MediShield for Secondary Depression

Assoc Prof Fatimah Lateef asked the Minister for Health whether the use of MediShield for secondary depression can be reviewed as it is not a primary mental disorder but secondary to other medical or drug-induced diseases.

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The Senior Minister of State for Health (Dr Amy Khor Lean Suan) (for the Minister for Health): The Ministry of Health has indeed reviewed MediShield coverage for psychiatric conditions. Since 1 March 2013, MediShield coverage has been extended to inpatient treatment of newly diagnosed psychiatric conditions. All policyholders with psychiatric conditions, including primary and secondary depression that were diagnosed on or after that date are covered under MediShield.

When life-long and universal coverage under MediShield Life is introduced, all Singaporeans with pre-existing conditions including psychiatric conditions diagnosed before 1 March 2013 will also be covered by insurance for the treatment of these conditions. More details on MediShield Life will be announced after my Ministry has studied the final recommendations from the Committee. The Committee is expected to complete its review and submit the recommendations to the Government in the middle of the year.

In the meantime, subsidies continue to be available for psychiatric care at public hospitals. Medisave can also be used up to $150 per day and $5,000 per year. Financial assistance including help from Medifund will be available for those who face difficulty with their medical bills at our public healthcare institutions.

Assoc Prof Fatimah Lateef (Marine Parade): I thank the Senior Minister of State for the response. I would like to ask her how to come to a consensus on this issue of secondary depression. A patient has got Parkinson's disease for 10 years, and then develops depression which is secondary depression only in the last two years. Upon admission to hospital, MediShield was denied as an inpatient because the response from the institution was that it was a psychiatric condition. However, this is not a primary psychiatric or mental health condition, but a secondary depression, secondary to Parkinson's.

First, let me say that I empathise with the case raised by the Member. It is a specific case. Let me say that in this particular case, it is really, unfortunately, a question of timing. Allow me to briefly explain. First, MediShield claims are based on the conditions for which that person was admitted, and not the original trigger. So, it is the primary condition for which the person was admitted. In this particular instance, the hospital had determined at that point in time of admission, that the primary reason for the admission was depression. Prior to 1 March, depression was not covered by MediShield. So, there was admission prior to 1 March 2013. And then, there was another admission in 2013 after 1 March.

As I have noted earlier, since 1 March 2013, MediShield coverage was extended to inpatient treatment of newly diagnosed psychiatric conditions. Again, when the patient was admitted, the hospital determined that the primary reason for admission was depression. But because depression was already diagnosed prior to 1 March 2013 for this case, it is pre-

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existing condition and, therefore, again, MediShield coverage could not be extended to this particular case.

As I have noted, once MediShield Life is introduced, all patients with pre-existing conditions, for psychiatric conditions whether it is primary or secondary, will be covered by MediShield. In the mean time, Government subsidies actually are already inherent when the patient is admitted to subsidised wards in the hospitals. In addition, the patient can utilise Medisave of up to $150 per day or $5,000 per year for inpatient psychiatric treatment. If the patient is needy, he can avail himself to financial assistance through Medifund.

Let me end by saying that we are aware of the case, and for the admission in 2013, we are actually working with the hospital to better understand the condition for admission and the treatment. We will assist the patient in whatever way we can.