MediShield Life: Higher claims, added coverage but premiums set to rise

Singaporeans will soon enjoy greater protection from hefty medical bills thanks to a major review of the MediShield Life scheme.

Beginning April 1, 2025, the national health insurance scheme will see a refresh of its claim limits for both inpatient and existing outpatient treatments.

Over the following months and years, coverage will gradually expand to include new outpatient treatments and home-based care services, as well as selected costly new therapies like cell, tissue, and gene therapies.

"We are most concerned about unexpected health episodes that require you to stay in hospital for a long time, maybe even ICU, some unfortunate things happen and you chalk up a big bill," explained Health Minister Ong Ye Kung at a media briefing.

"That bill is rising and therefore we are increasing the claim limits for such bills."

For instance, daily claim limits for normal wards will jump from $1,000 to $1,630 for the first two days of hospitalisation. The Intensive Care Unit daily limit will more than double from $2,200 to $5,140. To alleviate the financial burden on kidney dialysis patients, monthly claim limits will be raised by 60 per cent, from $1,100 to $1,750.

Beyond hospital stays, outpatient treatments will also see significant enhancements.

"The centre of gravity for healthcare has shifted from hospitals to community and home," noted MediShield Life Council chairwoman Fang Ai Lian.

"It becomes very important that we should improve patient access in those settings which are outside the inpatient settings."

Coverage will be expanded to include new treatments such as negative pressure wound therapy and paediatric home care, as well as home-based services like home ventilation and respiratory support services. This will allow patients to receive quality care more conveniently and at lower costs.

Perhaps the most significant change is the inclusion of CTGTPs, breakthrough one-time treatments that can potentially cure serious diseases.

"These things are very expensive, but this is what MediShield Life is for," explained Mr Lee Ming San, a council member. "It’s to help to try and make healthcare more equitable."

These enhancements come with a price tag: premiums are expected to rise by an average of 22 per cent per policyholder by the end of the third year.

However, the government has announced a $4.1 billion support package, including enhanced premium subsidies, increased MediSave top-ups, and a one-off release of capital from the MediShield Life Fund.

MOH emphasised that the support package will be robust enough to fully offset premium increases for over 90 per cent of Singaporeans over the next three years.

The ministry also underscored its commitment to ensuring that no one will lose their MediShield Life coverage due to financial hardship.