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We must pay a premium for "best" healthcare.

Wednesday, February 7, 2018

Reader says...
I would like to ask you regarding H&S insurance. I have spoken to a few agents to understand more about the H&S products that they are offering.

They would frequently mention “Do you want to stay in private for the best healthcare?” “With riders, you don’t have to worry about co-insurances or deductibles..”

Sounds enticing but I got a shock when I looked at the premiums I have to paid in the long term run and also, I am wondering how am I be able to pay for the premiums once I stopped working in the future. Premiums are highly likely to increase in the future.

So, I asked myself do I really need the ‘best’ healthcare? I am quite contended with decent healthcare that has government subsidies.

As such, I thinking of getting a H&S + rider that has coverage for B1 and below.

The reasons being:
• The premiums paid in the long run is still within my range

• I don’t want to be slapped with a huge bill that cannot be claimed and end up worrying about it

• I hope to have affordable out-patient treatments as a subsidised patient. As some illness need permanent follow ups and not everything can be claimed. 

For Ward B2 and below, one will be considered as subsidised patient. The rest will be considered as private

Can I ask for an unbiased third party view? I am ok with staying in B1 and below + decent healthcare from the public hospital. 

Do think the coverage is sufficient for my requirements? Or am I missing something? Thanks for talking to yourself again.

AK says...
If you are OK with staying in B2 or C ward, then, you only need Medishield Life.

If you wish to stay in B1 or better ward, then, you need a private shield plan.

I am inclined to believe that a higher class ward will provide a more comfortable stay which could help promote recovery.

However, whichever class we are warded in, I believe that we would have access to the same quality of healthcare. :)

Related post:
Is my insurance agent scaring me?


AK71 said...

SG Simeon says...
Appreciate if someone can share their real life experience. That's will be helpful too.

AK says...
I have relatives who stayed in C wards and also in A wards. Frankly, I think it is just a difference in the environment. I stayed in a private hospital before and I wasn't very impressed by the level of service. I actually thought I was given better attention during my stay in SGH.

AK71 said...

Tong Xiang Yap says...
Ak u never tell him the story of FOC coverage by CPF MA? Let govt pay for our insurance. Issue resolved.

AK says...
I might have mentioned it since it is a pet topic but I am growing old and forgetful... ;p

csky said...

It is easier to downgrade the plan in the future than to try to upgrade the plan as you get older.

So one option is to get the highest that you can afford now, and as you get older, consider downgrading if it becomes a financial burden.

So far, for my older parents, we have had better luck with private hospital than public hospital, so it might be good to have a choice as long as you can afford it.

Kexin said...

I'm not sure how old u are but premiums tend to be affordable at a younger age. One option is to go on a better coverage plan first and u can always downgrade later when u find the premiums too expensive.

KC Chan said...


I would like to share my view and experience.

If you are young, buy the highest available plan with riders. Slightly more expensive, but you will be well covered. As you grow older and feels that you don't need the coverage, then downgrade to save on the premiums. But please be aware that as you get older, you might not be able to upgrade when you get health problems and therefore your choices will be limited (I assume you are healthy when younger).

Currently I only know Prudential has a variable plan - it means if this year you do a claim, next year your premium will be adjusted (loaded with higher premium) whereas the other comapnies’ plans currently don’t have this variable premium plan (I may be wrong as I am not updated in this area since I can’t shop around for a new plan at my age). It is when you are older that you will need health insurance the most and you may not see the need at a young age. And when you are older, you may be limited in choices as you cannot change company nor plan by then. So choose the company that you buy from wisely.

More than 10 years ago, I bought the highest available plan with all the riders. Last year I was hospitalised and I simply opted for B2 class (actually without realising what was the plan that I have in the first place). Anyway, the insurance company paid me 200 per day in cash for opting for a lower class. The head of department was overseeing my case during my stay in a Government Hospital so I can vouch for the quality healthcare in Singapore.

My view for health insurance is not to be penny wise and pound foolish.

Have a wonderful day.


Baba said...


Hope to give a different perspective of the matter.

With regards to hospital insurance, there is a lot of consideration of what ward is comfortable is enough for us. My parents and I felt that coverage up to B ward would be sufficient. Under these plans, if we opted for private hospitals, we would only be covered up till 75%.

6 months ago, after a detailed health check-up, my father was diagnosed with 90%/ 100%/ 100% blockage in his heart arteries. In spite of immediate danger to his life, NUH's waiting time for the heart bypass operation was 1 month. We were thoroughly confident with the team at NUH, and very uncomfortable with the waiting time. The primary (NUH) and secondary (private) opinions agreed that my father would be liable to drop dead at any given time in unfortunate circumstances. Imagine having that mental stress while waiting for your operation!

We decided to bite the bullet and opt for Mount Elizabeth (even though we would not have 100% coverage) as my father would be able to have his operation immediately that weekend. Happy end to the story as he has recovered well and has resumed regular exercise and healthy eating habits.

Ever since then, I have switched to the more expensive private option. I realise that in times of emergencies, it's the availability of doctors that is a significant factor, not that ward I am staying in. I believe insurance is an essential risk mitigation cornerstone as I progress in life. I understand not everyone can afford private healthcare, and we should only be spending within our means.

I hope this viewpoint will offer a something different for those assessing their options for the year.


SkinnyOldMan said...

Hi AK,
I would like to share this story which might be food-for-thought for all of us :

My mother-in-law was discovered to have a brain tumour (benign) which caused her to black out with the risk of injury from falling. We opted for surgery.
She started out as a subsidised patient at SGH. When we opted for surgery, as a subsidised patient, we went through the financial counselling and was told that the bill would be about $6K. We were told the risk involved = become partially paralysed, vegetable, die etc. When we asked whether her doctor (Assoc Prof XYZ) would be the one doing the cutting, SGH said no, and that it would be left to the team on duty. We preferred Assoc Prof XYZ to personally do the cutting and were not willing to undertake the perceived risk. To have that, my MIL has to became a private patient. We went ahead. Final bill = $56K. My MIL recovered 100%, and the risk factors were averted. Of course, I recognise that maybe remaining as a subsidised patient would have achieved the same outcome. But I am a Sinkiapolean who is kiasu and kiasi. : )

The point I am making is that (1) there is a huge 10-fold difference in subsidised and private patient cost at the restructured hospitals (2) at the point when we had to undergo treatment, we may not be willing to take any risks.

So, I encourage the writer who says he is ok with subsidised care to think again, and if he is convinced of his position, then ok, go ahead and make the informed decision. Otherwise, it might be useful to pay and buy more insurance so that there is choice at the critical moments of life.

coven said...

The advantage of buying private insurance, is to get quick immediate attention when an acute disease strikes. The issue of public hospitals is that it's sometimes difficult to be admitted to hospital, when your medical condition is deteriorating. It's either through A&E or the Specialist Outpatient clinics. The wait for Specialist appointments can take few weeks to few months, and there's also a general lack of public hospital beds.

Even if you are finally admitted to a public hospital, it takes a while to go up the ranks of public doctors. You are first examined by a Medical Doctor (MO), wait to do some tests, examine results and then referred to a more senior doctor say Registrar, then wait to do more tests. If results are still not good, then referred to a more more senior doctor/specialist say Consultant, then do more tests. Compared to the private hospitals, where u are immediately seen by a senior specialist/consultant doctor. In acute diseases, time is of the essence. Not all doctors are equal, experience and skills do play an important part, hence the big differences in medical costs :)

AK71 said...

A big thank you to everyone who commented in this blog. :)

There seems to be a preference for private hospitals over government hospitals and there is nothing wrong with this as long as it is affordable and gives peace of mind which I always say is priceless.

For many people, managing costs or, indeed, containing costs probably ranks low on the priority list when it comes to healthcare matters.

Personally, I have a H&S which covers private hospital stay as well. I upgraded my mom's plan to private as well because I feel better to have options. Whether we exercise the option or not is something else: H&S for my mom.

Venkatesan said...

I agree it is better to get the best cover you can afford. But To everyone who says to opt for private plan now and tone it down later - think of it this way: when you are younger, probably have insurance from your company you pay a lot for an insurance you mostly wont tap on. But when you are old and really need the insurance - you'd tone it down? More prudent to do research before you buy the plan or atleast ASAP after you've gotten the cover and decide what you want based on your wants and abilities. The sooner you decide the more money you might save in case you opt for toning down.

To add to the data points, I personally had ACL surgery to the knee - it was painful but not life threatening. Subsidized surgery would have costed ~5k but the waiting time was 6 months-1yr. I was in pain so opted for private - it cost ~25k but was done the very weekend. Please remember this when you choose the plans - its generally not the most life threatening ones which will make us suffer, but the most painful ones. I started saving money in SRS and invest it in STI ETF/bluechips just to ensure I can afford those premiums when I really need insurance. I suggest everyone to come up with a proper financial plan in case you choose to go with private cover rather than hand waving and thinking you can tone it down if you cannot afford - thats just throwing money away if you ask me.

Laurence said...

NTUC Income Enhanced Incomeshield new premium rates from 1 Mar 2018 has been published. A whopping increase of up to 35% for the Incomeshield premium. And a staggering increase of up to 45% for the Riders.

Enhanced IncomeShield Yearly Premium Rates for insured person who is a Singapore Citizen or Permanent Resident

Annual premium rates for Assist Rider

AK71 said...

Hi Laurence,

With Medishield Life having kicked in, all H&S plans cost more and will continue to be so.

We should try to get "free" H&S plans. ;)

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