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Pro-ration

 

Pro-ration of Class A/B1 and Private Hospital Bills

Bills for higher class wards (e.g. Class A, Class B1 and private hospitals) are pro-rated to their equivalent Class B2 bill size based on the pro-ration factors in the table below.

 

Pro-ration of Bills for Singapore Permanent Residents and Non-Singaporeans

For Singapore Permanent Residents (SPRs) and non-Singaporeans, the pro-ration factor due to citizenship status will be applied to the charges incurred by you before the MediShield Life claim is computed. This is to equalize the MediShield Life payout for Singaporeans and non-Singaporeans.

 

The percentage to be applied to your hospital bill is as such:


Ward Class
Percentage of charges incurred used to calculate MediShield Life Claim
Singaporean SPR Foreigners
C (Public Hospital) 100% 44% 20%
B2 (Public Hospital) 100% 58% 35%
B2+ (Public Hospital) 70% 47% 35%
B1 (Public Hospital) 43% 38% 35%
A (Public Hospital) 35% 35% 35%
Private Hospital 25% 25% 25%
Community Hospital (Subsidised) 100% 50% 50%
Community Hospital (Non-subsidised) 50% 50% 50%
Inpatient Palliative Care Service (Subsidised) 100% 50% 50%
Inpatient Palliative Care Service (Non-subsidised) 50% 50% 50%
Subsidised Short Stay Ward 100% 58% 35%
Non-subsidised Short Stay Ward 35% 35% 35%
Subsidised Day Surgery 100% 58% Not applicable
Non-subsidised Day Surgery (Public Hospital) 35% 35% 35%
Non-subsidised Day Surgery (Private Hospital/Clinics) 25% 25% 25%
Subsidised Outpatient1 100% 67% Not applicable
Non-subsidised Outpatient1,2 50% 50% 50%

 

1 Continuation of Autologous Bone Marrow Transplant for Multiple Myeloma will follow the outpatient pro-ration factors

2 Non-subsidised bills for outpatient cancer treatments and home parenteral nutrition will be pro-rated. Bills for dialysis-related treatments and immunosuppressants will not be pro-rated.


Deductible

 

A Deductible is the amount you would need to pay for claim(s) made in a policy year, before there is a payout from MediShield Life. You only need to pay the full Deductible once in a policy year.

 

However, the Deductible is waived if your claim is for outpatient treatments.

Deductible (Per Policy Year) As of age next birthday
Ward Classes For ages 80 and below For ages 81 and above
Class C1 $1,500 $2,000
Class B2 & Above $2,000 $3,000
Day Surgery $1,500 $2,000
Outpatient Treatment Not Applicable

 

 

 

 

1 Community Hospital, Inpatient Palliative Care Service, Short Stay Wards and Continuation of Autologous Bone Marrow Transplant for Multiple Myeloma will follow the deductible for Class C for patients in subsidized wards, and the deductible for Class B2 and above for patients in non-subsidised wards.

 


Co-insurance

 

Co-insurance is the amount you need to co-pay after meeting the Deductible.

 

Co-insurance

Inpatient/Day Surgery
Claimable amount accumulated within a policy year

First $5,0001 10%
Next $5,000 5%
Above $10,000 3%
Outpatient Treatment 10%

1 Inclusive of deductible

 



Accumulated claimable amounts (before deductible and co-insurance) from previous hospitalisations

 

Claimable amounts (before deductible and co-insurance) from previous hospitalisations within the same policy year are accumulated to offset against the deductible.

 



Total paid from previous claims

 

Total paid claims from previous hospitalisations within the same policy year.