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Enhanced Incomeshield (H&S) for my mom.

Monday, February 4, 2013

When I signed up for Incomeshield in 1999, my mom signed up for it too, convinced of the benefits. I tried to get my dad to sign up for it too but he didn't and now it is too late because of his many ailments. He only has basic Medishield.

I upgraded to Enhanced Incomeshield with an Assist Rider when it became available a few years ago. So, it means that I only have to pay 10% of my total medical bills if I were to be hospitalised and this 10% has an annual cap of $3,000 in my case. So, if my hospitalisation and related bills were to total more than $30,000 in any year, I would still pay a maximum of only $3,000.







Recently, I convinced my mom to upgrade her basic Incomeshield to the same as what I have. It took me a while to convince her because of the cost involved.

As we grow older, the premium increases and she was concerned that she would end up having to pay more than $2,000 a year for the upgrade. I told her that I was not worried about the cost. I was more worried that NTUC Income might not approve the upgrade.

As my paternal grandmother is now undergoing long term treatment, I used her as an example. She only had basic Medishield and it expired when she turned 80. Her medical bills run easily into the tens of thousands of dollars a year. Even with basic Medishield, she depleted my father's Medisave account and more.

I told my mom that the annual premium is money well spent and that I would pay on her behalf if need be. After all, without a good hospitalisation and surgery plan, I could possibly be paying for her future hospitalisation bills.







My mom was not happy with what I said. Oh, yes, she is quite "pantang" (which means "superstitious" in local lingo for those who don't know).

Well, when I am convinced about something, I am relentless in pursuing the course. My mom actually complained that I was nagging! Finally, she gave in and I brought her to NTUC Income Centre to do the necessary.

I am pleased to say that her upgrade has recently been approved with coverage excluding a pre-existing condition. Now, at least, I only have to worry about paying for my dad's future medical bills because basic Medishield is not as good when it comes to cost sharing.

I would urge everyone to consider not only getting a good lifetime hospitalisation and surgery (H&S) plan for ourselves but also for our parents, if they do not have one already. The peace of mind that comes with this is priceless.







I am not doing this to advertise for NTUC Income. It just so happens that I have been with them for a long time and I know this product. You should definitely shop around and compare the different products available. If you have not done this, do it soon. Do it today, if you can.

Just make sure it is a lifetime plan and make sure to buy a rider to cover the deductibles which leaves only the co-insurance payable by us in the event of a claim. We can use the money in our Medisave account to help pay the premium for the plan but not the cost of the rider.

I hope no one is "pantang" about me talking about something like this a few days before the Chinese New Year.

Related posts:
1. Millionaire or not, plan for retirement.
2. Eldershield.
3. What should a Singaporean have by age 35?

53 comments:

LoveLocks said...

It got me thinking, I got no insurance coverage minus the basic imposed by the government,
Will research and get one policy as a new year gift to myself.

Thanks AK71

skipper said...

Ak,
The correct word is "pantang" or superstitious. "Pandang" is to look in Malay.

I was lucky I signed up for IncomeShield Preferred with Assist Riders that covers everything from the first dollar and also a $125 daily payment for hospitalisation, when they first offered it. They don't offer these anymore.

AK71 said...

Hi LoveLocks,

Possibly my first good deed of the day. You are welcome. ;)

AK71 said...

Hi skipper,

And I call myself a Singaporean! Shame on me! Bad AK! Bad AK! ;p

OK, I will make the correction. Kamsiah you. :)

You got a good deal! So, I guess you do not have any intention of upgrading to Enhanced Incomeshield?

I just checked my policy. I will also get $125 a day if I were to stay in a Restructured Hospital Class A Ward. If I should stay in a Class B Ward, I would get $150 a day.

RayNg said...

Hi Lovelocks & others,

Good article on insuranc by Tan Kin Lian.

Be prudent in buying insurance. Understand what needs to be insured and what can be left uninsured
http://tankinlian.com/Admin/File.aspx?ID=281&Frame=1

AK71 said...

Hi RayNg,

Thanks for sharing the link.

I have made it into a hyperlink for everyone's convenience:
Tan Kin Lian's blog.

Mr. Tan' reputation in the industry is well known.

skipper said...

Ak,

No worries, Malay is not your second language.
My mistake. It is Enhanced indeed and not Preferred. I am paying more in cash now, almost equivalent to CPF's annual limit of $800.

AK71 said...

Hi Skipper,

Nope, Chinese was my 2nd language in school. I know only enough Malay to order Nasi Padang. ;p

My mom has to pay quite a bit in cash as well after maxing the annual limit of $800 from her Medisave after the upgrade too. You are quite a bit older than I am then.

Well, at least you do not have to pay even the co-insurance with your Assist Rider. My version of the Assist Rider covers only the deductible, not the co-insurance. :(

SnOOpy168 said...

AK accused of nagging for a good deed done ?!?! Ask your mom to see me. (kidding lah.)

About 5-6 years ago, I put my mom onto something similar. Just before she turned 76, aged next birthday. This is the magical dateline for a lot of new policy - cross this year and it is very hard to get anything approved (even the travel insurance are renewed on reduced terms).

Now that she is in the high risk group of over 80 years old, and premiums crosses over $2400 pa. Max $800 from medisave and balance in cash. She had wanted to give up to avoid these money "down the drain".

Like her knee cap ops earlier, I told her that this will be the time to spend those hard earned savings.

AK71 said...

Hi SnOOpy168,

Actually, if I had been more concerned and asked my mom to upgrade her policy the same time I did a few years ago, it would have been better.

At that time, she had not developed osteo-arthiritis in her kness yet. Now, this condition is excluded in her upgraded policy but still covered under the same terms as her basic Incomeshield policy which she had before.

The upgrade became available when I was staying out alone and interacting less with her at home. Now, I spend a lot more quality time with her and I am able to do my job as a son better. :)

Old age is definitely not a time to penny pinch on H&S plans.

EY said...

Hi AK,

I bought this same plan as you and found out recently that there are plans which cover 100% H&S. I've recently made a switch to Great Eastern. Can't remember if the premium is slightly more. Intend to review again this year to cut cost further as I reckon that I'm happy enough just staying in Class B ward. I don't sleep well in air-con rooms anyway. But then again, I probably shouldn't mind over-insuring in this area as the cost of medical treatment is escalating.

But you are right, we need to plan for our parents and arm-twist them into submission if necessary. My dad only had basic Medishield and my siblings and I were chipping in to pay for his medical bills. He was scheduled for a 5-day radiotheraphy session after CNY that was going to dent our accounts by $11,000! And that's with no guarantee of success in treating the cancer cells in his lungs. He was also treating his tonsil cancer and heart problem. :(

Fighting a chronic disease is a long drawn process. So one shouldn't dismiss the importance of having adequate coverage in H&S.

Thanks for the timely reminder. Nothing to be pantang about. :)

Cheers,
Endrene

tccs077_blog said...

Hi AK

Very caring of you to highlight this important insurance. Medical cost will 'eat up' a big amount of our savings if we do not guard against it.

Another point to note is that many of us would think that this insurance is not needed if we have a job, as the company would have us covered in a group medical insurance. However, we may not know when we will leave the company due to unforseen circumstances. By then, our health may not be good enough for the insurance company to accept our application.

AK71 said...

Hi Endrene,

Actually, when I upgraded to Enhanced Incomeshield a few years ago, the plan was for Class B/C wards.

Last year, I decided that I was financially comfortable enough to jump two levels up and to pay a higher premium for Private/Class A wards and to have the Assist Rider added on as well. I have a twistd mind. ;p

Even if there is a H&S plan out there which pays 100%, I will stick to what I have now. I think I can pay that $3,000 maximum in co-insurance a year if it does come to pass. Too much work to switch plans. :)

AK71 said...

Hi tccs,

Many people don't give this topic enough thought. I am sure many are like my dad who would just shrug it off (and now regrets it).

My dad only has basic Medishield which is not lifetime in coverage. Also, with his penchance for staying in private hospitals, I fear that I will have no choice but to get prepared to pay in future.

When he was admitted to Gleneagles Hospital for an operation on his gall bladder, the bill came up to $15,000 for the 5 days stay or something. Medishield paid $1,000. Imagine that.

skipper said...

Ak,

To all your readers, be very careful about switching insurance companies for your MediShield. I have friends who after switching within the first year, had exclusions inserted when they suffer from some ailment. These were deemed to be existing conditions by the new insurance company. Like for your mother's case, pre-existing conditions are not cover under the Enhanced scheme and this is for the same company, what more a different company.

AK71 said...

Hi skipper,

Thanks for bringing up a very good point! Indeed, we should beware!

My mom's pre-existing condition is still covered under basic Incomeshield (which she was covered under since 1999) but excluded from the upgrade to Enhanced Incomeshield. I guess this is possible because it is an upgrade by the same insurer.

If she had switched to another insurer, her pre-existing condition would probably not be covered at all!

Good reminder. :)

coven said...

agree H&S insurance are a must! i read from others experiences that hospital bills in singapore are unfortunately not waived off even in the event of death. hence the hospital will pursue the immediate family for the outstanding bills and work out a longterm payment back.

actually if we are still young, earning and have no medical issues, I guess we should get the most expensive private insurance plans (~few hundreds in a year anyway), and also use cash to pay for the co-insurance. 10% and 7% gst must not seem much, but a 6figures private hospital bill is not uncommon. Going public hospitals on the flip side, is the medical attention is slow. Wait for hospital appointment sometimes takes months. In acute illnesses, few months can do alot of damage or even death

Just my 2c with some personal experience :)

coven said...

agree H&S insurance are a must! i read from others experiences that hospital bills in singapore are unfortunately not waived off even in the event of death. hence the hospital will pursue the immediate family for the outstanding bills and work out a longterm payment back.

actually if we are still young, earning and have no medical issues, I guess we should get the most expensive private insurance plans (~few hundreds in a year anyway), and also use cash to pay for the co-insurance. 10% co-insurance and 7% gst might not seem much, but a 6-figures private hospital bill is not uncommon. Going public hospitals on the flip side, is the medical attention is slow. Wait for public hospital specialist appointment sometimes takes months. In acute illnesses, few months can do alot of damage or even death

Just my 2c with some personal experience :)

EY said...

Hi AK,

Glad that skipper raise the point about non-coverage on pre-existing condition. Didn't occur to me at all as I have no medical problems thus far. This will become very relevant as I grower older and develop some ailments. I'd better stick to one insurer.

These days, government jobs don't give very good medical benefits aside from not having job security. Most of them offer contractual employment for initial 2 years. And if we should become medically unfit, we could lose our jobs. So on second thought, I probably shouldn't downgrade my plan, especially now that I'm switching to a new job. Better be safe than sorry.

Thanks again for getting this conversation going. :)

Cheers,
Endrene

AK71 said...

Hi coven,

Wow! A 6 figure bill from a single stay in the hospital? Must be really serious! I cannot imagine it but it could one day come to pass. Heavens forfend!

I agree that we want the best possible medical care if we can afford it. Having the best H&S plan will definitely help although perhaps not the most expensive one. If it costs more but gives value for money, it is not expensive to me. :)

AK71 said...

Hi Endrene,

See? That is why it is good to have financially savvy seniors like skipper around us. ;)

Hey, I sincerely mean what I say hor. Not poking fun at skipper.

Thanks, skipper. :)

seefei said...

AK
good work! i already 'enhanced" my incomeshield on the advice of my good insurance agent.

some new insurance schemes are introduced at market friendly prices and it is good to recognise this.

It is good to know our insurance well and maximise the bang of our bucks. LOL

AK71 said...

Hi seefei,

Definitely value for money plus the fact that it gives us peace of mind. :)

I wonder if someone from NTUC Income might stumble upon this blog post and offer to take up the Leaderboard ad space at the top of my blog. ;p

skipper said...

Ak,

Haha, I certainly do not envy the young nowadays. So glad I am not looking for another job. Much, much better to be a senior now. The only caveat is that you have sufficient to see you through. Now, what is sufficient??

AK71 said...

Hi skipper,

You are right, of course. I don't even envy the school going ones. Lots of stress in the system. :(

Lucky are the ones who have sufficient to retire on. What is sufficient? Care to do a guest blog on the topic? ;p

skipper said...

AK,

Let me think about it over CNY. I just might surprise you. But this topic has been written by Dr Michael Leong in his blog last year. Still have not collected my CPF yet, so not so senior lah.

Luck favours those who are prepared. So, opportunity fund, dry powder or money in a tin can is very important.

AK71 said...

Hi skipper,

Now, I have something to look forward to even after the CNY holidays! A guest blog from skipper! Yeah!

My email: ak71@sillypore.com

:)

Serendib said...

Hi AK, what's your plan for dealing with medical costs should your mom live beyond 90? Medishield does not cover beyond 90, and I'm worried that my parents ( not to mention our generation) could be left with no H&S cover. Appreciate your thoughts.

AK71 said...

Hi Serendib,

This is one reason why I got my mom to upgrade from Incomeshield to Enhanced Incomeshield. There is no maximum coverage age. Yes, the coverage is for a lifetime. :)

Unfortunately, my dad dragged his feet so many years ago and has too many medical conditions now. He only has Medishield and I must be ready to pay for his medical bills in future. This is worrisome. :(

See NTUC Enhanced Incomeshield.

Serendib said...

Hi AK, youre spot-on. I was under the impression that enhanced medishield plans would expire when medishield did, but you're right - they carry on for life. Thanks!

AK71 said...

Hi Serendib,

Good news, indeed! Now, both of us sleep better at night. :)

AK71 said...

Medical insurance scheme MediShield will be revamped to become MediShield Life -- to offer universal coverage and better protection for large hospitalisation bills.

Prime Minister Lee said: "The MediShield Life will not stop at 90. So don't worry, it will cover old people. Secondly, MediShield Life will be universal. It will cover everybody, every Singaporean -- old ones , young ones, those newly born.

"Even those who are now outside the MediShield network, we will bring them back in. You may be elderly, you may have dropped out, you may have pre-existing illnesses, we will bring you back in -- it may cost you a bit more but it can be done. There will be no more opting out for MediShield."

This means patients can expect to pay less cash out-of-pocket. But with better benefits and coverage, the premiums for MediShield Life will be higher too.

http://www.channelnewsasia.com/news/singapore/nd-rally-new-medishield/781478.html

18 Aug 2013

AK71 said...

Changes to the MediShield scheme signal a major shift in Singapore's healthcare financing policy. Coverage will no longer stop at 90 years of age and will include those with pre-existing illnesses. As a result of these enhancements, premiums will go up.

The health minister also said the individual has a role to play to ensure that universal coverage will not lead to an over-consumption of healthcare services. That is why there is a need to have deductibles and co-payment.

Over time, the implementation details of MediShield Life will be studied, including exploring ways to include those who are currently excluded from the scheme, as well as talking to private insurers on how their plans can be integrated.

http://news.xin.msn.com/en/singapore/medishield-life-premium-increases-to-be-affordable-health-minister

08/20/2013

pirate said...

Hi AK

Any particular reason that you selected NTUC?
The AIA rider premiums went up significantly recently, and I am thinking to switch.

Thanks

AK71 said...

Hi pirate,

I thought it offered the best value for money and I had good claim experience.

kai xiang said...

Hi AK,

Wonder if you can share if you got Enhanced Preferred with Plus Rider? Is that the policy u got? I am at a relatively young age 28 and already has that, but my partner currently only has Enhanced Advantage with Assist Rider. She has some medical issues with her back so likely if she were to upgrade she ll get exclusion in relation to her back. Wondering if it's worthwhile to pay that additional premiums instead of reinvesting that sums over time to self-insure.

Appreciate if you can share ur thoughts! :)

Thanks,
KX

AK71 said...

Hi Kai Xiang,

I got my mom to upgrade to the same plan I have but she has problems with her knees and so that condition is excluded from coverage but it would still be covered under Medishield Life.

So, if your partner were to upgrade her plan, her back problem will be excluded from the coverage but should still be covered under Medishield Life. Everything else will be covered by the upgraded plan.

Please confirm this with the insurer. :)

Hongjin said...

Hi AK

Sadly my parents are rejected to upgrade to the enhanced income shield because of their "three highs". The reason why I want to go to enhanced ntuc is that I can add rider to limit the expenses we have to fork out per hospitalisation.

My father is actually a mild case but I think ntuc prefer to err on the side of caution. So as of now, my parents are currently under the old plan incomeshield plan b (which cannot be upgraded /or add rider).

What my financial adviser has told me to do is to follow up with medical report for my parents and perhaps with a doctor letter to acknowledge that their health are much better before they can even be considered to be upgraded again.

My question is if all fails, is the old ntuc incomeshield plan b enough to cover their hospitalisation. My worry is more of us as children paying out huge amount for their hospitalisation in the event they are hospitalised.

AK71 said...

Hi Hongjin,

I had to stop my mom from removing the rider from her Enhanced Incomeshield.

The rider is very good and limits what we must pay to only $3000 a year in case of hospitalisation.

That peace of mind is priceless and something I willingly pay for.

So, I can understand why you want to get it for your parents too and I hope you are successful in your future attempt.

If your future attempt should fail, then, you will have to pay the deductible and a bigger co-insurance which can be daunting if the bill is quite large.

In such an instance, there is still the option to stay in Class C ward to keep cost to as low as possible which was what we did for my late paternal grandmother.

Class C ward is heavily subsidised and should be financially manageable for most. :)

Hongjin said...

Thanks AK. Hope to update good news if any. In the process of doing another checkup and hopefully with doctor recommendation letter after seeing report, ntuc can accept

AK71 said...

Hi Hongjin,

Although Class C ward is an option, we want more comfortable conditions for our parents if possible.

So, crossing fingers and toes that your request for an upgrade in coverage is successful after a review. :)

Hongjin said...

Thanks, AK! After this small episode, I would not want my children to go through the same situation. As what ntuc says, I really hope to be the last sandwich generation.

AK71 said...

Hi Hongjin,

Oh, I remember that advertisement by NTUC Income.

Being sandwiched is not only uncomfortable, it also gives a feeling of being vulnerable to being eaten up! Help!

What you are doing for your parents shows that you are financially prudent.

Your children will not have to worry about you. :)

Hongjin said...

Hi AK

it's been a while. Some updates not sure good or bad

Recently Great eastern has got back to us based on my father's report and has offered a hospitalisation plan to stay at a1 with rider. But there are exclusions with heart related illness as he has high blood and high cholesterol.

Should we still stick to the current ntuc incomeshield (not the enhanced one) that does not have rider but covered all illnesses or should we change to the offered plan which can cover much more expense but have exclusion?

Will like to seek some opinion before we proceed.

Understand the final choice is mine but like to ask for some perspective before we decide. So dun worry, I will look at whole picture . Not taking your opinion as the holy grail :)

AK71 said...

Hi Hongjin,

For my mom, she was upgrading her plan with the same insurer (NTUC Income). So, her pre-existing medical condition is still covered under her old NTUC Incomeshield plan but excluded from her upgraded plan.

In your dad's case, because it is a change of insurer altogether, heart related illnesses will not be covered by both GEL and NTUC Income. In the event that he is hospitalised for heart related illnesses, he would only be covered by Medishield which means staying in B2 or C wards.

B2 and C wards are heavily subsidised. So, they should be relatively affordable even without any riders. Of course, they might not be as comfortable as Class A ward.

You have a very tough choice to make.

Hongjin said...

Hi AK

Exactly, I dun feel comfortable with plan that does not cover everything. My ideal case would be to get the upgrwded plan just like your mum.

And having exclusions means GE can decide whether or not every hospitalisation stems from the excluded conditions. I dun feel safe.

I still have a few years to try before my dad reach 75 years old. I guess I have to keep trying.

Thank you for your opinion :)

AK71 said...

Hi Hongjin,

I think it might be a good idea to try NTUC Income again a year later with another medical review.

My mom is watching her diet and does power walking for an hour every morning which has helped to bring down her cholesterol level significantly.

Reducing salt intake would help with blood pressure too.

Alcohol intake and smoking would send blood pressure up. So, none of these, I hope.

Good lifestyle changes could help to see a more positive medical report. :)

Hongjin said...

Thanks AK. Yup health is really wealth.

AK71 said...

Hi Hongjin,

Yes, it is. Crossing fingers and toes for you. ;)

Hongjin said...

Hi AK

it's me again. Last night i was sitting at my home thinking of the insurance plan and I realized the weather was so hot even at night with my fan at full blast. So I envisioned the scenario of my parents being sick and yet are warded in b2/c wards. I dun think they feel good.

The problem is the GE plan with exclusions (heart disorders,. cerebrovascular and hypertension) is a tricky one.

I have a few questions in my head but no answer. Maybe would like to seek you valuable opinion again.

1. If my father is sent to the hospital, we may not be sure where to ward him because there will come a point of time we need to decide at the admin. The problem is, the medical assessment may not be out soon enough for us to decide and the doctor may or may not link his current illness to his excluded terms.

2. If we take up GE, it means we need to fall back on medishield life if he is warded because of heart related illness. And I realise the pre and post hospitalisation bills are not covered under medishield life. Can these expenses burn our pockets ? I heard these expenses may sometimes be more than a hospitalisation stay.

3. If we do not take up the GE plan, will it be a missed opportunity?

Because with each year, the probability of insurance taking up my aging father even with improved health is lower due to higher risks with age.

Hahah tough decision....

AK71 said...

Hi Hongjin,

Yes, it is a very tough decision and I wouldn't want to be in your shoes.

Unfortunately, in such an instance, all I can do is to provide you with a listening ear.

OK, it is more a reading eye. ;p

However, I will say that having the three highs means chances of getting illnesses related to them are higher which is why GE wants them excluded in your dad's case.

Insurance companies like to insure what has a low probability of happening and if something has a high probability of happening, they will charge more. If something is almost certain to happen, they will not insure no matter how much you pay them. Strong hint there. ;)

Of course, peace of mind is priceless.

Whatever you do, it must give you peace of mind. :)

Hongjin said...

Yes. A peace of mind and a heart of gratitude to repay what my parents has done for me all their lives have allowed me to make up my mind.

thank you again.

AK71 said...

Hi Hongjin,

Your heart is in the right place and I am glad you have come to a decision that will give you peace of mind. :)


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