers the bulk of your hospital bill, there are out-of-pocket costs which you would have to pay for, such as:

  • Deductible (the first $3,500 of the bill) – this is the basic sum you must contribute to your bill before you make your claim
  • Co-insurance (10% of the remaining bill, minus the deductible)

Co-insurance plan

However, you would not be required to pay for these compulsory cash payable portions if you have subscribed to a rider.

What are Integrated Shield Plan riders?

An Integrated Shield Plan 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.

Your Integrated Shield Plan will pay for the bulk of your hospital bill, while the rider will cover the deductible and co-insurance portions of your bill.

The bottom line is: if you own an Integrated Shield Plan covered for ‘Private Hospitals as Charged’ as well as an additional rider, you would be entitled to claim 90 – 100% of your private hospital bill.

For example: let’s say you go for cataract surgery in a day procedure (no hospitalisation required) and the total bill comes up to $11,065. If you have an Integrated Shield Plan with co-pay rider, you would have to pay 5% of the bill, which works out to $553.25.

However, if you have an Integrated Shield Plan with full rider, you won’t have to pay any out-of-pocket costs at all, as your medical bill would be fully covered by your insurance!

It is 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.

Get an estimate for your medical bill at Mount Elizabeth Hospital

Private healthcare is more affordable than you think. With the right Integrated Shield Plan, you can be assured of receiving prompt and quality treatment in a comfortable environment, all without fear of breaking the bank.

Which Integrated Shield Plans are available?

These Integrated Shield Plans provide coverage for private healthcare at our hospital:

  • AIA HealthShield Gold Max A
  • Aviva MyShield Plan 1
  • AXA Shield Plan A
  • Great Eastern Supreme Health P Plus
  • NTUC Income Enhanced IncomeShield Preferred
  • Prudential PruShield Premier

Mount Elizabeth Hospital Bill Estimator

Using this hospital bill estimator, you can provide information on your Integrated Shield Plan and riders, and we will give you an approximation of your out-of-pocket expenses for common surgical procedures.