Debunking Myths About Integrated Shield Plans (ISPs)

This was originally posted on Planner Bee.

As healthcare costs continue to rise, more Singaporeans are opting to purchase additional coverage through private health insurance in the form of Integrated Shield Plans (ISPs) to complement MediShield Life“.

Singapore’s Ministry of Health (MOH) and insurance companies have also gradually introduced measures to help people guard against the financial impact of critical illnesses, while encouraging people to tap on healthcare services responsibly.

In this article, we debunk the common myths about ISPs, so you can navigate the complexities of insurance options and be sure to choose a plan that provides adequate protection and aligns with your financial capabilities.

What is an Integrated Shield Plan?

ISPs are policies people buy to supplement their MediShield Life plan. Different ISPs provide different levels of coverage. Some cover the cost of staying in a Class A or B1 ward in a public hospital, while others cover the cost of being admitted into a private hospital, which offers you greater control and comfort in your healthcare choices.

You can also buy an additional rider that helps to partially or fully offset the deductible and co-insurance portions of your bill.

Since all ISPs generally provide similar coverage, and hospital and medical bills can only be claimed from one plan, you can only use MediSave to pay for one ISP at any point in time. Some Integrated Shield Plans come with additional benefits such as coverage for alternative treatments, maternity benefits, and outpatient treatments. These additional benefits can vary among insurers and plan types.

How do I know if I have an Integrated Shield Plan?

You can check whether you have an Integrated Shield Plan by logging on to your Central Provident Fund (CPF)account to check.

1. Go to cpf.gov.sg
2. Log on to my cpf Online Services
3. Go to “Healthcare“
4. Look under “Health insurance” section

Myth 1: It covers the charges incurred for outpatient diagnostic scans and scopes

In general, Integrated Shield Plans do not cover outpatient diagnostic procedures such as X-rays, annual health screenings, and CT scans unless they are part of pre- and post-hospitalisation treatments, or part of inpatient treatments.

The following procedures are covered under Integrated Shield Plans:

1. Outpatient treatment

Outpatient treatments include kidney dialysis, cancer treatment, radiotherapy, chemotherapy, stereotactic radiotherapy, immunosuppressants for organ transplants, and erythropoietin. Find out more about the benefits provided by a standard Integrated Shield plan via the MOH website.

2. Inpatient & day surgery

This includes treatment costs, ward admissions, and surgical costs. Diagnostic endoscopies are also covered and categorised as day surgeries, as they are considered necessary even if they do not lead to inpatient treatments. However, there may be limits set to this coverage, so check with your insurer to be sure.

3. Selected pre- and post-hospital treatments

Mandatory follow-up treatments and diagnostic costs incurred before or after hospitalisation are covered.

Myth 2: I can file a claim for all pregnancy-related treatments

Not all pregnancy-related treatments are covered under an Integrated Shield plan. A limited list of serious complications that arise during pregnancy and delivery are eligible for claims. These conditions include inpatient treatments for congenital anomalies, involuntary miscarriages aft­er 13 weeks of pregnancy, or an ectopic pregnancy. As different insurers provide different benefits, check with your provider on the exact policy terms.

Myth 3: Integrated Shield Plans do not provide lump-sum payouts

This is not true. While Integrated Shield plans are primarily meant to offload exorbitant hospitalisation and treatment costs, some rider plans offer lump-sum payouts of up to S$10,000 per lifetime if a person is diagnosed with a critical illness the plan covers.

Myth 4: Integrated Shield plans can fully cover my bill

In 2018, the Singapore government changed the terms of Integrated Shield Plans after noting that policyholders had over-consumed healthcare services as hospital bills were covered fully.

To encourage people to be prudent with using healthcare services, and keep health insurance cost affordable, new Integrated Shield Plan policyholders will have to pay at least 5% of their hospital bill.

However, the good news was that premiums will be reduced by up to 50 percent, depending on the age of the policyholder and terms of the policy. Nonetheless, it’s crucial to understand the co-payment structure, including any deductibles or co-insurance, to be prepared for potential out-of-pocket expenses. Some plans may offer riders to minimise co-payment requirements.

Myth 5: I have a critical Illness plan, therefore I don’t need an Integrated Shield plan

A critical illness plan gives you a lump-sum payout if you are diagnosed with a critical illness. This payout can be used to cover medical expenses, lifestyle adjustments, or other financial needs during a critical illness. However, it does not cover hospitalisation, surgery, and medical treatment costs.

Integrated Shield Plans, on the other hand, primarily focus on hospitalisation and medical expenses. They enhance the coverage provided by the basic MediShield Life, offering benefits such as coverage for hospitalisation, surgical procedures, and related medical expenses.

While critical illness plans and Integrated Shield Plans serve different purposes, they complement each other rather than being mutually exclusive.

Myth 6: I can buy an Integrated Shield plan when I am older

Private insurers provide riders to cover the costs of co-insurance and deductibles. However, riders cannot be paid for using MediSave and you have to use cash to pay for it.

Myth 7: Switching plans will result in loss of coverage

Policyholders have the flexibility to switch between Integrated Shield Plans without losing their existing coverage, provided they adhere to certain guidelines. It’s advisable to consult with your insurer and understand the terms and conditions before making any switches. Considerations should include waiting periods and coverage continuity.

Myth 8: Premiums for Integrated Shield Plans are unaffordable

While premiums for Integrated Shield Plans can vary based on coverage and insurer, there are options available to suit different budgets. Many insurers offer tiered plans, allowing you to choose coverage that aligns with your financial capacity. Additionally, government subsidies and MediSave can be utilised to offset premiums, making coverage more affordable.

Myth 9: All Integrated Shield Plans offer the same coverage

Integrated Shield Plans come in various tiers and from different insurers, offering varying levels of coverage. It’s essential to carefully compare the features, benefits, and premiums of each plan to choose one that best suits your needs. Some plans may include additional benefits such as coverage for pre- and post-hospitalisation expenses, higher ward class options, and overseas treatment.

Are you adequately covered?

Before getting an Integrated Shield Plan, consider what your needs are. For example, if you are hospitalised, are you fine staying in a no-frills ward in a public hospital, or would you want to stay in a higher-class ward, or in a private hospital? Do you prefer that the co-insurance and deductible portions of your bill are covered?

Compare the Integrated Shield plans available in the market and choose one that meets your needs. Have more burning questions? Do not hesitate to drop us an email at [email protected] and we will be more than happy to help.

Read more: Your Complete Guide to Integrated Shield Plans in Singapore