Questions to ask when getting health insurance in Singapore

There are many issues to consider when taking out medical insurance and, thankfully, Singapore health insurance system does not overburden you with more complexities. However, you need to have the correct knowledge about what is available to you, how much it costs, how it relates to your medical condition and how a health insurance policy can help you in times of need.

The following are among the pertinent questions you should ask before and during your application process.

In what way will I be covered with my health insurance?

Health insurance can cover anything from casual visits to the clinic for minor ailments to medical emergencies that require major surgery or long-term illnesses. In Singapore, insurance policies cover the following broad categories.

• Hospitalization insurance - pays hospital medical expenses incurred as a result of an accident or illness.
• Critical illness insurance – this is during major illnesses such as cancer and heart attacks and helps to pay for treatment and other medical-related expenses.
• Disability income insurance – if you are unable to work because of a disability, this helps you receive an income.
• Long-term care insurance – these schemes provides assistance in paying for nursing or home care if you are too weak to look after yourself.
• Medical expense insurance – this covers medical expenses for minor conditions and ailments that require out-patient visits to your doctor or clinic.
• Hospital cash insurance – this type allows you to receive money while you are in hospital and losing income as a result.

Should I choose a government-sponsored plan or go private?

If you are a Singapore citizen or permanent resident, then you are eligible to come under the government’s health insurance schemes delivered through the Central Provident Fund (CPF). The CPF is a compulsory pension fund scheme in which you and your employer contribute a percentage of your monthly salary. CPF related medical insurance plans are fairly basic in nature with limited coverage. The CPF’s two major schemes are Medisave and MediShield, which is open only to citizens and PRs. Medisave covers sudden medical needs such as hospitalisation, maternity and certain outpatient treatments. MediShield caters for catastrophic situations that result in large medical bills.

Private companies in Singapore can provide similar health insurance policies and also offer expanded, customised plans that are not covered by Medisave or MediShield. Going private allows you the flexibility to choose plans that cater to your lifestyle standards and coverage needs. Private plans are likely to cost more.

What are the exclusions? Do companies cover pre-existing conditions?

The majority of medical insurance plans will not cover you for pre-existing conditions, in other words, long-term ailments that you already suffered from before seeking a health insurance plan. Make sure the exclusions are clarified to you before you sign in order to protect yourself and know exactly what you are eligible for and what you are not. Some companies do insure pre-existing conditions, though there may be a waiting period, often two months or more, before you can make any claims. You should be particularly aware of this if you are thinking about changing plans. Another company may promise better benefits but it doesn’t mean they would accept pre-existing conditions.

Am I already covered by another policy, such as from my CPF?

Some people seek private health insurance plans as a means of filling in any holes they may exist in their CPF coverage.

How much will it cost now and over time?

The payment schedule varies depending on your insurance policy, health condition and company you choose. Regular-premiums plans are usually paid in regular amounts over a period of time, usually one year. Single-premium plans call for one lump sum payment at the start of your plan. You must decide on the quality of healthcare you require should you fall ill and the corresponding premium rates. Make sure that once you are happy with a price, you are able to pay it consistently over a period of time. Some plans demand variable payments, which means the premium may change after a certain time or a certain incident, such as hospitalisation.

What happens when policy expires?

Two things could happen. Your policy could be cancelled or you can renew it. Some plans allow companies to cancel prior to the date of renewal, which is usual one year from the day you sign up. Others offer guarantees that you are covered as long as you pay your premiums. In these cases, cancellation is rare. As the expiring date approaches, your insurer is likely to get in touch with you through mail reminding you that your plan is up for renewal. Be aware that some health insurance policies give companies the right to change benefits and premium rates upon renewal. Make sure you have studied the terms and conditions before going through with the transaction. Your best bet would be to opt for a health insurance policy that provides guaranteed renewals and no negative surprises in benefits and premiums over the course of the policy period.

Am I penalised if I don’t pay the premium on time?

You should carefully read the terms and conditions before buying your health insurance policy. Your insurer can cancel your plan if you fail to pay on time.

How does a policy end?

You plan could end when you reach the maximum age determined by your particular policy or you have received the maximum amount of benefits. Your insurer could also cancel your policy for their own reasons as per terms of the policy or if you have failed to pay your premiums. You could also decide against renewing your policy after it expires. Make sure you are aware of the situations under which a policy can be terminated especially by the insurance company.

How do I make a claim?

Making a claim is the underlying reason you took out health insurance in the first place. Normally, you will need to complete a claim form provided by the insurer and submit this with evidence of treatment, such as hospital bills and medical reports. The insurer may ask for additional supporting documents. In some cases, you may only need to show the doctor or hospital administration your insurance documents and they will go to the company to seek payment. It is important that you make your claim within the time period stipulated in your policy. When choosing a medical insurance, you should opt for an insurance policy that offers the minimum bureaucracy when filing a claim and handles your claims in an efficient and timely manner.

How do claims affect my premium?

You should study the terms and conditions of your plan carefully. There may be clauses that provide for higher premiums should you make a claim. Clearly, you should opt for a policy that does not raise its premiums if you had to make claim(s).

Am I covered during overseas travel?

For example, CPF programmes Medisave and MediShield do not cover your medical bills overseas. Some private health insurance policies offer worldwide coverage. Some plans may have geographic limits while others may only reimburse you based on what it would have cost had you sought treatment in Singapore. Quite often, Singapore charges are cheaper. You should take note of any restrictions in your plan and decide how important the worldwide coverage is to you. You should be fully aware of what you are entitled to before buying your policy.

Where can I go in case of disputes?

The Financial Industry Disputes Resolution Centre (FIDReC) can help to settle disputes in a fair and cost-efficient manner. The Centre handles claims between customers and companies up to S$100,000 and other claims of up to S$50,000. FIDReC rulings are final and binding on the insurer but not on you. If you are not satisfied with the ruling, you can take the matter to court or seek help from the Consumers Association of Singapore, Singapore Mediation Centre or Small Claims Tribunal. The FIDReC website can be found here.

Getting professional help in choosing the right policy

A professional and independent health insurance broker in Singapore will be in the best position to offer you medical insurance policies that best suit your needs. They deals with these matters on a daily basis and know the ins and outs of medical insurance policies offered by various insurance companies in Singapore. You might be able to save a lot of time by asking an independent health insurance broker to assist you with buying the right policy.