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Andy Chan

16 Mar 2021

Insurance

Do hospitalisation plans cover treatment for critical illnesses?

Looking to get Critical Illness coverage. From my understanding, it is meant to cover you so that you don't need to worry about your loss of income while recovering. However, once I'm 60-65 yo and my dependents are economically productive, is the CI and ECI coverage still necessary? Do hospitalisation plans cover the costs of treatment?

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Elijah Lee

16 Mar 2021

Senior Financial Services Manager at Phillip Securities (Jurong East)

Hi Andy,

It's a good question that you asked, and often, I see many people confused about CI coverage vs Hospitalization coverage.

The short answer is: Hospitalization coverage covers the hospital bills. CI coverage provides money for your bills.

The long answer? Read on:

So, when we are talking about hospital bills, it can be anything that arises from a treatment that was done at a hospital, and required you to be admitted. For example, surgery to remove a tumour. The scope of coverage is broad, but as long as you were deemed medically necessary to receive the treatment at the hospital, then you will be covered. So yes, the costs of treatment relating to critical illness at a hospital will be covered as well.

Beyond that, follow up treatments (as well as medical bills incurred prior to admission) will also be reimbursed after you have paid for them. Thus, claims such as follow up chemotherapy, etc, will be paid for by a hospitalization plan.

What about your bills? There are plenty of bills that can occur. Yes, you do suffer loss of income, but ultimately what we want to cover are our expenses at a minimum. (If you can afford enough CI cover to cover your income, then by all means. But this may not be possible for everyone). There are plenty of bills to consider, ranging from food to utilities to even the mortgage on your house.

I'd link you to this article that was just published earlier this month, and highlight the costs of cancer that most people will face, and that are not covered by a hospitalization plan:

Some notable lines from that article include (and I'll give my thoughts as wel)l:

"He recalled the immense physical and financial toll the cancer treatments took on her and the family."

Now while no one can really remove the physical toll, you can at least ensure the financial one is lessened dramatically with a CI payout

"Dr Tay, his oncologist, said that smoking is the top risk factor for lung cancer and this includes the use of other tobacco products such as cigars or pipes."

That is why CI coverage for smokers always cost far more

"After his mother’s experience with cancer, Mr Loy bought an insurance plan that “covers everything”. He is now thankful for it because he estimates that the treatments would have cost around S$1 million from the time he was diagnosed."

While I have no clue what he bought, there isn't a single plan that covers everything. Different types of insurance work in unison to provide a complex web of coverage that ensures that financial impact is reduced. This is why hospitalization plan as a stand alone isn't enough.

"Dr Tay said that other than private insurance, the Central Provident Fund’s MediSave and MediShield Life insurance plans provide financial coverage for cancer treatments such as chemotherapy, radiotherapy and immunotherapy.

However, the amount of coverage would vary according to the insurance plan that the individual has."

This boils down to knowing what your coverage scope is. If you thought that you were covered for private hospitals when you were only covered for government B2, or that you were going to get a payout upon early CI but it was actually late CI, you will be out of luck if something happens.

"The doctor told me to rest for half a year but I was thinking, how will my kids be fed if I don’t work?"

Self explanatory. Although he might not need to replace his income, but at the very least, expenses must be met.

"After his diagnosis, Mr Loy made drastic changes to his diet and the entire family started eating clean. Meals prepared are low on salt, sugar and oil. Processed foods were cut out."

Sometimes, special diets are required for patients who are recovering from a CI. This may not be cheap; economies of scale have led to mass processed food being far cheaper than natural ones. This is just one of the added costs of a CI. Other factors may include alternative treatment, second opinion from specialist, health supplements, transportation costs, home care or nursing costs, cost for a helper, costs of modifying a home to fit you (e.g. grab bars if you are wheelchair bound due to a stroke), etc. All these costs are independent of whether your dependents are economically productive. This is why to answer the last part of your question, I believe that CI and ECI coverage would be extremely helpful even in retirement. You will get funds to take care of these costs, without having to liquidate retirement assets in the midst of a market crash, sell off your property, borrow from relatives, or turn to your children for assistance. This affords you a certain level of dignity as you focus on the road to recovery.

I won't go as far as to say that CI and ECI coverage is compulsory in retirement, but I strongly advocate that one should have at least some amount of coverage to take care of such costs. While you are working, sure, you will probably need more CI/ECI cover. But when you retire, having some coverage can prove to be a boon rather than a bane.

JeffreyLeeZQ

16 Mar 2021

Writer at Jeffreyleezq.com

In general yes.

But you might wanna take note that if the treatment per se has not been approved by MOH, it might not be covered.

This is why I always recommend my friends and families to be adequately covered by a CI plan, so that in the event the treatment is not approved here in Singapore yet, they still have the resources to consider what we call "alternative treatments" overseas.

For example, new treatments for Cancer are always emerging, but until they have been approved by MOH here in Singapore, you might not be able to claim it from your shield plan. And this is where your CI plan will come in handy for you to be able to afford such treatments overseas, should you be keen to go for such "alternative treatments" at countries that might have already approved it as a form of treatment.

Cheers.

- Jeffrey (jeffreyleezq.com)​​​

Pang Zhe Liang

16 Mar 2021

Fee-Based Financial Advisory Manager at Financial Alliance Pte Ltd (IFA Firm)

Generally, the healthcare insurance (e.g. MediShield Life, Integrated Shield Plan) covers the cost o...

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