FAQ: What you need to know about upcoming changes to Integrated Shield Plan riders

To illustrate how the new requirements work, let’s take the example of a 60-year-old patient named Patrick. He currently has a private hospital Integrated Shield Plan and rider, but decides to switch to the new rider in April next year, saving him S$1,600 in rider premiums per year.

Three years later, he undergoes knee joint replacement surgery at a private hospital, incurring a bill of S$56,900.

As a private hospital patient, he has to pay S$3,500 in deductibles.

After deducting this sum from the total, the 5 per cent co-pay cap means Patrick also has to fork out 5 per cent of S$53,400, which is S$2,670.

His base Integrated Shield Plan will cover S$48,060. For the deductibles and co-payment, Patrick has to pay a sum of S$6,170, which can be fully covered by MediSave, resulting in no out-of-pocket costs.

If he had chosen to stick with his existing rider, it would have covered the S$3,500 in deductibles. He would receive about S$6,000 in rider payouts, which is 95 per cent of the total bill after deducting what his base payout will cover. 

From his total bill of S$56,900, the 5 per cent cap means Patrick needs to co-pay about S$2,840, which can also be fully covered by MediSave, resulting in no out-of-pocket costs.

However, by switching to the new rider, Patrick had already saved S$4,800 of rider premiums in cash over the last three years.