Enhancements to MediShield Life
By Shawn Lee
If you’ve only got a minute:
- MediShield Life will see significant increases in claim limits for inpatient and outpatient treatments, including daily limits for hospital stays and specific outpatient procedures like kidney dialysis.
- The updates will expand coverage for high-cost treatments, including gene therapies and certain expensive medications, making groundbreaking therapies more accessible to patients without imposing overwhelming financial burdens.
- Premiums will rise by up to 35%, with adjustments phased over 3 years. The Government will provide S$4.1billion in support which will help offset the cumulative increase in MediShield Life premiums over the next 3 years for nearly everyone.
Singaporeans and Permanent Residents can expect significant enhancements to our national healthcare insurance scheme MediShield Life, from April 2025. Premiums will also head north but its impact will be mitigated by subsidies and a premium support package.
This compulsory lifelong coverage extends to all Singaporeans and Permanent Residents, including our seniors and those with pre-existing conditions.
Its goal is to help manage large hospital bills and selected costly outpatient treatments, like kidney dialysis and cancer chemotherapy.
Starting in April 2025, these updates will gradually roll out, offering you better protection against serious health issues that can lead to overwhelming medical costs. The changes also aim to make innovative types of care more accessible.
Why a Review Was Necessary
MediShield Life was designed to fully cover 9 in 10 subsidised bills at public healthcare institutions, with deductibles and co-insurance taken care of through MediSave.
Unfortunately, rising medical expenses have reduced this coverage. It now fully covers just under 8 in 10 subsidised bills. From 2020 to 2023, MediShield Life payouts rose by 9.8% annually, leaving some patients with unexpected financial burdens during tough times.
Moreover, as healthcare evolves, treatments are increasingly shifting to outpatient and home settings. While advancements in medical technology have opened doors to life-saving therapies, many of these come with high costs.
What’s New?
1. Increased Claim Limits
One of the most impactful changes is the rise in claim limits for inpatient and day surgeries. For instance, the daily claim limit for a normal ward stay will increase from S$1,000 to S$1,630, and for intensive care, it will more than double from S$2,200 to S$5,140.
Plus, the annual claim limit will grow from S$150,000 to S$200,000, giving you greater peace of mind when facing hefty medical expenses.
2. Enhanced Outpatient Coverage
Outpatient care will also see substantial improvements. For example. the claim limit for kidney dialysis will jump from S$1,100 to S$1,750 per month, making a real difference for those who rely on this treatment.
New outpatient and home-based treatments, including repetitive Transcranial Magnetic Stimulation (rTMS) for depression, will be introduced.
Additionally, the co-insurance for outpatient treatments will shift from a flat 10% to a tiered structure ranging from 3% to 10%, making larger bills more manageable.
| Co-Insurance | |||
|---|---|---|---|
| Outpatient | First $5,000 of claimable amount (inclusive of deductible) | 10% | 10% |
| Next $5,000 of claimable amount | 5% | ||
| Claimable amount above $10,000 | 3% | ||
3. Support for High-Cost Treatments
The enhancements will also expand coverage to high-cost treatments, such as Cell, Tissue, and Gene Therapy Products (CTGTPs). These treatments can be critical for serious conditions like cancer and genetic disorders. By October 2025, MediShield Life and MediSave will cover these treatments on the MOH’s CTGTP list, initially covering 2/3 of subsidised patients.
Coverage will also expand to selected high-cost drugs that are clinically-proven and cost-effective, improving affordability for patients with blood conditions like hemophilia. For instance, risdiplam, used to treat spinal muscular atrophy, can cost around S$90,000 annually even after subsidies. This allows patients to access groundbreaking therapies without overwhelming costs.
Important Considerations
1. Increase in Premiums
With these new benefits come changes in premiums. You can expect increases of up to 35%, averaging around 22% per person. Premiums will be adjusted from 1 April 2025 upon policy renewal or inception.
To ease this transition, adjustments will be phased in evenly over 3 years, supported by an additional S$4.1 billion in government premium support. Most Singaporeans, especially those with lower MediSave balances, will receive extra MediSave top-ups.
There will also be increased premium subsidies of up to 60% for lower-income and middle-income older Singaporeans. This package will help offset the cumulative increase in MediShield Life premiums over the next 3 years for almost everyone.
The Government has reassured that no one will be denied coverage due to an inability to pay premiums. Those struggling with bills after subsidies can apply for financial assistance such as MediFund or appeal to the MOH for additional MediSave use beyond limits.
2. Changes in Deductible Amounts
Starting in April 2025, the inpatient deductible will rise by up to S$1,500, while a new S$500 annual deductible for outpatient treatments will be introduced from 1 January 2026, fully payable through MediSave. This means you will need to pay a larger amount of your bill before the insurance kicks in.
However, the deductible paid for inpatient treatments will count towards the outpatient deductible and vice versa. For example, if a patient has paid S$500 toward their inpatient deductible, they will have met the outpatient deductible for that policy year.
To help Singaporeans manage this increase, MOH will raise MediSave limits, so those with sufficient MediSave balances generally won’t see an increase in cash out-of-pocket expenses.
3. Revision of Pro-Ration Factors for Private Unsubsidised Bills
Pro-ration factors for private unsubsidised bills will be adjusted as the current proration factors have not kept pace with the growth of private and unsubsidised bills.
This means that if you choose a ward higher than B2/C, and only have MediShield Life, you will receive less coverage than before, leading to higher out-of-pocket costs.
Let us take the case of a 60-year-old Singaporean undergoing day surgery at a private hospital with only MediShield Life who incurs a total bill of S$40,000. Previously, with a pro-ration factor of 25%, they could claim up to S$7,450. However, with the revised pro-ration factor to 10%, their claim drops to just S$450. (how to work out the numbers plse?)
This means they would need to pay S$39,550 out of pocket through MediSave or cash, compared to S$32,550 previously.
Example: Claim computation
| MSHL Claim Amount (S$) (Before 1 April 2025) | MSHL Claim Amount (S$) (From 1 April 2025) | |
|---|---|---|
| Ward & Treatment Charges | 10,000 (25% x 40,000) | 4,000 (10% x 40,000) |
| Less deductible | (2,000) | (3,500) |
| Claimable Amount | 8,000 | 500 |
| Less Co-insurance | 550 (10% x 3,000) + (5% x 5,000) | 50 (10% x 500) |
| MediShield Life pays | 7,450 (19%) | 450 (1%) |
| Balance (payable by MediSave and/or cash) | 32,550 (81%) | 39,550 (99%) |
Looking Ahead
As we face rising medical costs and evolving treatment approaches, these enhancements aim to provide greater financial security. With increased claim limits, better outpatient coverage, and support for high-cost treatments, MOH is taking important steps to ensure that essential healthcare remains accessible. With these new measures, we can feel more assured that our national healthcare insurance scheme is evolving to better meet our needs during life’s most challenging moments.
At the same time, it’s more crucial than ever to manage your healthcare insurance expenses carefully especially with rising premiums. Understanding your health coverage is vital so you can choose ward classes that match your insurance when you need care. Being unaware of your coverage could lead to significant out-of-pocket costs.
DBS has partnered with major insurers in Singapore to make health insurance easily accessible online for purchase. You can now independently learn, compare, and buy a plan most suited to your own needs. Find out more on DBS Health Marketplace.
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Disclaimers and Important Notice
This article is meant for information only and should not be relied upon as financial advice. Before making any decision to buy, sell or hold any investment or insurance product, you should seek advice from a financial adviser regarding its suitability.
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