Wednesday, 27 October 2010

Contradicting or me?

Khaw Boon Wan's latest blogpost, 'Keeping Umbrellas Strong', mentioned that he paid only $8 for a Heart By Pass surgery. All thanks to his Medishield and a private Shield supplement. Medisave took care of his co-payment.

I'm confuse by both his blogpost and MOH Spokesperson's facebook response on how Khaw paid only $8. To me, there is a slight contradiction between the two.

This was extracted from MOH facebook (

I'm going to dissect this paragraph:

"Health Minister’s total bill for his bypass surgery came up to about $25,000; of which $20,000 was paid by insurance, and $5,000 by Medisave. Minister had subscribed to Basic MediShield (since it was launched in 1990) and topped it up with a private Medisave-approved Shield which covers Class A and private hospitals. He did not have any riders. The insurance premium for someone in his age range (51-60 years old) is about $330 - $662 for a Shield plan targeted at Class A hospitalisation. Presently, one can use up to $800 per policy per year from Medisave to pay for Medisave-approved Shield plans."

His total bill is $25, 000 ( I believe this is a round off figure).

He has a Medisave-approved Shield plan or what is better known as an Integrated Shield plan. This is a combination of Medishield and a private Shield. There are 5 companies in the market that provides this.

The Medisave-approved Shield reimburse $20, 000. Again this could be a round off figure.

All Medisave-approved Shield comes with deductibles and co-insurance. Since there is no mentioned of which company his Shield plan was bought from, I assume that his deductibles is $3, 000 and co-insurance is 10% (adopted by most Insurer).

The claim should look like this:
Total bill : $25, 000
Less deductibles: $3000
Balance: $22, 000
Less Co-insurance: 10% of $22, 000 = $2200
Balance that Medisave-approved Shield plan will reimburse (less exclusions or pre existing, if any) = $19, 800

The total amount of both deductibles and co-insurance is $5200.

He did not have any riders that is the extra plans that private Insurer offer to cover both deductibles and co-insurance. Like what is mentioned on facebook, can I assume that the $5000 from Medisave was used to finance both deductibles and co-insurance?

But his blog post states this, 'Medisave took care of my co-payment of the bill'.

Co-payment is used as a separate term from deductibles in the MOH website.

Click on this link, to see how the website separates co-payment from deductibles. If co-payment comprises of both deductibles and co-insurance then it should not separate the two terms.

If co-payment does not include deductibles then according to the statement above from his blog, Medisave only took care of $2200 not $5000 that was reflected in facebook.

And if my assumption is right, Medisave-approved Shield plan reimburse $19, 800. Medisave was used to pay his co-insurance or co-payment that is $2200. How did he pay for deductibles of $3000? How did he only pay $8?

Is there something wrong with the way I interpret the two?

I hope to have someone to enlighten me on this.

I've nothing against the scheme, in fact, I think that one should not opt out from Medishield and according to one's budget or hospitalisation preferance should buy a Medisave-approved Shield plan because Medishield has its flaws.

Medishield comes with per event claim limits and annual limits. That is to say, every item that is claim comes with a limit, one don't get to claim full. It is when a Medisave-approved Shield is bought then this claim might be claim in full because most of them are 'As-Charged', excluding pre-existing conditions and exclusions. Medishield is only good for hospitalisation in C or B2 ward. If one chooses to stay in a different word, pro-ration factor will kick in.

Since one can either use money in Medisave for hospitalisation charges or pay the premiums for Medisave-approved Shield plans, I think it makes more sense to use it to pay premiums for a Medisave-approved Shield plan. This is because with the current ceiling allowed for Medisave which is $39, 500, this can easily be wiped out for any treatment or surgery of catastrophic disease in Singapore's expensive healthcare treatment :(

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