Statistics on Claims under MediShield Life and MediSave Withdrawals for Psychiatric Treatment in Last Three Years

Ms Anthea Ong asked the Minister for Health in the last three years (a) what is the breakdown of MediSave withdrawals for inpatient psychiatric treatment and outpatient care respectively, in terms of (i) applications made and (ii) amounts withdrawn; (b) how many patients have reached the withdrawal limits, broken down by (i) cap of $150 per day (ii) cap of $5,000 per year for inpatient care and (iii) cap of $500 per year for outpatient care under the MediSave500 scheme; and (c) how are the mental health conditions included in the Chronic Disease Management Programme determined.

Singaporeans who require psychiatric treatments can receive subsidies of up to 80% of their bills at public healthcare institutions. MediShield Life provides additional coverage should they require an inpatient stay, and MediSave withdrawals can be made to offset the remaining cost of their bills.

From 2016 to 2018, an average of 4,400 MediShield Life claims were approved and about $4 million paid out each year for inpatient psychiatric treatments. As MediShield Life is meant to cover medically necessary treatments for subsidised patients, the claim limit does not take into account patients with longer period of stays that may generally be due to social reasons. Among subsidised patients, around two in 10 exceeded the 35-day cap, and another four in 10 were within the 35-day cap but exceeded the $100 per day limit. About 300 claims each year are excluded from coverage as they are for treatment of injuries resulting from attempted suicide.

Over the same period, an average of 4,800 patients withdrew about $6 million from MediSave for inpatient psychiatric stays each year. Based on the latest available data, less than one in 10 subsidised patients exceeded the yearly withdrawal limit of $5,000, while less than three in 10 subsidised bills exceeded the daily withdrawal limit of $150 per day.

For outpatient care, an average of 14,000 patients a year utilised Medisave for psychiatric conditions under the Chronic Disease Management Programme (CDMP) from 2016 to 2018. These conditions are selected in consultation with a Clinical Advisory Committee comprising clinical experts. The factors considered include level of disease burden, effectiveness of early intervention, and availability of clear clinical guidelines. The MediSave limit for CDMP was raised to $500 in 2018, and about two in 10 patients who withdrew MediSave for psychiatric conditions reached the yearly withdrawal limit.

MediShield Life and MediSave limits are reviewed regularly to ensure that they cover the majority of subsidised patients’ bills. The on-going review of MediShield Life, including the claim limits, by the MediShield Life Council is expected to complete by end 2020.

Those who cannot afford their treatment even after subsidies, MediShield Life and MediSave can approach the medical social workers for MediFund and other financial assistance.