$14k bill shock for retiree after operation

Retired businessman Steven Choo’s medical bill came up to $14,501, but even combined, Medisave and MediShield would only cover $1,710. -myp
Ethan Lou

Thu, Aug 02, 2012
my paper

 

Retired businessman Steven Choo, 60, underwent angioplasty at the Singapore General Hospital (SGH) to unclog blood vessels in his legs last November.

Mr Choo, who is diabetic, underwent the procedure – with “balloons” and stents used to unblock the arteries – which prevented gangrene from spreading from his toes.

But the successful operation marked the start of another round of problems for him. On the day he was discharged from hospital, he received a shock: His medical bill came up to $14,501, but Medisave and MediShield would cover only $900 and $810, respectively, or $1,710 combined.

SGH also told him he would not get his $6,620 deposit back, and that he still owed it $5,381, Mr Choo told my paper in an interview. The remaining $790 was covered by a government grant.

The Central Provident Fund (CPF) Board told him that the Medisave claim submitted by the hospital did not indicate a surgical procedure. This meant he could not claim the full amount he should have been entitled to: $3,050.

Insurance company AIA, which handles his MediShield account, told him likewise.

Mr Choo then hand-delivered a four-page report from his doctor to the CPF Board, explaining that angioplasty is a surgical procedure. But then he got another shock.

He said: “CPF Board wrote to tell me that they’re not paying because (the angioplasty) was not done in a ‘proper’ place.”

The CPF Board’s letter, dated Feb 8, read: “Only surgical procedures performed in a properly equipped operating theatre… are Medisave claimable.”

The head of SGH’s diagnostic radiology department, Associate Professor Tay Kiang Hiong, told my paper that Mr Choo’s angioplasty had been planned to take place in an operating theatre. But his operation was moved to an angiography suite – where angioplasty is also typically conducted.

This was because “there were urgent and complicated cases that needed to be performed in the operating theatre”, said Prof Tay.

Mr Choo then sent an e-mail message to the CPF Board arguing that he had been penalised because of where his operation was conducted.

The case remained in limbo for three months, said Mr Choo, who wrote to the CPF Board repeatedly, only to receive the same reply each time that his appeal was under review.

In May, the Ministry of Health (MOH) sent him an e-mail message informing him that his appeal had been successful.

Not long after, Mr Choo’s MediShield claim was also approved.

AIA told my paper that the claim was reviewed twice because there were inaccuracies in the initial claim.

Late last month, SGH called Mr Choo to tell him that both Medisave and MediShield amounts due to him had been paid out fully.

He was also entitled to a $638 refund from his deposit.

Six months later, the problem has been resolved but it has left Mr Choo irate. He said: “If I did not fight for it, where would I get the money from?”

Mr Choo added that he hopes that others would not have to be put through the same ordeal.

An MOH spokesman told my paper that angioplasty typically takes place in operating theatres.

As Mr Choo’s angioplasty took place in an angiography suite, it “was not deemed a surgical procedure”.

This is why SGH did not submit a Medisave claim for the procedure, said the spokesman.

The spokesman added: “We have since clarified with SGH that an angioplasty procedure… can be submitted for Medisave claims, even if it took place in the angiography suite.”

ethanlou@sph.com.sg

Updated 07:43 PM Jul 18, 2012
SINGAPORE – Adjustments to MediShield – a basic and catastrophic insurance scheme – are set to kick in by the first quarter of next year.

Among the changes: increasing MediShield coverage for large bills by increasing yearly limits from S$50,000 to S$70,000, and lifetime limits from S$200,000 to S$300,000; and extending MediShield to cover short-stay wards at the Emergency Department and inpatient psychiatric treatment.

The age ceiling for coverage will also go up from 85 to 90. Deductibles – bills to be paid by the patient before payouts from MediShield – will also go up by S$500 for Class B2 and C hospital bills, to S$2,000 and S$1,500 respectively.

In turn, premiums will need to go up. According to the Ministry of Health (MOH), after the Government Medisave top-up, those aged 21 to 60 will see their monthly premiums go up by S$1 to S$5. The rest will see premiums decrease.

The MOH also proposed other changes to MediShield which are up for public feedback – the idea to extend coverage to newborns with congenital conditions. The MOH said this will cost Singaporeans aged 20 and below about S$1 more a month in premiums.

To keep MediShield premiums affordable, the Government had announced a one-time Medisave top-up of S$400 during Budget 2012, as well as permanent Medisave top-ups to the elderly under the GST Voucher Scheme. MediShield premiums are paid for via Singaporeans’ Medisave accounts. These are part of the aim to double State healthcare spending to S$8 billion over the next five years.

The public may send feedback to moh_info@moh.gov.sg.

Source: todayonline.com/Singapore/EDC120718-0000132/MOH-announces-enhancements-to-MediShield

CRITICAL ILLNESS INSURANCE

Critical illness insurance pays a lump sum either when you are first diagnosed with a critical illness covered by the policy, or after having a type of surgery covered by the policy. The lump sum does not depend on your admission into hospital or on your actual medical expenses. A critical illness benefit can be sold as a stand-alone plan or policy or be packaged into a life policy or as an optional rider to a life policy.

The types of critical illnesses covered may vary from one insurer to another. But most major illnesses and types of surgery are covered by almost all policies.

These include

  • major cancers,
  • heart attack,
  • coronary artery bypass surgery,
  • stroke and kidney failure.

Do note that:

  • The benefits are paid only if the disease or surgery exactly meets the definition stated in the policy. Definitions of diseases covered by a standard critical illness policy are fixed across all insurance companies in Singapore.
  • There is usually a waiting period for certain diseases or types of surgery. If any disease or type of surgery specified by the policy is diagnosed or carried out during the waiting period, no benefits will be paid.

Some critical illness policies pay a smaller amount for earlier stages of cancer, or make several payments upon diagnosis of different insured critical illnesses, subject to the sum insured or policy limits.

 

 

Disability Income Insurance

Disability income insurance pays a fixed amount each month to replace the income you would lose if you are unable to work as a result of an accident or illness. These policies may pay up to 80% of your average monthly salary. The policy aims to ease your financial loss, but will not completely replace the income you earned before the accident or illness.

Do note that:

  • There may be a deferred period during which benefits will not be paid. Benefits are payable only if you are continuously disabled after the deferred period. The monthly income benefit will usually be paid for up to 5 or 10 years, or until you are 60 or 65.
  • The monthly payments are stopped or reduced when you start working again, even if it’s not the same work that you did before your illness or accident. The reduction in benefits may be in proportion to any recovery you make. The insurer will assess your rate of recovery through medical check-ups.
  • Clarify with your insurer how disability is defined in the policy. Some policies may define disability as not being able to perform your usual work. Others may define it as not being able to do any work at all. The amount of premium payable can vary depending on a number of factors, including the definition used. Do check with your insurer for the definitions used in your policy.

Hospital Cash Insurance

Hospital cash insurance pays a fixed amount of money for each day you are hospitalised for medical treatment or surgery. The total amount paid under this policy may be more or less than your actual medical expenses.

Do note that:

  • A hospital cash insurance policy may have a waiting period. This means benefits are paid only after you have been hospitalised for more than a set number of days.
  • Benefits may also be paid for only a fixed number of days each year or the life of the policy. If it’s for a fixed number of days over the life of the policy, the policy will end once the lifetime limit has been reached.

Waiting periods and benefit limits may vary across policies.

 

 

Medical Expense Insurance

Medical expense insurance pays for certain medical expenses incurred because of an accident or illness. Medical expenses can arise from any of the following medical treatments or procedures:

  • in-patient medical treatment or surgery,
  • day surgery,
  • consultations with specialists before, during and after the hospital stay,
  • X-rays and laboratory tests.

‘Major’ medical expense insurance will pay expenses for longer hospital stays due to a major illness like cancer or for major surgery such as heart bypass surgery or organ transplant.

Do note that:

  • The policy may not fully pay for actual medical expenses incurred.
  • The policy will usually include limits for each illness, disability, by policy year or lifetime.
  • Certain conditions and pre-existing conditions may be excluded from cover. Treatment that is not for medical reasons may also be excluded.
  • Investigative procedures such as tests / biopsies for diagnosis purposes, for example to detect a specific illness or medical condition may or may not be included.
  • Waiting periods may also apply. If so, expenses will not be paid during the waiting period. See more on Waiting Periods.
  • Some policies may also have ‘deductible’ and ‘co-insurance’ features.
  • With medical expense insurance, the total reimbursement you will get from all your policies is limited to your actual expenses. So buying additional medical expense insurance policies does not necessarily provide extra benefits.

 

 

This is a matrix compiled by the Health Ministry of Health Insurance Plans in Singapore for Private Hospitals.  It covers the following health insurance companies:

  • AIA
  • Prudential
  • Great Eastern
  • Aviva

For Daily ward and treatment charges, surgery, surgical Implants and approved medical consumables as well as for the following treatments:

  • Kidney Dialysis
  • Radiotherapy
  • Chemotherapy
  • Immunotherapy
  • Stereotactic Radiotherapy
  • Immunosuppressants for organ transplant
  • Erythropoietin

Health-insurance-singapore-comparison

SINGAPORE, Jun 12, 2012 (BUSINESS WIRE) — Aetna , a leading global diversified health care benefits company, announced today that it has received a license to begin selling health insurance in Singapore. Aetna is now marketing health policies for groups and individuals in Singapore.

“We’re very pleased to offer our insurance products in Singapore,” said Derek Goldberg, Aetna International’s managing director for Southeast Asia. “Singapore is a very attractive market for Aetna. It has a vibrant, growing economy and a large number of expatriates and local residents who may need global or regional health care coverage.”

In addition, Singapore is the perfect regional hub from which to develop further business opportunities in Southeast Asia, Goldberg noted.

Upon receiving the license, Aetna introduced its flagship International Healthcare Plan (IHP) to the Singapore market. IHP provides comprehensive health benefits aimed primarily at customers who travel extensively or live outside of their country of origin. In addition, a new Aetna benefits product, Aetna Healthy Aessentials, made its debut in Singapore ahead of a planned worldwide roll-out. The new health plan is targeted to customers who require regional coverage, and fills a market gap between existing local plans and high-end global plans like IHP.

According to Michael Elliott, general manager for Aetna’s Asia-Pacific region, Aetna’s entry into Singapore demonstrates the company’s commitment to growing its business in the region. “Aetna aims to be the global leader in empowering people to live healthier lives. By leveraging our 158 year history and experience as a global leader in health care, we believe we have a lot to offer to the Singapore and Southeast Asian markets in terms of product and service innovation.”

Elliott added that Aetna also will offer technology-enabled health management services in Singapore and regionally.

About Aetna International

Aetna International is committed to helping create a stronger, healthier global community by delivering comprehensive health benefits and health management solutions worldwide. Aetna International’s expatriate business is one of the industry’s largest and most prominent international health benefits providers, supporting more than 430,000 members worldwide. The organization’s expatriate offerings include medical, dental, vision, life, disability and emergency assistance. Aetna International’s health management business collaborates with health care systems, government entities and plan sponsors around the world to design and build locally-applied health management solutions to improve health, quality and cost outcomes. For more information, see www.aetnainternational.com .

About Aetna

Aetna is one of the nation’s leading diversified health care benefits companies, serving approximately 36.1 million people with information and resources to help them make better informed decisions about their health care. Aetna offers a broad range of traditional, voluntary and consumer-directed health insurance products and related services, including medical, pharmacy, dental, behavioral health, group life and disability plans, and medical management capabilities, Medicaid health care management services and health information technology services. Our customers include employer groups, individuals, college students, part-time and hourly workers, health plans, health care providers, governmental units, government-sponsored plans, labor groups and expatriates. For more information, see www.aetna.com .

SOURCE: Aetna

        
        Aetna 
        Cynthia Michener, 1-860-273-8553 
        michenerc@aetna.com

Related: doctors.com.sg/health-insurance.html

 

International SOS Singapore contact information

 

iSOS members can tap into their round-the-clock resources, including:

  • a team of full-time doctors and nurses
  • multilingual customer service executives and managers
  • healthcare management experts
  • in-house travel department
  • security and technical consultants
  • an aviation desk to identify suitable aircrafts for evacuations
  • priority access to two air ambulances
  • our global network of alarm centers and clinics
  • a network of thousands of preferred service providers worldwide

 

Office information
SingaporeInternational SOS Pte Ltd
331 North Bridge Road
#17-00 Odeon Towers
Singapore, Singapore 188720  SingaporeAdmin Tel: +65 6338 2311
Admin Fax: +65 6338 7611

http://www.internationalsos.com/en/asia-pacific_singapore.htm

Alarm center
SingaporeOpen 24 hours a day
International SOS Pte Ltd
Tel: +65 6338 7800
Tel (Japanese): 65 6336 3080
Fax: +65 6338 7611

 

 

http://www.doctors.com.sg/health-insurance.html

ManuCare

Making concrete and stable plans for unforeseen circumstances today will ensure that you have the best possible medical care should the need arise. That is the essence of ManuCare.

Features and benefits:

  • Reimburses your entire hospital bill, subject to only three limits – a daily room and board limit, an annual limit and an overall lifetime limit.
  • Allows annual renewal for long term protection regardless of your state of health, up to age 75. No medical evidence is required.
  • A choice of four plans – Executive, Deluxe, Premier and Elite to best complement your needs and lifestyle.
  • 24-hour emergency assistance service for ManuCare Deluxe, Premier and Elite plans.

 

http://www.doctors.com.sg/health-insurance.html