All full-rider plans, except for Prudential’s PruExtra Premier Rider, will transit* to co-pay riders upon renewal from 1 April 2021.
Full riders are no longer sold as of March 2018 due to the Ministry of Health’s requirements. (Today, if you are buying an Integrated Shield Plan, your options for riders are only co-payment riders with a minimum of 5% co-payment.)
The thing to note is that the co-payment (your out-of-pocket costs) will likely not exceed 5% of your total hospital bill and will be capped at $3,000, if you obtain pre-authorisation with your insurer prior to your surgery with a specialist on the insurer’s panel. This is subject to annual and lifetime policy claim limits. For example, if your hospital bill is $30,000, with 5% of co-payment, your out-of-pocket costs will be $1,500.
This 5% of the co-payment may be offset partially or fully by MediSave and/or your corporate insurance. It is advisable to check with your Human Resource department if you are covered under a corporate insurance.
As part of the recent changes, some insurers have also introduced claims-based pricing for selected Integrated Shield Plans. Learn more about claims-based pricing below.
* As of 31 March 2021. Please check with your insurance agent for the latest policy changes. Private insurers include AIA, Aviva, AXA, Great Eastern, NTUC Income and Prudential.
Claims-based pricing
Some insurers such as Prudential, AIA and Great Eastern have introduced claims-based pricing for selected Integrated Shield Plans. With claims-based pricing, your rider premiums at each policy renewal are adjusted based on your claims during the previous policy year. How this is calculated is dependent on your insurer.
For example*, the standard premium for a co-pay rider at 38 years old is $722. If a claim is made at a private hospital in 2021, your premium at the next policy year (2022) will increase by 1.5 times to $1,083. The adjusted premium will go then back to the standard level in 2023.
*This scenario is based on a Great Eastern TotalCare Elite-P co-pay rider as of 1 April 2021 with a claim amount > $2,000. Please check with your insurer to find out more information about your plan and premiums.
Call or WhatsApp Parkway Insurance Concierge at +65 9834 0999 to find out more about your Integrated Shield Plan coverage.
While health insurance in the United States can help pay most of your medical bills, there will still be a portion that must be paid out of pocket. Use this article as a guide to help you better understand these costs and to give you a better idea of what to look for while shopping for health insurance.
Premium
A premium is the initial cost of buying insurance coverage and can be paid as a lump sum or as installments throughout the duration of the policy. If you fail to pay your premium when it is due, your insurance policy will be automatically cancelled. Depending on your insurance carrier, your policy may be restored if you pay the outstanding amount within a certain time period.
Deductible
The deductible is the amount of money you are responsible for paying for medical expenses before the insurance company begins to pay on your behalf. For example: If you choose a plan with a $1,000 deductible, you are responsible for the first $1,000 of your medical bills. After your deductible has been paid your insurance company will begin to pay for all eligible expenses.
Most insurance plans have different deductibles for different types of coverage, for example you might have to meet a $1,000 deductible before your insurance will pay for a hospital visit, but only a $250 deductible before your insurance will pay towards prescription medication. Keep in mind that the higher your deductible, the lower your premiums will be each month, but you will also be responsible to pay more when you seek treatment.
Coinsurance
Coinsurance is a cost sharing agreement between the insurance company and the insured. This means that the insured must pay a certain percentage of his or her medical costs (after the deductible has been paid). These percentages differ from plan to plan so be sure to check the policy wording before choosing a plan.
Copayment
Not to be confused with coinsurance, copayment is the set amount you pay each time a medical service is accessed. Copay fees vary between policies, but are typically $25 or less. Your insurance policy for example, may require you to pay $25 for a doctor’s appointment and $10 per prescription up to a specified coverage limit.
Out-of-pocket Maximum
This is the highest dollar amount that you must pay for covered expenses under your insurance policy, including deductibles and coinsurance. After this dollar amount has been reached, your eligible medical bills will be covered 100%. Generally these maximums are between $1,000 for an individual and up to $11,000 for a family. Most likely you will never reach this out-of-pocket maximum, but it can serve as a nice safety net.