CPFB | What MediShield Life covers you for

Updates on 20 Apr 2021

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Benefits

Claim limits

Find out the benefits of MediShield Life coverage.

Hospitalisation and day surgery

Limits for hospitalisation and day surgery

Applicable for admissions or treatments received on or after 1 October 2022

Inpatient/day surgery	Claim limits
Daily Ward and Treatment Charges¹
- Normal ward²	$800 per day*
- Intensive care unit ward	$2,200 per day*
* An additional claim limit of $200 per day applies for the first two inpatient² days
- Psychiatric (up to 60 days per policy year)	$160 per day
- Community hospital (Rehabilitative)³	$350 per day
- Community hospital (Sub-acute)³	$430 per day
- Inpatient palliative care service (general)	$460 per day
- Inpatient palliative care service (specialised)	$500 per day
Surgical procedures	A	B	C
- Table 1 A/B/C (less complex procedures)	$240	$340	$340
- Table 2 A/B/C	$580	$760	$760
- Table 3 A/B/C	$1,060	$1,160	$1,280
- Table 4 A/B/C	$1,540	$1,580	$1,640
- Table 5 A/B/C	$1,800	$2,180	$2,180
- Table 6 A/B/C	$2,360	$2,360	$2,360
- Table 7 A/B/C	$2,600	$2,600	$2,600
Implants	$7,000 per treatment
Radiosurgery, including Proton Beam Therapy – Category 4	$10,000 per treatment course
Continuation of autologous bone marrow transplant treatment for multiple myeloma	$6,000 per treatment

¹ Includes meal charges, prescriptions, professional charges, investigations and other miscellaneous charges

² Includes eligible Mobile Inpatient Care @ Home stays

³ Claimable only upon referral from a hospital after an inpatient admission or from a public hospital’s emergency department for further medical treatment.

Choose the ward type that best meets your budget

Learn how much you need to pay in cash for each hospitalisation

Find out more

Outpatient Treatments

Claim limits for outpatient treatments.

Applicable for admissions or treatments received on or after 1 December 2023

Outpatient treatment	Claim limits
Patients receiving treatment for one primary cancer
- Cancer drug treatment¹	$200 - $9,600 per month, depending on cancer drug treatment¹
- Cancer drug services	$3,600 per year
Patients receiving treatment for multiple primary cancers²
- Cancer drug treatment¹	Sum of the highest cancer drug treatment limit amongst the claimable treatments received for each primary cancer per month
- Cancer drug services	$7,200 per year
Radiotherapy for cancer
- External (except Hemi-body)	$300 per treatment
- Brachytherapy	$500 per treatment
- Hemi-body	$900 per treatment
- Stereotactic	$1,800 per treatment
- Proton Beam Therapy - Category 1	$300 per treatment
- Proton Beam Therapy - Category 2	$500 per treatment
- Proton Beam Therapy - Category 3	$1,800 per treatment
Kidney Dialysis	$1,100 per month
Immunosuppressants for organ transplant	$550 per month
Erythropoietin for chronic kidney failure	$200 per month
Long-term parenteral nutrition	$1,700 per month

¹Refer to the Cancer Drug List on the MOH website for the applicable claim limit.

²Defined as two or more cancers arising from different sites and/or are of a different histology or morphology group. The claim limits for patients receiving treatment for multiple primary cancers are accorded on an application basis; doctors are to send the application form to MOH for assessment.

Maximum claim limits

The maximum claim limit per policy year is set at $150,000 with no lifetime limit on the amount you can claim from MediShield Life.

Maximum claim limits

Maximum claim limits	Claim limits
Per policy year	$150,000
Per lifetime	No limit

Exclusions

Excluded treatments and procedures

There are a number of standard exclusions which are not covered by MediShield Life.

Standard exclusions

These treatment items, procedures, conditions, activities are not covered by MediShield Life and cannot be claimed (Applicable for admissions or treatments received on or after 1 March 2021):

Ambulance fees
Cosmetic surgery
Dental work (except due to accidental injuries)
Vaccination
Infertility, sub-fertility, assisted conception or any contraceptive operation, including their related complications
Sex change operations, including their related complications
Maternity charges (including caesarean operations) or abortions, including their related complications, except treatments for serious complications related to pregnancy and childbirth
Treatment of injuries arising from the insured's criminal act
Treatment of injuries arising directly or indirectly from nuclear fallout, war and related risk
Treatment of injuries arising from direct participation in civil commotion, riot or strike
Expenses incurred after the 7th calendar day from being certified to be medically fit for discharge from inpatient treatment and assessed to have a feasible discharge option by a medical practitioner
Surgical interventions, including related complications, for the following rare congenital conditions which are severe and fatal by nature: trisomy 13, bilateral renal agenesis, Bart's hydrops and anencephaly
Optional items which are outside the scope of medical treatment
Overseas medical treatment
Private nursing charges
Purchase of kidney dialysis machines, iron-lung and other special appliances
Treatment which has received reimbursement from Workmen’s Compensation and other forms of insurance coverage.

Understand MediShield Life payouts

MediShield Life benefits are designed to cover subsidised bills incurred by you in Class B2/C wards and subsidised outpatient treatments/day surgery at public hospitals. For a full list of hospitals participating in the MediShield Life scheme, please click on the link below.

Bills for other wards, private hospitals, and non-subsidised treatments, as well as bills incurred by Permanent Residents will be pro-rated before the claims under MediShield Life are computed.

Here’s a breakdown of the three key components in your bill that affects your MediShield Life payout amount.

Medical institutions (PDF, 0.4MB)

Claim limit

Your claim limit depends on the type of treatment you receive and the length of your hospital stay.

You’ll have to pay the portion of bill above your claim limits.

The deductible

This is the fixed amount you have to pay, before your MediShield Life payout start.

The deductible is payable only once every policy year.

Co-insurance

After paying your deductible, you’ll also need to pay a percentage of your claimable amount.

The co-insurance ranges from 10% to 3%, decreasing as your claimable amount increases.

The portion of your bill covered by MediShield Life

Your MediShield Life plan will pay for the portion of your bill (within your claim limits), minus the deductible and co-insurance.

Applications

Learn how to authorise the use of your MediShield Life or get reimbursed

Using MediShield Life to pay for your medical fees

Firstly, inform the medical institution that you want to claim from MediShield Life. Then follow the required process.

How to apply

Getting reimbursed for your medical expenses

Have you already claimed and are looking to be reimbursed?

Learn more

FAQs

Common questions

I intend to visit a clinic/hospital. How do I know if I can use MediShield Life coverage in that clinic/hospital?

What are the hospitalisation and outpatient treatment benefits under MediShield Life?

How will the new Cancer Drug Treatment benefit under MediShield Life and MediSave impact my claims from 1 September 2022?

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