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Navigating Health Insurance: A Guide To Understanding And Choosing The Right Plan

health insurance guide

Health insurance is an essential component of Singapore’s healthcare system, providing individuals with financial protection and access to quality medical care. When it comes to selecting the right health insurance plan, integrated shield plans play a vital role. This article serves as a comprehensive guide, focusing on integrated shield plans in the Singapore context, to help you navigate the intricacies of health insurance and make informed decisions regarding your coverage.

1. Understanding Integrated Shield Plans:

Integrated Shield Plans (IPs) are comprehensive health insurance plans that offer additional coverage on top of the basic benefits provided by the MediShield Life scheme. These plans are offered by private insurers in collaboration with the Central Provident Fund (CPF) Board. IPs provide policyholders with enhanced coverage for hospitalization, specialist consultations, and related medical expenses, enabling greater flexibility and access to a wider network of healthcare providers.

2. Key Features of Integrated Shield Plans:

When considering integrated shield plans, it’s essential to understand their key features:

a. Coverage for Private Hospitals:

Integrated shield plans can provide coverage for treatment in private hospital wards, allowing policyholders to benefit from personalized care and enhanced amenities.

b. Choice of Doctors and Hospitals:

With an integrated shield plan, you can access a broader network of doctors and hospitals, giving you more options for medical care and specialist consultations.

c. Additional Benefits:

Integrated shield plans may offer additional benefits such as coverage for some outpatient treatments, pre- and post-hospitalization expenses, and emergency overseas medical treatment.

d. Deductibles and Co-Insurance:

IPs typically involve deductibles and co-insurance, where policyholders share a portion of the medical expenses. Understanding these cost-sharing components is crucial to managing your healthcare expenses effectively.

3. Evaluating Integrated Shield Plans:

When choosing the right integrated shield plan for your needs, consider the following factors:

a. Coverage Needs:

Assess your healthcare requirements, including hospitalization, specialist consultations, and specific medical treatments. Look for a plan that aligns with your needs and provides comprehensive coverage. Do consider that your health care needs may increase as you age.

b. Preferred Hospitals and Doctors:

Check if your preferred hospitals and doctors are within the insurer’s panel, ensuring you have access to the healthcare providers you trust. Some insurers like Income will give you better coverage if you use doctors within their panel.

c. Affordability:

Evaluate the premium costs of different integrated shield plans and ensure they fit within your budget. Strike a balance between comprehensive coverage and affordability. Remember that you can use your MediSave to pay for your Integrated Shield plan premium up to certain limits. The limit is up to $300 per year for those at age 40 years and below on their next birthday. $600 per year for those at age 41 to 70 years on their next birthday.

Note that you cannot use MediSave to pay for Integrated Shield rider premiums.

d. Claims Process and Customer Service:

Research the insurer’s reputation for efficient claims processing and excellent customer service. A smooth claims experience and responsive customer support are crucial when dealing with healthcare matters.

The table below shows how long it takes each insurer to process Integrated Shield Plan (IP) claims that eventually resulted in a payout. Please note that the durations below do not apply to rider claims. 

InsurerMedian Claims Processing Duration (days)175th Percentile Claims Processing Duration (days)2
AIA0 (Same Day)1
Singlife0 (Same Day)1
HSBC Life11
Great Eastern0 (Same Day)1
Income0 (Same Day)1
Prudential0 (Same Day)1
Raffles Health Insurance2 *

(1 January to 31 March 2023)
1 Median Claims Processing Duration means that 50 out of 100 claims are processed by the insurer within the indicated number of days in the table.
2 75th Percentile Claims Processing Duration means 75 out of 100 claims are processed by the insurer within the indicated number of days in the table.
* As RHI was approved to provide IPs from 16 July 2018 onwards, the number of claims processed by RHI is currently insufficient for analysis. 

Note: The number of days that insurers take to process claims includes the time it takes to obtain medical records from claimants or medical institutions.

Information from MOH.

e. Claims based pricing

Several insurers have introduced claims based pricing for their riders which means that if you make claims, they reserve the right to increase your rider premiums. The premiums for the basic Integrated Shield plan is not affected. Some plans like Income Integrated Health Insurance plan do not have claims based pricing.

Conclusion:

Understanding and choosing the right health insurance plan, particularly integrated shield plans in the Singapore context, is essential for protecting your health and financial well-being. By comprehending the features and benefits of integrated shield plans, assessing your coverage needs, and seeking professional advice when necessary, you can make informed decisions that align with your healthcare requirements and budget. Remember, a well-selected integrated shield plan provides you with peace of mind, access to quality medical care, and financial protection against unexpected healthcare expenses. Take control of your health insurance journey today and secure a healthier and more confident future.

Posted in Insurance, Life & Health