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 :(


xizor2000 said...

Thanks Lilian for your post. I was going to work on a post myself but I am too lazy to work on the facts of my insurance. I was also about to look for a break down of his bill so your breakdown here is helpful.

Anyway, for comparisons. I paid an annual premium of $2000+ for my dad (going beyond 72 this year). And because the frakking policy cap the amount I can use to $880 (or $800), I had to top up a good $1200 _IN CASH_. Personally, I would appreciate if I can paid IN FULL with my medisave.

My dad was hospitalised recently, and the bill came up to $4000+. After all the deductions and what not, I still had to pay $1000+ from my Medisave. A rider I bought gave me back $500 in cash (in reality to buy some health food for my dad for recuperation). So even if I put that $500 BACK into the CPF, it would have still cost me $500+ in CPF. I could hardly fathom how Khaw arrived at his $8 bill.

Anyway, a former legislator called 沈富雄 in Taiwan was interviewed by 亞洲週刊 and he mentioned he paid (if I am not wrong) 500NT for his bypass op - that's like SGD25. IIRC, his insurance is covered by a policy paid for by the Taiwanese gahmen.

By boasting about how 'cheap' medicare cost him in Singapore is, Khaw has probably navigated into a potential minefield. This is something for the oppositon to work on and chew him apart in the coming elections because no one ever looked at the annual burden one has to shoulder 'just in case' compared to the other countries.

xizor2000 said...

**Correction to the 沈富雄 and Taiwan part** He has to pay 20,000NT$, that's roughly S$1000 - after all the medical insurance part. Basically about the same as what I paid for my dad's hospitalisation.

The only difference - the medical insurance burden is shared: Employer 60%, Employee 30%, Gahmen 10%. This is a unique system that works for Taiwan, and I am not proposing to implement it here piecemeal. But considering the fact that this guy paid $1000 for a BYPASS in CASH, with 70% of his medical insurance burden taken up by others, would demonstrate to us there is NOTHING for Khaw Boon Wan to boast about. :)

I have repost the 亞洲週刊 article here:

It's in traditional Chinese so it's a little hard to read.

Thank you for visiting