How Health Insurance Co-Payments and Deductibles Work in Singapore

How Health Insurance Co-Payments and Deductibles Work in Singapore

How Health Insurance Co-Payments and Deductibles Work in Singapore

Health insurance can feel complicated, but understanding co-payments and deductibles can help you manage costs. In Singapore, these two cost-sharing features exist in both public and private health insurance plans. Let’s break them down in simple terms.

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What Are Deductibles?

A deductible is the amount you pay out-of-pocket for healthcare services before your insurance coverage begins within a policy year. Under MediShield Life, Singapore’s basic health insurance scheme, the deductible ranges from SGD 1,500 to SGD 3,000, depending on your age and the ward class you choose. For instance, if your hospital bill is SGD 5,000 and your deductible is SGD 2,000, you must pay the first SGD 2,000 before insurance covers the remaining SGD 3,000.

Source: CPFB

Understanding Co-Payments (Co-Insurance)

After meeting the deductible, you share a percentage of the remaining medical costs with your insurer; this is known as co-payment or co-insurance. Under MediShield Life, the co-insurance rate starts at 10% and decreases as the claimable amount increases. For example:

  • For the first SGD 5,000 of the claimable amount: 10% co-insurance
  • For the next SGD 5,000: 5% co-insurance
  • For amounts above SGD 10,000: 3% co-insurance

So, if your claimable amount is SGD 15,000, your co-insurance would be calculated as follows:

  • First SGD 5,000: 10% of SGD 5,000 = SGD 500
  • Next SGD 5,000: 5% of SGD 5,000 = SGD 250
  • Remaining SGD 5,000: 3% of SGD 5,000 = SGD 150
Total co-insurance = SGD 500 + SGD 250 + SGD 150 = SGD 900.

Integrated Shield Plans and Riders

For better coverage, many Singaporeans opt for Integrated Shield Plans (IPs), which supplement MediShield Life with additional benefits from private insurers. These plans also involve deductibles and co-insurance. 

To reduce personal medical costs, policyholders can purchase riders that cover these expenses. However, since April 1, 2019, all new IP riders must include a minimum 5% co-payment to encourage prudent healthcare spending and prevent overutilization of medical services.

Why Do Deductibles and Co-Payments Exist?

These cost-sharing features serve to:

  • Promote responsible healthcare usage: When patients share in the cost, they are more likely to make informed decisions about their medical needs.
  • Ensure sustainability: By preventing overconsumption of medical services, deductibles and co-payments help keep insurance premiums affordable for everyone.

Find a Trusted Financial Consultant For Your Health Insurance Needs

Understanding how deductibles and co-payments work in Singapore’s health insurance system is important for managing your medical expenses effectively. By being aware of these components, you can make informed decisions about your healthcare and insurance options.

For personalized guidance on choosing the right health insurance plan, contact us today to speak with a trusted financial consultant.

All content on this site is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice. If you are experiencing a medical emergency, call 995 immediately or go to the nearest Accident & Emergency department.

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