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Mount Elizabeth Insurance Coverage

    Integrated Shield Plan

    To address concerns of rising healthcare costs, many Singaporeans choose to get private health insurance for additional coverage on top of what is offered by MediShield Life (the basic health insurance plan run by the Central Provision Fund Board).

    Some individuals also buy riders to cover the cost of the deductible (the fixed amount you must pay before your insurance kicks in) and co-insurance (the percentage you must pay after your insurance kicks in).

    This additional private health insurance, together with MediShield Life, make up what is known as an Integrated Shield Plan.

    Over the years, the Ministry of Health (MOH) in Singapore and insurers have come also up with several measures to encourage the responsible use of healthcare services to help keep healthcare costs sustainable.

    Here, learn more about Integrated Shield Plans, how recent changes may affect you, and how these plans can help to pay for your treatment and hospitalisation at private hospitals.

    Know your options – you may be surprised at how affordable private healthcare can be.


    Call or WhatsApp Parkway Insurance Concierge at +65 9834 0999 to find out more about your Integrated Shield Plan coverage.

    You can also estimate your out-of-pocket expenses for common surgical procedures at Parkway East Hospital, Mount Elizabeth Hospitals, and Gleneagles Hospital.

    • What are the latest changes to Integrated Shield Plans?

      Co-pay riders

      All full-rider plans, except for Prudential’s PruExtra Premier Rider, will transit* to co-pay riders upon renewal from 1 April 2021.

      Full riders are no longer sold as of March 2018 due to the Ministry of Health’s requirements. (Today, if you are buying an Integrated Shield Plan, your options for riders are only co-payment riders with a minimum of 5% co-payment.)

      The thing to note is that the co-payment (your out-of-pocket costs) will likely not exceed 5% of your total hospital bill and will be capped at $3,000, if you obtain pre-authorisation with your insurer prior to your surgery with a specialist on the insurer’s panel. This is subject to annual and lifetime policy claim limits. For example, if your hospital bill is $30,000, with 5% of co-payment, your out-of-pocket costs will be $1,500.

      This 5% of the co-payment may be offset partially or fully by MediSave and/or your corporate insurance. It is advisable to check with your Human Resource department if you are covered under a corporate insurance.

      As part of the recent changes, some insurers have also introduced claims-based pricing for selected Integrated Shield Plans. Learn more about claims-based pricing below.

      * As of 31 March 2021. Please check with your insurance agent for the latest policy changes. Private insurers include AIA, Great Eastern, HSBC Life, NTUC Income, Prudential and Singlife.

      Claims-based pricing

      Some insurers such as Prudential, AIA and Great Eastern have introduced claims-based pricing for selected Integrated Shield Plans. With claims-based pricing, your rider premiums at each policy renewal are adjusted based on your claims during the previous policy year. How this is calculated is dependent on your insurer.

      For example*, the standard premium for a co-pay rider at 38 years old is $722. If a claim is made at a private hospital in 2021, your premium at the next policy year (2022) will increase by 1.5 times to $1,083. The adjusted premium will go then back to the standard level in 2023.

      *This scenario is based on a Great Eastern TotalCare Elite-P co-pay rider as of 1 April 2021 with a claim amount > $2,000. Please check with your insurer to find out more information about your plan and premiums.

      Extended Panel

      Extended Panel is an initiative by the Multilateral Healthcare Insurance Committee (MHIC), which is appointed by the Ministry of Health (MOH), to allow integrated shield plan insurers to recognise each other’s panel doctors mutually. Under the Extended Panel, you may enjoy selected panel benefits when seeking pre-authorised treatments from specialists that are not on your insurer’s panel. If they are on other integrated shield plan insurer panels, follow your insurer fee schedule and meet their pre-authorisation terms. This initiative provides consumers with a wider choice of specialists and supports better continuity of care for patients.

      To qualify for an Extended Panel claim, complete these steps before your planned treatment:

      1. Obtain a pre-authorisation form from your insurer
      2. Request for your doctor to fill in the form and submit it to your insurer

      Call or WhatsApp Parkway Insurance Concierge at +65 9834 0999 to find out more about your Integrated Shield Plan coverage.

      You can also estimate your out-of-pocket expenses for common surgical procedures at Mount Elizabeth Hospitals, Gleneagles Hospital, and Parkway East Hospital.

    • What are Integrated Shield Plans?

      An Integrated Shield Plan rides on top of your existing MediShield Life to provide additional coverage for Class B1 or A wards, even for private hospitals. On top of this, an additional rider* can be bought to partially or completely cover the co-insurance and deductible components of the bill.

      An Integrated Shield Plan consists of:

      • MediShield Life
      • Additional Private Insurance Coverage

      This diagram will help you better understand Integrated Shield Plans:

      (Click to view enlarged image in a new tab)

      peh-integrated-shield-plan_v2

      MediShield Life^

      • All Singapore citizens and Permanent Residents are covered under this basic health insurance plan
      • Coverage for life
      • Covers pre-existing conditions
      • Covers treatment costs for Class B2/C wards at public hospitals
      • Premiums payable using MediSave

      Integrated Shield Plan

      • Provides additional coverage for treatment at private hospitals or Class A/B1 wards at public / restructured hospitals
      • Managed by private insurers
      • Option to top up with co-pay rider which covers co-insurance and/or deductible up to 95% to reduce your out-of-pocket costs
      • Premiums payable using MediSave, up to annual limits
      • Rider premiums payable by cash only

      * Terms and conditions apply.
      ^ Extracted from Ministry of Health, MediShield Life


      Depending on the plan you choose, Integrated Shield Plans and riders can provide coverage for:

      • Higher ward classes or stay at a private hospital
      • Higher annual claim limits
      • Claims for pre and post hospitalisation treatments
      • Short waiting time to see specialists. At Parkway East Hospital, you can get an appointment with a specialist within 24 hours
      • Choice of doctors

      If you have an Integrated Shield Plan and rider, you may be partially or even fully covered (for some existing policies) for treatment and single-room stay at private hospitals.

      Call or WhatsApp Parkway Insurance Concierge at +65 9834 0999 to find out more about your Integrated Shield Plan coverage.

      You can also get an estimate of out-of-pocket expenses for common surgical procedures.

      *From 1 April 2021, all Integrated Shield Plan riders will require 5% co-payment, including renewals of existing plans with full-riders. Only Prudential will maintain their PruExtra Premier Rider plans for their existing customers. Please check with your insurer to understand changes in your policies.

    • What do these insurance terms mean?

      To understand your Integrated Shield Plan coverage better, it is helpful to understand commonly-used terms in insurance.

      Deductible, co-insurance and co-payment are the 3 key patient-payable portions of a hospital bill when it comes to Integrated Shield Plans.

      Different plans apply the calculations differently.

      • Deductible

        Deductible is the basic sum you must contribute to your bill before you make your claim. This is a fixed maximum sum, and if the bill is less than the deductible, the patient pays the full bill.

        If a private hospitalisation deductible is fixed at $3,500 for a patient’s Integrated Shield Plan, this means the patient must first pay up to $3,500 before they can start making an insurance claim for their hospitalisation.

      • Co-insurance

        The co-insurance is a percentage that is calculated after deducting the deductible of the bill size. After paying the deductible amount, the remainder of the bill to be claimed is then used to calculate the co-insurance. This means that for every bill, the patient has to pay the percentage of the remaining bill (minus deductible), and the insurance pays the remainder.

        (Click to view enlarged image in a new tab)
        Co-insurance

      • Co-payment

        Co-payment is an additional component that a patient may have to pay. For riders, the co-payment is calculated as a percentage of the total bill size. Typically, the co-payment for most co-pay riders is 5% of the bill.

        Depending on your rider plan, most insurers have a co-payment cap. If the co-payment amount exceeds the co-payment cap the patient only needs to pay the co-payment cap. The rest is covered by the insurer. Most insurers apply a co-payment cap of $3,000 if policyholders seek treatment from the insurer’s preferred panel of doctors and if the treatment has been pre-authorised by the insurer.

      • Pro-ration (AIA plans only)

        Pro-ration applies to some Integrated Shield Plans (under AIA only) when a procedure is not pre-authorised. In the event of pro-ration, the insurer will only service the pro-ration factor percentage of the claim. For example, if the claim is $10,000, the insurer will only cover 85% of the claim, and the rest is to be paid by the patient.

        (Click to view enlarged image in a new tab)
        Pre-authorisation

      • Claim limits

        There are 2 types of limits for Integrated Shield Plans:

        • Lifetime limit – the maximum amount your claim can reach throughout your life
        • Policy year limit – the maximum your claim can reach in the policy year
      • Panel doctors

        Insurers have their preferred doctors whom they have selected to be on their panel. Patients who visit panel doctors may enjoy enhanced coverage and higher claim limits.

      • Pre-authorisation

        Pre-authorisation is a service where your insurer approves coverage for a hospital admission and/or day surgery based on your policy coverage, benefit entitlement and medical information provided by your doctor prior to the actual surgery.

        Pre-authorisation is always recommended for planned treatments as this can ease the claim process and patients may enjoy higher coverage. Where possible, patients should always seek pre-authorisation from their insurers before beginning treatment.

        Most insurers can provide pre-authorisation within a week.

      • Claims-based pricing

        With claims-based pricing, your rider premiums at each policy renewal may increase or decrease based on the claims paid by your insurer during the previous policy year. You will receive a discount of 10% – 25% off your premiums if no claims were made in the previous policy year.

        Depending on your hospitalisation experience (eg. at private or restructured hospitals, choice of insurer panel or non-panel doctors, the amount claimed and your age) your premiums may increase 1.1 – 2 times the standard premiums before they drop back to the standard level in the next renewals. The adjustments will be determined by your insurer.


      Still confused? Call or WhatsApp Parkway Insurance Concierge at +65 9834 0999 to get clarifications on your Integrated Shield Plan coverage.

    • Am I covered for treatment at private hospitals?

      If you have an Integrated Shield Plan (IP) and a rider that provides coverage for private hospitals, you may be covered for treatment at Parkway East Hospital.

      Below is a list of private hospital plans and co-pay riders offered by various insurers:

      AIA

      • Plan: HealthShield Gold Max A
      • Co-pay rider:
        • Max VitalHealth A Value
        • Max VitalHealth A
        • Max VitalCare*

      Great Eastern

      • Plan: SupremeHealth P Plus
      • Co-pay rider:
        • TotalCare Elite-P
        • TotalHealth Elite-P

      HSBC Life

      • Plan: HSBC Life Shield Plan A
      • Co-pay rider:
        • Enhanced Care

      NTUC Income

      • Plan: Enhanced Income Shield Preferred / Income Shield Plan P*
      • Co-pay rider:
        • Deluxe Care Rider
        • Classic Care Rider
        • Assist Rider*
        • Plus Rider*

      Prudential

      • Plan: PRUShield Premier
      • Co-pay rider:
        • Premier CoPay
        • Premier Lite CoPay
        • Preferred CoPay
        • Premier*

      Raffles Health Insurance

      • Plan: Raffles Shield Private
      • Co-pay rider:
        • Key Rider
        • Premier Rider

      Singlife

      • Plan: Singlife Shield Plan 1
      • Co-pay rider:
        • Singlife Health Plus-Private Prime
        • Singlife Health Plus-Private Lite
        • MyHealthPlus Option A*
        • MyHealthPlus Option A-II*
        • MyHealthPlus Option B*
        • MyHealthPlus Option C*
        • MyHealthPlus Option C-II*

      Please check with your insurer for your full policy details.

      *These are old rider plans that are no longer offered by the insurers for new customers.

      Call or WhatsApp Parkway Insurance Concierge at +65 9834 0999 to find out more about your Integrated Shield Plan coverage.

      You can also get an estimate of out-of-pocket expenses for common surgical procedures.

    • Does my Integrated Shield Plan cover pre and post hospitalisation treatments?

      With an Integrated Shield Plan that provides coverage for private hospitals, your pre and post hospitalisation bills may be covered if they are related to your hospitalisation. These bills may include fees for consultations, laboratory tests, radiology examinations, and rehabilitation sessions. For example, if you were admitted for a knee surgery, your pre-hospitalisation knee MRI and post-surgery imaging and rehabilitation fees may be covered along with your hospitalisation bill.

      The validity period of the pre and post hospitalisation coverage differs across Integrated Shield Plans, and can be up to 365 days pre and post hospitalisation. Please check with your insurer or financial advisor to find out the details of your eligible claimable expenses.

      Please keep the original medical bills or receipts for submission to your insurance company.

    • Can I use my Integrated Shield Plan for A&E treatment?

      Your Integrated Shield Plan can also serve as an emergency medical insurance.

      If your visit to our Accident & Emergency (A&E) department warrants a hospital admission with a minimum stay of 8 hours, you can use your Integrated Shield Plan that covers private hospitals (with a rider) to pay a minimal amount for both your A&E outpatient bill and your inpatient treatment.

      Some policies also cover the A&E outpatient treatment, up to a certain limit and can be used as both accident health insurance and emergency health insurance. Contact your financial advisor to understand your full policy details.

    • How can I check if I have an Integrated Shield Plan that covers private hospitals?

      You can find out if you have an integrated shield plan through the CPF Board website. You will require your SingPass to do this.

      1. Go to cpf.gov.sg
      2. Log on to my cpf Online Services
      3. Go to "My Messages"
      4. See "Insurance" section

      To find out the policy details of your integrated shield plan, please contact your insurance company or financial advisor.

      Call or WhatsApp Parkway Insurance Concierge at +65 9834 0999 to find out if your Integrated Shield Plan covers you and your loved ones at Parkway East Hospital.

      You can also get an estimate of out-of-pocket expenses for common surgical procedures.

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