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Does your insurance plan cover hospitalisation expenses related to Sars?

Category : Insurance, Medical Insurance

Published April 9, 2003
BT

Personal Finance

Are you covered?
Does your insurance plan cover hospitalisation expenses related to Sars? What should you look for in a medical plan? GENEVIEVE CUA reports

WORRIED about the expenses, if you fall ill with Sars (severe acute respiratory syndrome)? If you have a hospital and surgical (H&S) plan bought from a life insurer or if you’re covered under a company or group plan, you have one less reason to fret. Contrary to recent press reports, you’re likely to be covered for hospital expenses relating to Sars or other infectious diseases.

But if you are shopping for a plan now, underwriting may get tougher. Aviva, for one, is looking at imposing a period of six months for new contracts where Sars is explicitly excluded. Asia Life says it is in discussions with its reinsurer.

The almost unrelenting onslaught of ill news regarding Sars should yield one silver lining for insurers as more people wake up to the need for health cover – specifically, a good hospital and surgical plan. Says Sebastian Tan, Aviva’s assistant general manager (group life, accident, health): ‘Awareness has gone up for a lot of products, even life and term policies.’

This piece will deal with the importance of H&S plans and some key terms and conditions you should watch out for.

People are almost routinely confused over insurance contracts, which are typically difficult to read. But this can’t be over-emphasised: In any financial product, whether it is insurance or an investment, you must know exactly what you buy. If you can’t understand the terms – which may be couched in legalese or buried under layers of fine print – get help from a licensed adviser.

But first, on Sars. A check with Tan Tock Seng Hospital reveals that hospitalisation charges will be absorbed ‘on a case to case basis’. There is no choice, in any case, on the type of ward. All Sars patients go into Class C wards – at the daily rate of $37. Intensive care, at Class C, costs $80 a day.

How do you know your plan covers you? Look under the section covering policy exclusions. A check with the help of licensed independent adviser Cornerstone Planners shows that most contracts are silent on the issue of communicable or infectious diseases. These include Aviva, Axa, Asia Life and GE. If there is no specific exclusion, you can safely assume it is covered.

One contract – Manulife’s Manucare – has this as an exclusion: ‘Any communicable disease in epidemic proportion as declared by the government.’ A check with Manulife confirmed that Sars will be covered unless the Health Ministry declares it to be an epidemic. Queries to the ministry on what it deems to be an epidemic were unanswered.

More changes planned for MediShield

Category : Insurance, Medical Insurance

SINGAPORE: More changes have been planned for MediShield, the national insurance scheme. The Health Ministry plans to increase the daily claims limits as well as the premiums to be paid.

Giving this update at an event at the new Khoo Teck Puat Hospital, Health Minister Khaw Boon Wan said the revamp of the MediShield scheme aims to ensure that it can fulfil its goal of paying 80 per cent of larger hospital bills in B2 and C class wards.

Currently, the scheme only covers 60 per cent of such bills. So MOH proposes to substantially improve the MediShield claims limits.

For example, for normal wards, the daily claims limit will be raised from S$250 to S$450, while that for ICU wards will be increased from S$500 to S$900.

For surgical implants and approved medical consumables, patients stand to claim $7,000 instead of the current $2,500.

Patients undergoing chemotherapy could see a raise in claims limits from $150 to $270 for a 7-day treatment cycle, and $700 to $1,240 for 21- and 28-day treatment cycles.

Similarly, patients receiving stereotactic radiotherapy treatment could see a raise in claims limit from $1,000 to $1,800 per treatment.

To fund the increase in claims limits, MediShield premiums will have to be raised as well.

But for the vast majority of policy holders – those aged 60 years and below – the increase in premiums will be below S$5 per month.

For policyholders aged between 61 and 80, the premium increase will not exceed $10 per month. They make up 16 percent of all policyholders.

The impact will however be significant for a tiny minority (0.4% of policyholders, numbering fewer than 5,000 people) who are aged 81 and above. They could see an increase of up to $40 a month.

Given their small risk pool and the higher tendency to be hospitalised with large claims, it is a challenge to keep their premiums low.

To mitigate the impact, a higher deductible will be applied to policyholders aged 81 and above.

The deductible is the amount a patient would need to pay for claims made in a policy year before there is a payout from MediShield.

The proposed deductible for policyholders aged 81 and above is $3,000 for Class B2 wards compared with $1,500 for those aged 80 and below, and $2,000 for Class C wards compared with $1,000 for those aged 80 and below.

Also, Minister Khaw said his ministry is proposing to raise the Medisave withdrawal limit for policyholders 81 years old and above so that they can use Medisave to pay their MediShield premiums in full.

“We’ll raise it (Medisave withdrawal limit) for this age group so that hopefully they don’t have to come up with cash…the Medisave can pay for it (MediShield premium). And of course, the government’s top-up of Medisave will also help them somewhat,” he said.

The government has earlier decided to top up the Medisave of CPF members aged above 50, with those above 75 years old receiving the highest payout of $450.

To help MOH decide on how to proceed with the proposed changes, it is calling for public feedback. You can get more details and send your comments to its website.

- CNA/ir

Source: CNA