insurance ဆိုတာ ေရႊဗမာေတြအတြက္အလြန္ကို စိမ္းလြန္းပါတယ္. ဘာလ္ိုခံစားခြင့္ရွိတယ္ မရွိဘူးလဲဆိုတာကိုလဲ မသိက်တဲ့သူေတြ မ်ားပါလိမ့္မယ္ထင္ပါတယ္! အႏွစ္ ၃၀လံုး အစိုးရရဲ႕ ကၽႊန္ေတာ္တို႔တသက္ တံခါးပိတ္၀ါဒ ေတြေၾကာင့္ ျပည္သူလူထုေတြ မ်က္စိပိတ္နားပိတ္ ကမာၻသီးျခားစီ ျဖစ္ေနရတာပါ....
ျဖစ္ရပ္မွန္ေလးတခုပါ...insurance ႏွင့္ပတ္သက္ၿပီး သံသယျဖစ္ေနက်တဲ့ သူငယ္ခ်င္းလင္မယားေတြ အျဖစ္ပ်က္ေလးပါ...ေနာက္ၿပီးသတ္မွတ္ထားတဲ့ရက္ပိုင္းအတြင္းမွာ Claim လုပ္မွရတာပါ ရက္ၾကာလို႔ရွိရင္မရတတ္ပါဘူး၊ သူမတက္ေနတဲဲ့ Bugis က စာရင္းကိုင္သင္ေပးေနတဲ့ ပုဂၢိဳလ္ကေက်ာင္းက insuranceေၾကးေတြေကာက္ထားေတာ့ သူမတို႔ကျပန္ရမယ္ ထင္ေနတယ္ေလ၊ ဒါႏွင့္ဘဲ သူတို႔က ေဆးရံုတက္ဆင္းၿပီး ျမန္မာျပည္ကိုျပန္သြားတာျပန္လာမွ ၁လခြဲေလာက္ၾကာမွွ ျပန္ Claim တာမရေတာ့ ဘူးေလ သတ္မွတ္ခ်က္ရက္ေက်ာ္ေနၿပီလို႔ေျပာတယ္တဲ့ ေက်ာင္းကလဲ အမွန္တကယ္ insurance မ၀ယ္ ထားဘူးႏွင့္တူပါတယ္..ေနာက္ၿပီးႏိုင္ငံျခားသားဆိုၿပီးလိမ္တာဘဲျဖစ္ခ်င္ျဖစ္ပါလိမ့္မယ္၊ ဘယ္လို Policy ေတြႏွင့္လုပ္ထားမွန္မသိဘူးေလ၊(ကၽႊန္ေတာ္သိထားတာက ပံုမွန္ရက္ေပါင္း ၆၀ အတြင္း Claim လို႔ရတယ္ေလ)
သိတဲ့အတိုင္းဘဲ ႏိုင္ငံျခားမွာေနေကာင္ရင္ဘာမွမျဖစ္ေပမဲ့ ေနမေကာင္းလို႔ေတာ့ ပံုမွန္ေဆးခန္းေလာက္ႏွင့္ မရႏိုင္တဲ့ နာမက်န္းေဆးရံုတက္ၿပီး ေငြကုန္ေၾကးက်မ်ားတတ္ၿပီး စေပၚတင္ရန္လိုအပ္တဲ့ေငြေတြႏွင့္ ကုန္က်ေငြေတြ ဘာလိုမွရွာလို႔မရတတ္တဲ့ေငြေတြပါ...သူငယ္ခ်င္းေတြဆီ ေခ်းငွားမွေငြရသလို ရွာလို႔မေလာက္ႏိုင္ မရႈမကယ္ႏိုင္ေအာင္ျဖစ္ရၿပီး ေတာ္ေတာ္ဒုကၡေရာက္ရတဲ့ အျဖစ္ေတြပါ...
ဒါေၾကာင့္ မရွိမျဖစ္လိုအပ္တဲ့ ဒီလိုကိုယ္ပိုင္ Health insurance ေတြကို၀ယ္ယူူထားက်ဖို႔လိုပါတယ္လို႔ ေျပာခ်င္ တာပါ....
အဲ! ေျပာခ်င္တာက Health insurence ဆိုတာလဲ မိမိမွာလက္ရွိ ျဖစ္ေနတဲ့ေရာဂါႏွင့္ ဆက္ႏြယ္တာ ေနတာေတြႏွင့္ ပတ္သက္ၿပီးေတာ့အေလွ်ာ္မေပးတတ္သလို မေမွ်ာ္ လင့္ဘဲ ရုတ္တရက္ျဖစ္ပြားတတ္တဲ့ ေရာဂါေတြအတြက္ေလာက္ဘဲ အေလွ်ာ္အစားလုပ္ပါတယ္ဆိုတာ သိထားဖို႔ပါဘဲ...
ဒါေၾကာင့္ႀကိဳတင္ၿပီး မိမိဘာမွေရာဂါေတြမျဖစ္ခင္မွာႀကိဳတင္ကာကြယ္ၿပီး insurance ေတြယူထား ရပါတယ္...အကယ္၍ မိမိမွာရွိတဲ့ေရာဂါေတြႏွင့္ ဆက္ႏြယ္ေနတာေတြကိုျဖစ္လို႔ ေဆးရံုတက္ရင္ကို ေလွ်ာ္မေပးပါဘူး!
အလုပ္ရွင္ကေပးထားတတ္တဲ့ insurance ေတြက Accident ေတြအတြက္ဘဲျဖစ္တတ္္ပါတယ္၊ ဒီမွာလဲေျပာခ်င္တာက မိမိ၀ယ္ယူထားတဲ့ စာခ်ဳပ္ေတြရဲ႕ Policy စည္းမ်ဥ္းစည္းကမ္း ေတြႏွင့္လဲဆိုင္္တတ္ပါတယ္၊ ဥပမာ- ရိုးရိုးႏွင့္ Premium ဆိုရင္ ဘယ္လိုခံစားခြင့္ရွိတယ္ဆိုတာေတြေပါ့?
ပံုမွန္ျဖစ္ေရာဂါေတြအတြက္ ေဆးရံုးကုန္က်စရိတ္ေတြကလဲသိတဲ့အတိုင္းဘဲ ျပီးခဲ့တဲ့လကကၽႊန္ေတာ္ရဲ႕ မ်က္စိေရတိမ္ျဖစ္လို႔ို ခြဲထားတာကို CPF ထဲက Medishield ကေန ကုန္က်ေငြမ်ားတာေတြကို စေပၚေငြတင္ထားၿပီး ကုန္က်စရိတ္ ေတြကို insurance မွာ ျပန္ Claim ထားတာပါ.... အဲ! ေငြ amount နည္းတာေတြကိုေတာ့ Credit Card ႏွင့္လက္ငင္းရွင္းေပးရပါတယ္ေနာ္... Credit Card ရွိလို႔ေပါ့ေနာ္ မရွိရင္ Cash ႏွင့္ဆိုရင္ ဘဏ္ထဲေငြလက္မရွိရင္ေတာ့........ေနာက္ၿပီးေဆးရံုမွာ ၈နာရီေက်ာ္ေနရမွ medisave ကေန Claim လို႔ရတာပါ...
PRႏွင့္ စကာၤပူေတြ အတြက္...  Providing for your Healthcare
Needs | ||
| ...Stretching Your Medisave Dollars | ||
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Medisave Scheme is a national healthcare savings scheme
designed to help members pay hospitalisation expenses incurred in Class B2/C
wards in restructured hospitals. Medisave savings can also be used to pay for
certain outpatient treatments like chemotherapy, radiotherapy and dialysis. You
can use Medisave savings to pay for your own or your immediate family
members’1 hospitalisation expenses, day surgery and selected
outpatient treatments.
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1Immediate family members refer to spouse,
children, parents and grandparents. Grandparents must be Singapore citizens or
permanent residents.
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| Your Coverage Under Medisave | ||||||||
Medisave savings can be used for the following hospital
charges:
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| Medisave also covers the following hospitalisation and other approved expenses: | ||||||||
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Your Medisave savings can be used to pay for the following
outpatient treatments, subject to the withdrawal limit. Click here
for the type of outpatient treatment and its Medisave withdrawal
limit.
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The Medisave withdrawal limits are generally sufficient to
pay the charges incurred by a patient staying in a Class B2/C ward in a
restructured hospital. However, should you or your dependants decide to stay in
higher class wards or seek treatment from private hospitals, you or your
dependants may have to pay part of the bill in cash. It is therefore important
to choose a ward or medical service that you can afford.
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| Making A Claim Under Medisave | ||||||||
Medisave savings can be claimed for hospitalisation, day
surgeries and outpatient treatment expenses incurred in medical institutions
participating in the Medisave scheme.
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For a hospitalisation claim, the patient must have stayed in
the hospital for at least 8 hours (unless the patient is admitted for day
surgery) or died within 8 hours of being hospitalised.
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Click here
for a complete list of hospitals and medical institutions participating in the
Medisave scheme.
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The maximum amount of Medisave savings that a member can
claim for each hospitalisation, day surgery or outpatient treatment is subject
to the Medisave withdrawal limits. Multiple Medisave Accounts can be used to
co-pay the hospital bill. However, the same Medisave withdrawal limits will
still apply. This means that the Medisave withdrawal limits will not increase
with the number of Medisave Account holders paying the bill. This restriction is
meant to help members avoid over-using their Medisave savings, so that they have
sufficient Medisave savings for their own future healthcare
needs.
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For a member who passed away on or after 1 July 2006 during
his/her hospitalisation, he/she can use his/her Medisave savings to pay for the
last inpatient hospital bill in full, without being subjected to the existing
Medisave withdrawal limits. This is because the need to save for future
healthcare needs is no longer relevant.
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You or your dependants will have to inform the hospital of
your intention to claim from Medisave. You or your dependants will need to sign
the Medisave Authorisation Form (MAF), which is available from the hospital. The
form will be submitted by the hospital after you or your dependants have been
discharged.
If you did not sign the Medisave Authorisation Form (MAF) and
pass away during your hospitalisation, your immediate family members (spouse,
parents, or child who is 18 years and above) or committee of person could sign
the MAF to use your Medisave savings to pay your last inpatient medical bill. If
you do not have any immediate family members or committee of person to sign the
MAF, a relative who has been taking care of you may also write in to the
Ministry of Health through the hospital to seek approval for him/her to
authorise the withdrawal of your Medisave savings to pay your last inpatient
medical bill.
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Upon discharge, you will be given a bill. The hospital will
submit a claim from your Medisave account to the CPF Board. You will receive a
Medisave Withdrawal Statement showing:
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The hospital will also inform you of the
following:
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For more information on Medisave, click here.
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MediShield | ||||||||
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, which may otherwise be
depleted in the event of prolonged illnesses that require longer-term medical
treatment.
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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.
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Your Coverage Under
MediShield
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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.
You should also consider the standard of healthcare you wish to
have and your affordability when deciding on a medical insurance.
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.
GI Health Insurance En |
Medisave-approved Insurance
Medisave-approved Integrated Insurance Plans
Apart from the MediShield scheme, which the Central Provident Fund Board runs, you can also choose from amongst other Medisave-approved Integrated Shield Plans offered by private insurers.
Since 1 July 2005, each of these Medisave-approved plans have been integrated with basic MediShield to form a single integrated plan. These Integrated Shield Plans provide you with additional benefits and coverage when you opt for Class A and B1 wards in public hospitals, or private hospitalisation.
Policyholders on the Medisave-approved Integrated Shield plans retain the benefits and coverage of the basic MediShield tier, while enjoying enhanced coverage provided by their private insurers. Premiums are paid directly to the private insurers who will service all the policyholder’s needs. Similarly, private insurers will service all claims and sort out all back-end arrangements with CPF Board to include any payouts from MediShield.
Medisave can also be used to pay for premiums of these private Medisave-approved Integrated Shield plans. The Medisave withdrawal limits for Integrated Shield plan are:
- $800 per policy, per year, for those aged 75 and below next birthday;
- $1,000 per policy, per year, for those aged 76 to 80 next birthday; and
- $1,200 per policy, per year, for those aged 81 and above next birthday.
- NTUC Income's IncomeShield and Enhanced IncomeShield
- American International Assurance Singapore Private Limited's HealthShield Gold
- Great Eastern Life Assurance Co's SupremeHealth
- Aviva Ltd's MyShield
- Prudential Assurance Co's PRUshield
If you had a Medisave-approved plan with a private insurer before 1 July 2005, you will be transited to the new Medisave-approved Integrated Shield plans over a 2 year period by your private insurer. After the 2-year transition period is over, Medisave cannot be used to pay for the premiums of the old plans as they are not integrated with MediShield.
Service Indicators
(I) Claims return rate
The following claims return rate table shows how long it takes each insurer to process claims with positive payouts.
The phrase, cumulative claims return rate, refers to the percentage of claims processed by the insurer within one week, two weeks and one month. Note that the fifth column shows the median number of days it takes each insurer to process claims.
| Cumulative Claims Return Rate | Median Claims Return Rate (days) | |||
|---|---|---|---|---|
| <= 1 week | <= 2 weeks | <= 4 weeks | ||
| AIA | 91% | 93% | 95% | 0 |
| AVIVA | 85% | 89% | 94% | 1 |
| Great Eastern | 91% | 93% | 94% | 0 |
| NTUC Income | 94% | 95% | 97% | 0 |
| Prudential | 94% | 96% | 99% | 0 |
Note (1): The number of days insurers take to process claims includes the time it takes to obtain medical records from claimants or medical institutions.
(II) Letter of guarantee and medical records costs
When you are hospitalised, if your hospital can obtain a letter of guarantee from your insurer, you can reduce the amount of your upfront payment to the hospital. A letter of guarantee is an assurance of payment offered by insurers to hospitals, on behalf of a patient, for the portion of the hospital bill covered by insurance.
To process claims, insurers may require your medical records. Either you as a claimant, or your insurer, can request medical records from medical institutions. This request however, usually comes at a cost from $75 to $250. All insurers currently absorb the cost of obtaining medical records.
| Provides Letter of Guarantee** | Absorbs costs of obtaining medical records | |
|---|---|---|
| AIA | Yes | Yes |
| Aviva | Yes | Yes |
| Great Eastern | Yes | Yes |
| NTUC Income | Yes | Yes |
| Prudential | Yes | Yes |
(As of July 2012)
Note (1): Insurers who absorb the cost of obtaining medical records, do so in more than 90% of cases. There might still exist situations where the claimant is requested to pay for medical records.
Questions to ask when getting health insurance in Singapore
There are many issues to consider when taking out medical insurance and, thankfully, Singapore health insurance system does not overburden you with more complexities. However, you need to have the correct knowledge about what is available to you, how much it costs, how it relates to your medical condition and how a health insurance policy can help you in times of need.
The following are among the pertinent questions you should ask before and during your application process.
In what way will I be covered with my health insurance?
Health insurance can cover anything from casual visits to the clinic for minor ailments to medical emergencies that require major surgery or long-term illnesses. In Singapore, insurance policies cover the following broad categories.- Hospitalization insurance – pays hospital medical expenses incurred as a result of an accident or illness.
- Critical illness insurance – this is during major illnesses such as cancer and heart attacks and helps to pay for treatment and other medical-related expenses.
- Disability income insurance – if you are unable to work because of a disability, this helps you receive an income.
- Long-term care insurance – these schemes provides assistance in paying for nursing or home care if you are too weak to look after yourself.
- Medical expense insurance – this covers medical expenses for minor conditions and ailments that require out-patient visits to your doctor or clinic.
- Hospital cash insurance – this type allows you to receive money while you are in hospital and losing income as a result.
ႏိုင္ငံျခားသားေတြအတြက္.....
Foreign Worker Medical Insurance: Frequently Asked Questions
Rationale for Foreign Workers Medical Insurance
Details of Medical Insurance Requirement
Employers with Existing Medical Insurance
Submission of Medical Insurance Details
Rationale for Foreign Workers Medical Insurance
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