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What Insurance Should Your Elderly Loved Ones Have In Place As They Age?— A Full Comparison

Dec 11, 2021
Health has been at the forefront of everyone’s minds in the last few years so if you have been wondering if your ageing loved one’s insurance is enough to cover health expenses, say, a stay in a nursing home in Singapore, you’re not alone.

Every Singaporean and Permanent Resident is already covered by a basic health care plan called MediShield Life. However, at least 69% have opted to purchase Integrated Shield Plans that provide additional coverage on top of their existing basic plan.

If you are on the search for suitable insurance coverage for your loved ones, it may be overwhelming to go through the various healthcare plans out there without a firm grasp of the basics. So here is a useful guide of the insurance plans in Singapore and the additional healthcare plan options you can purchase for your elderly loved ones.

Let’s start by clarifying the basic terms.

 

What exactly is Health Insurance?

Health Insurance is a type of insurance coverage that aids in paying for medical expenses in cases of injury, illness or incidents resulting in disability. Here

are quick descriptions of other types of insurance coverages:

 

  •  Hospital Cash Insurance – gives you a fixed amount of cash for each day of your hospital stay.
  •  Critical Illness Insurance – pays you a one-time lump sum when diagnosed     with a critical illness or after undergoing surgery.
  •  Disability Income Insurance – partially replaces your income due to     accident or illness and can pay up to 80% of your average salary.

 

In Singapore, a mandatory social security savings scheme called the Central Provident fund was established to meet Singapore’s retirement, housing and healthcare needs. It consists of an ordinary account, special account, Medisave Account and Retirement Account. In terms of healthcare, it provides interest rates of 4%-5% to the Medisave Account.

 

What is MediSave?

MediSave is a savings scheme where employed/self-employed citizens put a percentage of their monthly salary into a Medisave account which can only be used for hospitalization and medical treatments and approved medical insurance, both public and privately funded. Publicly funded insurances include the following:

  •  MediShield Life

MediShield Life is a basic health insurance plan by the Central Provident Fund Board to ensure lifetime coverage for all Singaporeans and permanent residents, regardless of age or health conditions.

  •  ElderShield

ElderShield is a long term insurance plan for Singaporeans born before 1980. It is not compulsory so your loved ones may have opted out of it. Enrollment for

ElderShield ceased in 2019.

  •  CareShield Life

CareShield Life is a long term insurance place for Singapore Citizens and PRs that turned 30 years old in 2020. Loved ones enrolled in Elder Shield can be switched to CareShield Life, which has higher monthly payout amounts.

 

What is your loved one currently covered with? 

Before looking for additional coverage, it is best to know and understand the insurance your loved ones are already covered with.   It is compulsory for Singaporean citizens to have a MediSave account as well as MediShield Life coverage.

To check what medical coverage your loved one already has, you can go to the CPF website and log in using their SingPass to check their account. Click on ‘my cpf Online Services’ then head to the messages section to see their insurance. Your loved ones are covered by the following:

 

MediSave

MediSave is an account that can be used for almost all healthcare expenses such as Vaccinations, Health Screenings, Treatment for acute and chronic conditions, Cancer Treatment, Psychiatric Treatment, Rehabilitative Care as well as Palliative care. It is put into place to reduce out of pocket expenses on medical bills.

Those who are employed give out monthly contributions to their Medisave Accounts through their salary. Because it is dependent on income, those with low incomes or who had long periods of unemployment may not be adequately covered by MediSave.

To help grow your loved one’s MediSave account with an interest rate of 5% per year, it can be topped up from another MediSave account – yours or from other relatives. 

 

MediShield Life

It is a compulsory basic insurance plan that is designed to ensure that each Singaporean can afford a lifetime coverage of quality medical care, regardless of their MediSave savings. It protects Singaporeans from large medical bills and covers all Singapore citizens and PRs, including those advanced in age as well as those who have pre existing medical conditions.

Like Medisave, it can cover medical expenses but there is an annual claims limit. It subsidizes treatments in public hospitals and is paid through premiums that are calculated based on your socioeconomic status and can be fully paid for using MediSave. MediSheild Life cannot be revoked for inability to pay premiums.

It covers a portion of the hospital bills for B2/C type ward hospitalizations in public hospitals. If you opt for a private hospital or A/B1-type ward, it will only cover a small part of the hospital bill.  Without subsidies, MediShield Life premiums start at $145 for those below 20 years old and go up to $2055 for those above 90.

 

What are ElderShield and CareShield?

These are long term healthcare plans put in place to aid Singaporeans and PRs in the event of a severe disability that would require long term care. Participation for ElderShield is optional so your loved one may or may not be covered by it.  CareShield Life succeeded the privately-funded ElderShield in 2020. Your loved ones may be covered by the following:

 

ElderShield

ElderShield is a voluntary long term additional insurance plan for Singaporeans born before 1980. Premiums for ElderShield do not increase and ends when the insured turns 65. The total amount of premiums paid by age 65 for Eldershield 300 is $3700 for males and $5100 for women, while ElderShield 400 plan adds up to $4800 for men and $6300 for women.

In the case of severe disability, ElderShield gives monthly cash payouts of $300 and $400 (for ElderShield 300 and ElderSheild $400 respectively) and can last up to 5 to 6 years after the claim is made. The insured will still be covered by

ElderShield until a claim is made. 

Enrollment for ElderShield ceased in 2019.

 

Careshield Life

CareShield Life is a long term health care plan that provides lifetime cash pay-outs in the event of a severe disability that should require long term care. It began in October 2020.

For those born in 1979 or earlier, participation is optional. Those born in 1970-1970 and insured under ElderShield 400 will be switched to CareSheild Life from December 1 2021. Should they wish to, they can opt-out of CareSheild Life by December 31 2023.

Participation is mandatory for Singaporeans born after 1980 and they are automatically enrolled once they turn 30 years old. Insured will receive a letter and a personalized CareShield Life premium.

Unlike ElderShield, CareShield Life premiums increase with time and subsidies are provided based on socio-economic status. It is fully payable via MediSave, of the insured or their loved ones and will end at age 67.

 

Are Basic Health Insurances enough?

MediShield Life covers all Singaporean and PRs, including the old and those with pre-existing conditions. It is a basic insurance plan that covers both inpatient and outpatient treatments. It covers $800 daily ward charges in public hospitals to chemotherapy expenses that can add up to 3,000/month.

It has a maximum claim limit of $150,000, however, it has no lifetime claim limit. The downside is that is only a basic plan. It does not cover pre and posthospitalisation costs nor does it cover wards in private hospitals. It can be augmented by other plans, for example, an Integrated Shield Plan which extends the coverage to private hospitals and better class wards. It has pre hospitalisation coverage and also pays for post hospitalisation expenses.

MediShield Life provides a security blanket in the case of illness or hospitalization. Whether it is enough, depends on the age and the current health of the insured.

For those who are young and healthy, MediSheild Life may provide sufficient coverage. For the more vulnerable population, like the elderly, it may be worth going through the choices of insurance options that can ease your elderly loved one’s worries and properly provide for their healthcare needs.

 

What Can I Use Health Insurance for?

 Hospitalization

If you opt to choose for better amenities and focused care you get in private hospitals, the basic insurance only covers a small portion of it. Health Insurance has private hospital plans and extends its coverage in A/B1-type wards in a public hospital. So you or your loved one can focus on recovering without worrying about outrageous hospital bills piling up during your stay.

Choice of Doctor

If you would like to have a say in choosing your doctor, Private healthcare and

private hospitals can provide you with such options. 

 

What is Important When Choosing Health Insurance for the Elderly?

It is never too late to get insurance for your loved ones. Here are things you should consider when buying into a policy for your loved ones.

 

Pre-Existing Medical Conditions

If your loved ones have pre-existing conditions, it affects the insurance they can get. Insurance companies are known to reject applicants who have a history of illness. But don’t let this discourage you as it is still possible to find proper insurance coverage for your loved ones. Just expect that it will come with a higher price on premiums.

Even for loved ones who don’t have a pre-existing medical condition, it would still be worth shopping around for insurance so they can get proper hospitalisation

coverage. 

Regardless of their health status, MediShield Life still applies to them so you can at least be assured that your loved ones have a basic plan to cover their health care needs.   

 Maximum Entry Age for Insurance Policy

The highest entry age for most insurance policies is 75 years of age. It doesn’t mean that the insurance policy expires when your loved one turns 75. It simply means after your loved ones turn 75, they can no longer apply as they have

exceeded the entry age for the insurance policy. 

For your loved ones who have yet to turn 75, there are still various insurance options to choose from.  Even if they have turned 75, it’s still not too late to get insured as there are insurance policies that have a higher entry age limit.

It will be good to seek advice from insurance company representatives to know

more about them.

 

Cost and Coverage

Many companies provide a variety of insurance plans to choose from. The cost and coverage of these insurance policies differ from plan to plan. Some may include premium wards in private and public hospitals while others include pre and post hospitalisation treatment.

It is important to take stock of the minimum coverage you would like to get from your insurance as well as the maximum price you’re willing to pay for it. For example, if you’d like to have your insurance to have hospitalisation coverage in private hospitals, then expect it to come at more costly premiums. 

 Exclusions

Before signing into the policy, make sure to understand the exclusion clauses. These are put in to minimize the losses to the insurance company and if overlooked, it can inconvenience you and your loved one if the insurance plan you get doesn’t give you the coverage you thought it afforded. An example of an exclusion clause could be a waiting period before the insurance takes into

effect.

 The policy contract should list out the cases and specific conditions which the insurance policy do not cover and are excluded from the insurance. Take your  time to go through them and be sure to ask questions if there are exclusion

clauses you don’t understand. 

 

Personal Preferences

Start a conversation with your loved ones about how they feel about health insurance before signing any health insurance policy for them. Their thoughts and feeling should be taken into account when making a decision. Allowing them to voice out concerns and worries will help determine which health insurance is the best fit for them and which would give them a sense of security and assurance should they ever need to rely on it. 

 

Do Your Research

It’s important to go through the different health insurance policies that are available so you can choose the most suitable one. Weigh your priorities accordingly before signing into any policy. This is an important decision so take your time to consider what treatments and conditions you would like the

insurance policy to cover for your loved one’s healthcare needs. 

Health Insurance Singapore Comparison

MediShield Life and Integrated Shield Plan Comparison

The following table is a comparison of the MediShield Life and Integrated Shield coverage from Inpatient treatment to Hospital ward types covered by the insurance. Integrated Shield Plans enhances the existing MediShield Life that covers all Singaporeans and PRs and provides greater coverage for treatments. Integrate Shield Plans may also cover hospitalization in premium wards in public as well as private hospitals.

 

ClaimsDetailsMediShield LifeIntegrated Shield
InpatientDaily Ward Charges$800/day~$1,700/day
ICU Ward$2,200/day~$2,900/day
Surgical Procedures$240-2600~$590 – $16,720
Community Hospitals$250-$430/day~$650/day
Outpatient TreatmentsChemotherapy$3000/month~$5,200/month
Kidney Dialysis$1,100/month~$2,750/month
Radiotherapy$300-1,800$550-$1800
Hospital Ward TypePublic/Private hospitals and ward typesPublic hospital B2 and C wardsMay cover both private and public hospitals.

 

ElderShield 400 and CareShield Life Comparison

The following table is a comparison of optional long-term health care plans such as ElderShield 400 and CareShield Life. As ElderShield ceased accepting in 2019, CareShield Life was designed to provide a lifelong health care plan in case of severe disability. At higher premiums, it increases the monthly payout amount as well as the payout duration.

 

 ElderShield 400CareShield Life
Monthly Payout$400$600 (yearly increase)
Payout Duration6 years after first claimAs long as person is disabled
Coverage PeriodLifetimeLifetime
Annual Premium(Fixed)

Men: $175

Women: $218

(Increases Yearly)

Men: $206

Women $253

Premium TermAge 40 to 65 (26 years)Age 30 to 67 (38 years)
Opt out featureYesYes
MedisaveYesYes
Government SubsidyNoYes
EligibilityExcludes individuals with pre-existing disabilitiesExcludes Individuals with pre-existing  disabilities

 

Insurance to consider for your loved ones

MediSave-approved Private Integrated Shield Plans (IP)

Integrated Shield Plan enhances the MediShield Life coverage. It is funded by private insurers such as AIA, Aviva, AXA, Great Eastern, NTUC Income, Prudential, and Raffles Health Insurance.

Integrated Shield Plan accounts for hospitalization costs in premium (class B1 or A) wards in public hospitals or private hospitals. It provides a higher annual claim limit and even increases the claim limits of each medical condition. Different insurance providers offer multiple levels of Integrated Shield Plans that can include additional benefits such as pre and post hospitalisation coverage as well as organ transplant benefits.

Integrated Shield Plans can be fully or partially paid for using MediSave and the cost varies per year, ranging from $300 per year for those below 40 years of age to $900 per year for those 71 and over. The price quoted includes the premiums of MediShield life and varies depending on the age of the insured, the extent of the coverage and the insurance provider.

In addition, you can also purchase an Integrated Shield Plan Rider. Insurance riders are additional benefits that you can purchase to further enhance your existing coverage. Integrated Shield Plan Riders can reduce you out of pocket expenses such as deductibles and co-insurance. It may even offer benefits such as lump sum payout upon diagnosis of critical illnesses and extend coverage to emergency overseas medical treatment.

 

CareShield Life

As mentioned earlier, CareShield was put into place to succeed ElderShield. Much like ElderShield, CareShield Life is optional and provides basic protection for life. It provides lifetime cash payouts in the event of a severe disability that requires long-term care. The payout depends on the year the claim is made, beginning at $600 if the claim was made on the year of enrollment. 

Your loved ones may or may not already be covered by ElderSheild. If they are, then perhaps they would like to make the change. To make the shift convenient, those who were born from 1970 to 1979 and have ElderShield 400 are automatically enrolled into CareShield Life by end of 2021.

They have the option to opt out by 2023. For those who don’t have insurance yet, you may consider getting CareShield Life. Premiums increase over time and are fully payable using MediSave. Subsidies are also provided based on socio-economic status which ensures that everyone is insured for life. 

 

Private Insurance Coverage

Additional private insurance coverage tends to cost more. But the prices are justified if you consider the greater coverage and higher payout it provides when compared to the basic health insurance plans. The plans can be categorized into the following:

 

  • Health Insurance are the Integrated Shield Plans that enhance the coverage of MediShield Life. It covers expenses such as surgery, hospitalization and outpatient fees. Others would offer broader coverage that may include pre and post hospitalization, home nursing and alternative medicine expenses. Premiums that cover public hospital stays can range from $700-$2000/year depending on the age while for those that cover private hospital stays, premiums range from $2000 – $5000 a year.

 

  • Personal Accident Insurance covers outpatient expenses from accidents or infectious diseases. It also provides payouts in the case of death or accidents that result in permanent disabilities. These generally include outpatient consultation fees, scans, medication, equipment and other treatments.  For people aged 65 years old and below, premiums can range from $200-$1000 per year.

 

  • Life Insurance provides a lump sum payout for income replacement in the case of terminal illness, permanent disability or death. It has a maximum entry age of 65 and can cost around $300 per year.

 

  • Specialized Insurance for your elderly loved ones is also a good option as these take into consideration age-related health issues and have fewer exclusions. It covers expenses such as hospitalization, outpatient rehabilitation and physiotherapy as well as disability payout. Premiums cost about $150-300 per year for those between the ages of 50 to 75.

Conclusion

Opening up a conversation on health insurance with your elderly loved ones may be difficult. Discussing topics of illness or death can be daunting for anyone. But if you maintain open communication regarding future healthcare with your loved ones, it may alleviate their worries and clear the air regarding any misconceptions they might have about health insurance.

It is never too late to get health insurance for your loved ones. Looking into what additional insurance coverages can be added to their basic health care plan may provide you and your ageing love ones a sense of assurance should they ever fall ill and require Retire Genie services or have a need to visit the hospital.

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