MediShield is a basic medical insurance scheme designed to help pay part of the expenses arising from the insured’s hospitalisations and certain outpatient treatments for serious illnesses at approved medical institutions. MediShield works most effectively for hospitalisations at B2/C class level at restructured hospitals. It is meant to complement a member’s Medisave savings.
MediShield has deductible and co-insurance features. A "deductible" is the minimum claimable amount that you would need to pay when you make a MediShield claim - the deductible applies on the claimable amount rather than the incurred hospital bill. You only need to pay the deductible once in a policy year. You will also need to pay a portion of the claimable amount with the remaining paid by MediShield. This arrangement is called "co-insurance". You can use your own or your immediate family members’ Medisave savings to pay for the deductible and co-insurance.
Click here for more information on deductibles and co-insurance.
You need not pay any deductible for outpatient treatments. MediShield will pay 80% of the actual expenditure up to the claimable limit.
From 1 July 2005, MediShield will pay more for large hospital bills at the Class B2/C level. Members who are insured under MediShield will enjoy higher claim benefits.
MediShield is suitable for those who wish to stay in subsidised wards, Class B2/C. The scheme has been designed to pay more for large hospital bills and the claim benefits are based on the charges at Class B2/C ward level.
You can still claim under MediShield for charges incurred at higher class wards. However, the MediShield claim payment will only cover a small part of the hospital bill. As a result, you may end up withdrawing more Medisave (subject to withdrawal limits) and cash to settle your hospital bills.
For those who can afford private hospitals or Class B1/A ward facilities, you may wish to purchase Medisave-approved Integrated Shield Plan from the private insurers.
Click here for more information on benefits of MediShield and the assured amount.
Click here for examples of amount that can be claimed through MediShield.
Click here for a list of treatments and medical expenses that are not covered under MediShield.
Making A Claim Under MediShield
MediShield can be claimed for hospitalisation, day surgeries and certain outpatient treatment expenses incurred in medical institutions participating in the MediShield scheme. Similar to a Medisave claim, the patient must have stayed in the hospital for at least 8 hours to qualify for claims for hospitalisation expenses. The only exception is when the patient is admitted for day surgery.
Click here for a complete list of hospitals and medical institutions participating in the MediShield scheme.
You need to inform the hospital of your intention to claim MediShield. You are not required to sign any form. The hospital will submit a MediShield claim on your behalf after you or your dependants have been discharged. If you are also claiming from Medisave, the hospital will submit both claims together to the CPF Board. It will take about 7 working days to process normal cases. A longer time will be required for cases where additional medical information is required for claim assessment.
To estimate the maximum amount that you can claim from Medisave or MediShield, click here to go to our Medisave/MediShield Online Calculator.
Information provided here is taken from CPF webpage.