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How does your MediShield Life Claim work?

26 Jul 2016 
SOURCE: CPF Board

​Trying to understand the numbers on your hospital bill can be a daunting task. Not to worry though, here's a simple breakdown of the various components and how your MediShield Life claim works.

 How does your MediShield Life Claim work.png

The large portion of your hospital bill highlighted in green is covered under MediShield Life, while those highlighted in blue, namely parts of the bill above the MediShield Life claims limit, the deductible and co-insurance components, is payable by the patient or yourself with cash and/or Medisave. 

 

Claim Limits

 

The maximum amount you can claim from MediShield Life depends on the claim limit for the type of expenses you incur, such as the type of treatment and length of hospital stay you require.

 

In general, the maximum claim limit per policy year is set at $100,000 with no lifetime limit on claims under MediShield Life.

 

Thankfully only around 10% of hospital bills exceed these claim limits!

 

For more information on claim limits, you can refer to MOH's website.   

 

Deductible

 

The deductible is a fixed amount you need to pay once every policy year, either using Medisave or cash, before you receive your MediShield Life payout. Small claims are mostly sieved out through the deductible so your premiums can be kept affordable.

 

For those aged 80 and below, the deductible is $1,500 for stays in Class C wards, and $2,000 for stays in Class B2 and above wards. For those above age 80, the deductible is $2,000 and $3,000 for stays in Class C and B2 and above wards respectively.

 

Co-insurance

 

The co-insurance is a percentage of the claimable amount you need to pay after the deductible.

 

Under MediShield Life, the co-insurance rate ranges from 10% to 3% and decreases as the bill size increases. This means greater coverage under MediShield Life and a lesser amount of co-insurance you need to pay, especially for larger hospital bills.

 

Claimable Amount for Inpatient & Day Surgery

Co-insurance

(Percentage of Claimable Amount)

$0 - $3,00010%
$3,001 - $5,00010%
$5,001 - $10,0005%
>$10,0003%
Co-insurance for all Outpatient Treatments 10%

 

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