Asked on 28 Oct 2020
There is also the requirement for only panel doctors, regardless of whether I have a rider plan. This defeats getting the best plan and topping up with a rider since I want maximum coverage, which pre-authorisation + panel doctor requirement doesn't give. Does anyone know of insurers with the same policy?
As a matter of fact, there is a 85% pro-ration factor if and only if the treatment fulfils all the following four conditions, 1) Treatment is for non-emergency admission / day surgery; 2) Treatment is sought at non-AIA Preferred Providers; 3) Certificate of Pre-Authorisation is not obtained; 4) Not any of the exempted minor surgical procedures.
The lack of any one or more of the above mentioned four points means that the 85% pro-ration factor will not apply.
Of course, the above is subject to the relevant policy's terms and conditions, e.g. treatment falls under the eligible expenses, is medical necessary, and reasonable and customary.
More Details: What does Integrated Shield Plan cover in Singapore
As to whether you should keep or switch your existing integrated shield plan, you should speak with your agent for a professional evaluation, rather than personal opinions here.
Finally, insurers are shifting their focus towards the use of panel doctors in an attempt to control medical costs and stop errant practices. Therefore, it may not be a totally bad thing altogether.
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