Healthcare in Singapore may rank amongst the best in the world, but it comes at a premium price when compared to other countries in Southeast Asia. For citizens and permanent residents (PRs), a mandatory national health insurance plan named Medishield, subsidises medical fees for specialist treatment and hospital accommodation. Foreigners don't qualify for this though, so it’s essential to get some basic health insurance coverage from a private insurer. In some medium and large companies, employees may be partially covered by a group health insurance policy too.
Both private and public healthcare are available in Singapore, and are accessible to both citizens and foreigners. Public healthcare is offered by government-run polyclinics and hospitals, and treatment costs are generally much lower than what’s charged by private healthcare providers. The tradeoff, however, is a longer waiting time for both general consultations and specialist appointments.
In general, Medishield and private health insurance policies start off with a deductible or co-payment scheme, where you either need to pay a minimum amount before any claims can be made, or you pay a certain percentage of the medical fees while your insurer pays the rest.
Some private policies limit the healthcare coverage to a list of clinics, which is much like the Health Maintenance Organisation (HMO) programmes in the United States. The government also runs a mandatory Medisave programme, which makes it compulsory for employers to contribute a portion of Singaporean and PR salaries to a national medical savings account. This is also similar to the concept of the Health Savings Account (HSA) in the United States.
Health insurance in Singapore can be classified into several categories:
- Medical expense insurance
- Hospital cash insurance
- Critical illness insurance
- Disability income insurance
- Long-term care insurance
Almost all residents in Singapore should have some medical expense insurance, as hospitalisation fees can run up to tens of thousands of dollars each time. A typical policy should cover the hospital stay in a shared ward, plus the surgery, consultation and medicine.
While undergoing treatment or recuperating, the loss of income can be recovered by claiming from a hospital cash policy. And in the long term, critical illness, disability income and long-term care insurance can help you pay for ongoing treatment and replace your lost income permanently.
Medishield, the mandatory national medical expense insurance, reduces the out-of-pocket expenses for Singapore citizens and PRs by co-paying a portion of the hospitalisation bill after a small deductible. The co-payment amount varies depending on whether the healthcare provider is publicly or privately-run and the type of hospital ward accommodation that was occupied; it’s usually applicable for major hospital treatment or expensive outpatient treatment.
Foreigners, who aren't covered by the national medical insurance, need some private health insurance to cover their hospitalisation expenses. Many policies cover the entire bill up to a certain limit (“as charged”), or offer a co-payment scheme to reduce the insurance premium. A cheap policy is a cost-effective option, as long as you have a few thousand dollars set aside for the copayment portion if required.
For Singaporeans and PR, Medishield coverage automatically starts from the first Medisave contribution, although you can opt-in to commence earlier.
If you're a foreigner on a Work Permit or S-Pass, your employer must insure you with health insurance coverage of at least S$15,000 per year right from the start of your employment. This is to be paid for by the employer, although there may be a co-payment component of up to 10% of your monthly income for non-work related claims.
Those on an Employment Pass aren't mandated by law to be covered by their company’s insurance and aren't required to purchase a policy, but it's advisable to get some coverage as soon as possible.
The government has measures to help lower-income individuals afford basic Medishield coverage, so anyone caught not paying for the premium will be dealt with the same severity as tax defaulters. This may involve a penalty of up to 17% of the outstanding premiums, paying back the interest lost to the Medishield Life Fund, recovering the amount from the defaulter’s employer or bank, or taking legal action against the defaulter.
If you're on a Work Permit or S-Pass and don't have any company health insurance coverage, your employer may be fined up to S$5,000 or jailed for up to 6 months. You won't be penalised, though.
Private insurance policies usually offer more comprehensive coverage for medical conditions and geographic locations, but you’ll need to pay a higher premium. Some also offer flexibility with add-on riders that extend the protection with critical illness or hospital cash coverage.
Medishield is a mandatory national insurance that all Singaporeans and PRs need to purchase. Foreigners don't qualify for it..
You may enhance your Medishield coverage by purchasing an Integrated Shield Plan, which is offered by some private insurers in Singapore. Pay an additional premium either from your Medisave account or in cash, and you’ll be covered for more conditions and medical procedures, with a higher limit and better hospital accommodation.
A concept similar to HMOs is present in a selection of clinics supported by private insurance policies, but there are no insurers that offer a HMO policy comparable to those in the United States.
You may be covered by a group health insurance policy arranged and paid for by your employer. Usually covering most major treatment and shared ward accommodation in public hospitals, this may be sufficient if you don't intend to stay in Singapore after the end of your employment.
On average, expect to pay around S$1,000 to S$1,500 per annum for a policy that covers medical expenses of up to S$1 million per annum. For example:
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Some policies might offer a discount if you pay the annual fees upfront. If you intend to start the coverage as early as possible, you’ll need to transfer some money to Singapore to pay for your premium. TransferWise helps remit money from your bank account overseas into a Singaporean account and uses the same exchange rate shown on Google. This can save you the hefty fees charged by conventional money remittance services that's usually hidden from their customers. You can also maintain a borderless account on TransferWise, which lets you store up to 27 currencies on a single account, including the Singapore dollar.
You don't need to select a family doctor or GP for consultation in the Singapore healthcare system, and can seek different doctors for their medical opinions. Nevertheless, it's advisable to stick with a trusted doctor for regular visits so he or she can understand your medical history and healthcare needs better.
Pre-existing conditions are seldom covered by health insurance, although exceptions may be made by the insurer. In most cases, insurers will consider offering coverage to clients with pre-existing conditions on a case-by-case basis. There are several possible outcomes:
- Insurer takes the risk and sells the policy with full coverage, including pre-existing conditions.
- Asks you to pay an additional premium that covers the pre-existing condition.
- Impose a moratorium period, usually between 1-2 years, during which you're not allowed to make a claim on treatment for the pre-existing condition.
- Impose a moratorium period, and then cover the pre-existing condition but at a lower limit on claims afterwards.
- Exclude the pre-existing condition from the insurance coverage.
- Decline to sell the insurance policy.
Unfortunately, you may only make a tax deduction on life insurance premiums or voluntary Medisave contributions above the mandatory minimum amount. Medical expenses aren't tax-deductible.
In Singapore, insurance is sold mostly through agents representing an insurer, or independent financial advisors selling policies from several insurers. These agents are usually recommended through word of mouth referrals or at roadshows in areas with a lot of visitors. .
It’s advisable to do your own research before seeking out an agent, since they're paid a commission on every policy sold. Information on various health insurance policies and premiums are available on the insurers’ websites, which helps consumers make an informed decision without listening to a sales pitch. A list of registered companies is available on the Life Insurance Association of Singapore website, or you can browse the Singapore doctors’ directory list.
Online comparison websites also help consumers make informed decisions on what insurance policy to purchase, and then refer an agent to the consumer in return for a commission.
There’s no standardised insurance card in Singapore for policy holders. The nearest equivalent is the national identity card (NRIC), which is used in polyclinics and government hospitals. Lower income families and senior citizens can apply for a CHAS card, which grants the holder subsidised medical treatment at polyclinics and selected private clinics. In both cases, you’ll have to show the card at the reception of the clinic when registering for a consultation.
If you purchased a private insurance policy, you might receive a health card from the insurer with details of the hotline to call in case of an emergency, and the coverage that you qualify for.
Again, you can also visit insurance comparison websites to get a summary of various policies offered by selected insurers. Note that some insurance policies aren't listed on these sites, and only available through agents or directly on the insurer’s website.
In most cases, you'll need to pay the medical bill first and then make a claim. Many insurers have an online form to fill in, or a PDF document to download, print and fill in. For online submissions, you’ll be required to upload all the relevant documents including the invoices, hospital discharge summary and doctor’s report.
For hardcopy form submissions, make copies of the supporting documents to the original claim form. Submit the form at the official address listed on the insurer’s website, and the insurer will usually respond within 14 days by mail. If you have an insurance agent assigned to you, he or she may help you handle the paperwork.
Also, if possible, inform the agent or insurer beforehand to ensure the medical procedure or treatment is covered by your policy.
In closing, keep in mind that if you’re headed to Singapore for work or long-term stay, don't neglect getting health insurance, even if there are no regulations enforcing it. Medical treatment is relatively expensive and an unforeseen serious illness or injury can cost thousands of dollars at the least.
Fortunately, however, a wide range of health insurance policies are offered by many insurers at competitive prices and detailed information is easily available online. Do your own research to find what best fits your budget and lifestyle, and then approach insurance agents when you’re informed. Remember, there's no one-size-fits-all policy, so plan ahead and stay financially secure and healthy during your time in Singapore!