Implications of Claims-based Health Insurance Pricing on Older Policyholders and Those who Choose to Move to Public Healthcare System

Ms Mariam Jaafar asked the Minister for Health with regard to the introduction of claims-based health insurance pricing, what avenues exist to protect the interests of older policyholders and policyholders with pre-existing conditions.

Ms Mariam Jaafar asked the Minister for Health with regard to the introduction of claims-based insurance pricing, what is the number of Integrated Shield Plan holders who have switched to MediShield Life and moved into the public healthcare system.

Riders are optional private insurance products that are paid for by policyholders in cash, to provide as-charged and zero co-payment coverage. Since 2019, MOH has required a minimum 5% co-payment for all new rider products to mitigate the risk of a "buffet syndrome" and avoid unsustainable healthcare cost and insurance premium increases. Some insurers have chosen to implement the co-payment directly, through claims-based pricing (CBP), or a combination of the two.

Regardless of the healthcare insurance plans they choose, all Singapore Citizens and Permanent Residents are covered under MediShield Life, which is a basic health insurance plan that provides lifelong protection against large hospital bills regardless of pre-existing conditions. This protects the interests of all policyholders, including older Singaporeans who have pre-existing conditions. This can be supplemented with optional Integrated Shield Plans (IPs) if higher coverage is preferred. MediSave can be used for MediShield Life and IP premiums, and these are not subject to CBP.

Policyholders should carefully assess the terms of their private rider policy plans and consider discussing with their insurer a plan that is suitable for their needs.

There is currently no evidence to show that CBP shifts claims to public hospitals.