Annual Caps on Subsidies for Chronic Disease Management Programme

Mr Gerald Giam Yean Song asked the Minister for Health in 2012, 2013 and 2014, how many eligible patients reached (i) the annual withdrawal cap of $400 from their own MediSave accounts, not that of their family members; or (ii) the annual CHAS subsidy limits of $320 or $480 for simple chronic (Tier 1) or complex chronic (Tier 2) conditions respectively, for treatment of conditions under the Chronic Disease Management Programme (CDMP).

Subsidies at the specialist outpatient clinics, polyclinics and participating general practitioner (GP) clinics under the Community Health Assistance Scheme (CHAS) help to ensure that outpatient care is affordable. MediSave use is sized primarily to help Singaporeans pay for subsidised hospitalisation costs. Its use has been extended to outpatient treatment of chronic diseases under the Chronic Disease Management Programme (CDMP) to help patients to defray their cash payment for such treatments.

Under CDMP, up to $400 per year per MediSave account can be used for the treatment of 19 chronic conditions. The annual MediSave limit is reviewed regularly and was last increased in January 2012 from $300 to $400 per year. In 2014, about 5% of the 200,000 subsidised patients, or about 10,000 patients, fully utilised the annual $400 limit from their own MediSave accounts, up from 3% in 2012. This includes patients seeking care at the specialist outpatient clinics, polyclinics and CHAS GP clinics.

At CHAS GP clinics, patients can receive subsidies for the 19 CDMP chronic conditions under CHAS and Pioneer Generation (PG) packages. Generally, patients can be expected to co-pay for part of their treatment, with the lower-income and Pioneers paying less. In 2014, less than 2% of the 1.2 million CHAS members used up to their annual cap of chronic subsidy, similar to that in 2012 and 2013.

Outpatient subsidies were enhanced recently, together with additional subsidies for Pioneers, to help reduce the amount that patients need to pay using their own MediSave or cash. Pioneers also have a higher CHAS subsidy limit than other CHAS beneficiaries. In addition, since April 2015, the elderly have been able to use an additional $200 of MediSave a year to pay for various outpatient treatment, under the Flexi-Medisave scheme. These measures will help to reduce the number of patients, especially the elderly patients, who will exhaust their limits. My Ministry will continue to review the MediSave and CHAS limits regularly to ensure that outpatient care remains affordable.

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