For admissions at public and private hospitals, members are able to claim up to $1,000 per day from MediShield Life for the first two days of normal ward stay and $800 per day from the third day onwards. Members are also able to withdraw up to $550 per day from MediSave for the first two days and $400 per day from the third day onwards. If the actual cost for the claim item is lower than the MediShield Life claim limit or MediSave withdrawal limit, the member will only be able to claim or withdraw up to the actual cost.
In the example below, the daily hospital charges for a Singapore Citizen, 50-year-old member’s 45-day stay in a B2 ward and cost of his/her two surgeries (Table 5A and Table 7A) are lower than the MediShield Life claim limits and MediSave withdrawal limits. Hence, the maximum amount that can be claimed from MediShield Life and withdrawn from MediSave is the actual cost.
In this case, MediShield Life will pay $9,099 for the hospital bill and the remaining of the bill, i.e. $2,601 ($11,700 - $9,099), can be withdrawn from MediSave.
For admissions relating to psychiatric conditions at public and private hospitals, members are able to claim up to $160 per day from MediShield Life, up to 60 days per policy year, and withdraw up to $150 per day from MediSave (subject to a yearly limit of $5,000). Additionally, members will be able to claim up to $1,000 per day from MediShield Life and withdraw up to $550 per day from MediSave for the first two days of psychiatric ward stay. If the actual cost for the claim item is lower than the MediShield Life claim limit or MediSave withdrawal limit, the member will only be able to claim or withdraw up to the actual cost.
In the example below, the daily hospital charges for a Singapore Citizen, 83-year-old member’s 15-day stay in a B2 ward are lower than the MediShield Life claim limit and MediSave withdrawal limit. Hence, the maximum amount that can be claimed from MediShield Life and withdrawn from MediSave is the actual cost.
In this case, MediShield Life will have no payment as it is below the deductible amount and the hospital bill, i.e. $1,350, can be withdrawn from MediSave.
For psychiatric admissions at psychiatric hospitals (e.g. the Institute of Mental Health (IMH)), members are able to claim up to $160 per day from MediShield Life, up to 60 days per policy year, and withdraw up to $150 per day from MediSave (subject to a yearly limit of $5,000). If the actual cost for the claim item is lower than the MediShield Life claim limit or MediSave withdrawal limit, the member will only be able to claim or withdraw up to the actual cost.
For a Singapore Citizen, 50-year-old member’s 15-day stay in a C ward at IMH, the maximum assured amount that can be claimed from MediShield Life for daily hospital charges is $2,400 ($160 per day). After taking the deductible and co-insurance into consideration, MediShield Life pays $450.
For a 15-day stay at IMH, the MediSave Withdrawal Limit is $2,250 ($150 per day). In this case, MediShield Life will pay $450 for the hospital bill and the remaining portion of the bill, i.e $1,550 ($2,000 - $450), can be paid by MediSave.
For admissions at public and private hospitals, members are able to claim up to $1,000 per day from MediShield Life for the first two days of normal ward stay and $800 per day from the third day onwards.
As MediShield Life benefits are designed to cover subsidised bills incurred by Singapore Citizens at public hospitals, non-subsidised bills are pro-rated before the claims under MediShield Life are computed. In the example below, the total charges for a Singapore Citizen, 50-year-old member’s 5-day stay in an A ward in a Public Hospital will be subject to a pro-ration factor of 35% before the MediShield Life maximum claimable amount is computed. As the pro-rated daily hospital charges are lower than the MediShield Life claim limit, the maximum amount that can be claimed from MediShield Life is the pro-rated charges.
In this case, MediShield Life will pay $373.50 for the hospital bill and the remaining bill, up to the MediSave withdrawal limits, can be withdrawn from MediSave.
For admissions at community hospitals, members are able to claim up to $350 or $430 per day from MediShield Life for stays in Rehabilitative or Sub-Acute Wards respectively, and withdraw up to $250 per day from MediSave (subject to a yearly limit of $5,000). If the actual cost for the claim item is lower than the MediShield Life claim limit or MediSave withdrawal limit, the member will only be able to claim or withdraw up to the actual cost.
In the example below, the daily hospital charges for a Singapore Citizen, 50-year-old member’s 25-day stay in a B2 Rehabilitative ward are lower than the MediShield Life claim limit and MediSave withdrawal limit. Hence, the maximum amount that can be claimed from MediShield Life and withdrawn from MediSave is the actual cost.
In this case, MediShield Life will pay $1,260 for the hospital bill and the remaining of the bill, i.e. $2,140 ($3,400 - $1,260), can be withdrawn from MediSave.
For admissions at convalescent hospitals, members are able to withdraw up to $50 per day from their MediSave (subject to a yearly limit of $3,000). If the actual cost for the claim item is lower than the MediSave withdrawal limit, the member will only be able to withdraw up to the actual cost.
In the example below, the daily hospital charges for a member’s 45-day stay is lower than the MediSave withdrawal limit. Hence, the maximum amount that can be withdrawn from MediSave is the actual cost.
In this case, $1,870 can be withdrawn from MediSave.
For treatments received at day rehabilitation centres, members are able to withdraw up to $25 per day from MediSave (subject to a yearly limit of $1,500). If the actual cost for the claim item is lower than the MediSave withdrawal limit, the member will only be able to withdraw up to the actual cost.
In the example below, the daily hospital charges for a member’s 45-day treatment are lower than the MediSave withdrawal limit. Hence, the maximum amount that can be withdrawn from MediSave is the actual cost.
In this case, $870 can be withdrawn from MediSave.
For treatments received at geriatric day hospitals, members are able to withdraw up to $150 per day from MediSave (subject to a yearly limit of $3,000). If the actual cost for the claim item is lower than the MediSave withdrawal limit, the member will only be able to withdraw up to the actual cost.
In the example below, the daily hospital charges for a member’s 45-day treatment are lower than the MediSave withdrawal limit. Hence, the maximum amount that can be withdrawn from MediSave is the actual cost.
In this case, $1,650 can be withdrawn from MediSave.
For admissions with inpatient palliative care providers, members are able to claim up to $250 or $350 per day from MediShield Life, and withdraw up to $250 or $350 per day from MediSave for General Palliative or Specialised Palliative care respectively. If the actual cost for the claim item is lower than the MediShield Life claim limit or MediSave withdrawal limit, the member will only be able to claim or withdraw up to the actual cost.
In the example below, the daily hospital charges for a Singapore Citizen, 50-year-old member receiving General Palliative care and staying in a B2 ward for 10 days are lower than the MediShield Life claim limit and MediSave withdrawal limit. Hence, the maximum amount that can be claimed from MediShield Life and withdrawn from MediSave is the actual cost.
In this case, MediShield Life will pay $90 for the hospital bill and the remaining of the bill, i.e. $2,010 ($2,100 - $90), can be withdrawn from MediSave.
For day surgeries, members are able to claim up to $800 from MediShield Life, and withdraw up to $300 from MediSave for daily hospital charges. If the actual cost for the claim item is lower than the MediShield Life claim limit or MediSave withdrawal limit, the member will only be able to claim or withdraw up to the actual cost.
In the example below, the daily hospital charges for a Singapore Citizen, 50-year-old member’s day surgery in a subsidised ward and cost of his/her surgery (Table 4A) are lower than the MediShield Life claim limit or MediSave withdrawal limit. Hence, the maximum amount that can be claimed from MediShield Life and withdrawn from MediSave is the actual cost.
In this case, MediShield Life will have no payment as it is below the deductible amount and the hospital bill, i.e. $950, can be withdrawn from MediSave.
For cancer drugs, members will be able to claim the lower of the cancer drugs claim limit or 90% of the actual cost from MediShield Life.
Members will also be able to withdraw up to the cancer drugs withdrawal limit from MediSave. If the actual cost is lower than the MediSave withdrawal limit, the member will only be able to withdraw up to the actual cost.
Please refer to the MediShield Life outpatient cancer drug list on the MOH website for the applicable cancer drugs limit for MediShield Life and MediSave.
In the example below, the cancer drugs charges for a Singapore Citizen’s cancer drugs in a subsidised setting are lower than the MediShield Life claim limit or MediSave withdrawal limit. Hence, the maximum amount that can be claimed from MediShield Life is 90% of the actual cost, and the maximum withdrawable amount for MediSave is the actual cost.
In this case, MediShield Life will pay $630 for the cancer drugs and the remaining bill, i.e. $70 ($700 - $630), can be withdrawn from MediSave.
For cancer drugs and cancer drug services, members will be able to claim the lower of the cancer drugs and cancer drug services claim limit or 90% of the actual cost from MediShield Life.
Members will also be able to withdraw up to the cancer drugs and cancer drug services withdrawal limit from MediSave. If the actual cost is lower than the MediSave withdrawal limit, the member will only be able to withdraw up to the actual cost.
Please refer to the MediShield Life outpatient cancer drug list on the MOH website for the applicable cancer drugs limit for MediShield Life and MediSave. The cancer drug services limit is $3,600 per year from MediShield Life and $600 per year from MediSave.
In the example below, the cancer drugs and cancer drug services charges for a Singapore Citizen’s cancer drugs and services in a subsidised setting are lower than the MediShield Life claim limit and MediSave withdrawal limit. Hence, the maximum amount that can be claimed from MediShield Life is 90% of the actual cost, and the maximum withdrawable amount for MediSave is the actual cost.
In this case, MediShield Life will pay $810 for the cancer drugs and cancer drug services and the remaining bill, i.e. $90 ($900 - $810) can be withdrawn from MediSave.