From 1 Apr 2026, new integrated shield plan (IP) riders sold will have to meet the following requirements:
- They will no longer be permitted to cover the minimum IP deductibles set by MOH.
- The co-payment cap will be raised from a minimum of $3000 to $6000 per year.
How will this affect you?
The deductible is the fixed amount you pay first for hospital bills before your insurer starts paying, for each policy year. The deductible amount may vary among insurers, but the minimum deductible set by MOH for private healthcare is $2000 for day surgery and $3500 for inpatient admissions.
After the deductible, you pay a percentage (co-payment) of the remaining bill. For most IP riders, this is 5% of the remaining bill, which is capped at $6000 after the new policy changes.
If you are covered by a rider that meets the new requirements, you may be concerned whether the reduced insurance coverage will significantly increase the amount that you will have to pay out of pocket.
Fortunately, the costs incurred by the deductible and co-payment can be offset by your Medisave account. These out-of-pocket costs may also be offset by cost savings from paying a lower premium for the new rider. The premiums for these riders are expected to be about 30% lower than existing riders with maximum coverage.
For minor procedures such as cystoscopy, circumcision and prostate biopsies, which have a cost range between $4000 to 13000, we estimate that the out-of-pocket costs with the new riders after Medisave offset, would range between $600 to $2500, depending on the amount of your rider deductible.
For major surgeries such as stone surgeries and prostate surgeries, for which the bills are typically in excess of $20000, the out-of-pocket costs with the new riders should be minimal after Medisave offset.
We hope that these cost estimates will help you to make a better decision about seeking treatment. Before embarking on treatment, the hospital should be able to provide more details on these costs.
Reference:
New requirements for integrated shield plan riders to strengthen sustainability of private health insurance and address rising healthcare costs.
