Hi anon, I would highly encourage you to get the enhancement for Careshield Life (CSL). CSL is meant to provide for your long term care needs. These range from your nursing home costs to specialized care settings, etc, in a scenario where you cannot do 3 or more out of the 6 activities of daily living. The coverage is for life and it also makes sense as it is more likely that in retirement and old age, one suffers from some kind of disability that greatly interferes with your daily life. CSL, while providing a lifetime payout, only pays $600/mth. If you feel that is enough today, then you don't have to do anything. But in today's context, that is barely enough for a maid, let alone nursing home care. Even with the 2% escalation in payouts, we're looking at maybe a $1200/mth payout after age 67, 37 years from now. By then, costs would have increased from today as well. We're really just playing catch up. Thus, getting your CSL payout increased with a supplement plan (say, another $1000/mth extra on top of CSL) will ensure that you at least have $2200/mth if something happens after age 67. While that may not be enough by then, it is definitely a step up from $1200/mth. More importantly, if you are young and healthy now, you won't have any issues getting the suppplement plan, because you are still insurable. When chronic conditions like diabetes sets in, you won't be able to get any supplementary coverage at all. The risk of not buying , is just that if you have to claim, you will only have CSL to fall back on. The risk of buying , is that if you don't claim, the premiums will just go to the insurer's risk pool to pay out to those who have to claim, which is how insurance works in the first place. In conclusion, you should exercise your option to increase your payout now, when you are still young and healthy. Medisave can be used for this (up to $600/yr) which won't impact your cashflow, even if finances are tight. Medisave money cannot really be withdrawn, and there are caps on what it can be used for. CSL and supplement payouts are in cash , which gives you flexibility on how you want to deploy it.