IP rider changes aimed at mitigating shift of patients from private to public healthcare: MOH

SINGAPORE –

Changes to rider requirements

are part of the Ministry of Health’s (MOH) efforts to mitigate the shift of patients from private to public healthcare.

This will be achieved through putting the private healthcare sector and health insurance on a more sustainable path and ensuring private care remains accessible to Singaporeans in the long term, said Health Minister Ong Ye Kung in Parliament on Jan 12.

The new requirements will see those on new Integrated Shield Plan (IP) riders sold from April 1, 2026, shouldering a higher proportion of their hospital bills.

Acknowledging the short-term impact on the public healthcare system – with individuals on new riders possibly choosing to seek care at public hospitals to reduce their co-payment – Mr Ong said that his ministry will be monitoring it closely.

MOH may need to implement surge capacity for selected treatments, if more people turn to public hospitals for subsidised care, he added.

Surge capacity planning is incorporated into infrastructure design to ensure healthcare systems can adapt to unexpected demand. In the past, such measures have included converting designated spaces in public hospitals to take in more patients, for instance.

Mr Ong reiterated the ministry’s efforts in expanding public healthcare capacity, both in terms of hospital beds and outpatient capacity, as well as recruiting more manpower to deal with the increasing needs of the ageing population.

The trend of private patients moving to the public system is “an additional fuel to the fire that we are facing”, he added.

MOH announced in November 2025 that new IP riders sold from April 2026 will no longer be allowed to cover the minimum IP deductibles set by the ministry, meaning patients on the new riders have to pay at least $1,500 before insurance coverage kicks in.

The co-payment cap will also be doubled from the current $3,000 to $6,000, which means those on the new riders will need to pay a larger portion of their bills.

Half of those who buy IPs for private healthcare end up seeking subsidised care in the public healthcare system.

Mr Ong also highlighted that over the past years, there was a “discernible shift” of patients away from the private sector to the public sector. The proportion of patients in public hospitals has grown from 85 per cent in 2010, to 88 per cent in 2020, and has now reached 90 per cent.

Dr Hamid Razak (West Coast-Jurong West GRC), an orthopaedic surgeon who was from the public healthcare system, said his former colleagues in restructured hospitals have had “lots of sentiments” about the changes in rider requirements.

Waiting times for subsidised patients have already been increasing, and the situation may worsen if those on private riders switch to public healthcare after cost-sharing goes up, Dr Hamid added.

In response, Mr Ong said he is “equally concerned”, and assured those working in the public healthcare sector that the ministry is closely watching wait times and capacity adequacy, and placing much importance on healthcare workers’ well-being.

He reiterated that this was the reason why the Government is making the move on IP riders. While some patients prefer to seek care in public hospitals, which offer more medical disciplines and more holistic care, Mr Ong said one of the key reasons is the escalating cost of private healthcare, which has in turn been fuelled by IP riders that provided overly generous health insurance coverage.

This has led to a greater tendency for over-servicing and over-consumption of healthcare services. For the past three years, private hospital IP rider premiums have been growing at an annual average rate of 17 per cent, double that of the base IP premiums. This has led to about 100,000 policyholders cancelling or downgrading their IP rider policies each year.

“In short, the current design of IP riders may no longer make financial sense for many policyholders, and this change will help redress the situation,” said Mr Ong.

Responding to a query from Ms Poh Li San (Sembawang West) on how families facing hefty medical bills would be supported if their out-of-pocket expenses for co-payment become unaffordable, Mr Ong highlighted that six in 10 rider claimants should not have to pay cash out of pocket after tapping their MediSave funds.

For the remaining 40 per cent, about three-quarters would see an out-of-pocket cost of not more than $1,000, and the vast majority of the remaining quarter will have to pay $3,000 or less.

As a result of the new requirements, new riders are expected to cost a lot less – premiums will be about 30 per cent lower than those of existing riders with maximum coverage, said MOH previously.

Mr Ong said that for a 60-year-old on a private hospital IP and rider with maximum coverage now, the annual premium savings will be about $1,600 after switching to the new rider. Over three years, he would save $4,800 in cash, which would be more than sufficient to offset the increase in co-payment for a typical procedure.

For those in their 70s, the premium savings could go up to around $3,000 each year.

He also urged MPs to explain the rationale of the changes to their residents and encourage them to speak to their financial advisers, and consider switching to new riders instead of paying very high premiums to guard against rare health events.

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