A 5% co-payment will be required for all Integrated Shield plan riders beginning April 1, 2021, including renewals of existing IPs with total riders. This has implications for customers and premiums. Find out more by reading on. 

A refresher on the Integrated Shield plan 

Policyholders with an Integrated Shield plan (IP) can use their MediSave account to pay their premiums.

Our MediShield Life is backed by a second layer of insurance, the Individual Protection Plan (IP), which is not mandatory.

MediShield Life covers public hospital B2/C wards. Private hospital B1/A wards and private hospital IPs might give additional coverage. MediShield Life has a $100,000 annual claim limit.

Hospitalization and medical bill riders are also available for our insurance policies. Customers who paid their bills in full before April 1, 2019, were entitled to no co-payments. An extra year was allowed when the Ministry of Health declared new riders would require policyholders to make a co-payment and when insurers began developing new riders.

From April 1, 2021, full-riders will be phased out because of rising healthcare expenses and overconsumption of medical services. Therefore, the policyholders of all IP riders will now be required to co-pay a part of their medical expenditures.

What influence will this have on me as a user?

#1 A portion of the cost will be your responsibility. You’ll

A full-rider will no longer be available. This indicates that you’ll have to pay a portion of the bill. However, insurance companies have set a cap of $3,000 to ensure that consumers can deliver it.

In the end, how enough will you be required to pay for your services? To help paint a more accurate picture, allow me to give you an example:

Ben has to stay in the hospital after undergoing surgery. It is estimated that his bills total $100,000. Co-pay rider for his IP would require him to pay a $3,000 annual deductible before incurring the 10 percent co-insurance [10 percent times $100,000 – $3,500 = $9,650] on the balance. $13,150 is the result (9,650 + 3,500 dollars).

With the co-pay rider, however, there is a cap of $3,000 on his IP. Ben pays only $3,000 for his medical cost instead of $13,150.

#2 More accountability and responsibility 

You’ll now have to consider your options before deciding on the most April 1 (or even non-essential) remedy available. In addition, if you choose the most expensive choice, you’ll have to pay extra until the cap is reached.

#3 Lower premiums 

It is projected that premiums will be lower as a result of the change to co-pay riders.

For example, Policyholders who bought policies on or after April 1 will have their rates slashed by up to 50%. Like AXA Shield with the new co-pay rider, AXA Shield with the discontinued full-pay riders is 28% to 54% cheaper.

What happens if I have a current IP with a complete rider?

Since April 1, 2019, new IP riders sold have a minimum co-payment of 5% of the purchase price. A transition period will be required for anyone who purchased IP riders between March 8, 2018, and April 1, 2019.

Therefore, just like everyone else, you will be required to co-pay a portion of your expenses when they are renewed after April 1, 2021. you should have previously notified existing policyholders of the new rider adjustments by their insurer.

For example, The NTUC Income IPs with riders covering hospital expenditures in total have been advised since February 3, 2021, that policyholders who renew their policies after April 1, 2021, would be required to co-pay a portion of their bills. Next year, those with severe medical illnesses will be required to pay a co-payment for their care.

As a result, several insurers now provide premium discounts of up to 20% to policyholders who do not file a claim.

Panel vs non-panel specialists

Important note: The $3,000 co-payment cap applies only if the policyholder seeks treatment from the insurer’s panel of specialists. As the $3,000 co-payment threshold may not apply to non-panel specialists, you may have to pay additional charges.

As a result of these panels, insurers can keep the cost of healthcare manageable for both policyholders and insurance companies.

The fact that blocked doctors would not be involved on the panels has caused some dissatisfaction among some doctors in the private sector.

The new claims-based pricing implemented by April 1IA, Great Eastern, and Prudential will allow you to save money on future premiums if you maintain good health.

How will this co-pay rider insurance companies? 

Insurers benefit from this co-payment since it makes healthcare expenditures more accessible and manageable.

As of April 1, 2021, only co-pay riders will be accessible, which means insurance providers will have to convert February 3ll riders to new co-pay riders. In addition, policyholders will have to pay an additional premium for an IP with a co-pay rider.

Why the need for co-payment? 

Overconsumption, April 1rvicing and over-charging. 

Overconsumption, April 1rvicing, and overcharging are all examples of excessive consumption.

Overconsumption depletes hospital resources and increases healthcare expenditures. Insurance companies have been overwhelmed by unsustainable claims, which have resulted in significant losses.

This is a result of IPs with total riders, in which the insurer pays the entire cost. Like eating at a buffet, you overindulge because it’s free, and you’re not charged extra. 

Case in point: Bills for IP policyholders with total riders are 60% higher than for those without riders, according to the Insurance Information Institute.

Due to this, IP riders have been changed to require policyholders to make a co-payment.

In this way, consumers are held more accountable and discouraged from taking advantage of or overclaiming their IP by choosing the most expensive option, especially when it isn’t necessary or advised. Consumers are encouraged to select the best appropriate option for their circumstances to enable more intelligent medical care selections.

In the long-term, this helps to keep health insurance premiums cheap and April 1e a reality for customers and insurers alike.

Published On: October 2nd, 2021 / Categories: Uncategorized /