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Many of us are consumed by our hectic workday and lifestyle in Singapore. This packed schedule may come to a grinding halt for 46 people who are diagnosed with cancer every day.
Fortunately, a third of all cancers can be prevented by simply leading healthy lifestyles and avoiding risk factors, including sunlight, radiation, and certain industrial chemicals.
Getting cancer is no longer viewed as the death sentence it once was either. We can benefit from early detection. With advancements in medical treatments, the survival rate of cancer has steadily risen since 1973 from 19.5% to 58.7% today.
Rather than avoid the morbid conversation about cancer, we can empower ourselves with more knowledge for a better outcome. This includes understanding the recent changes to our cancer coverage in Singapore.
Changes To Outpatient Cancer Coverage Under MediShield Life
The Ministry of Health (MOH) announced a review of MediShield Life coverage in Sep 2020, including identifying potential gaps and solutions by the MediShield Life Council. This review process also collected Singaporeans’ views on improving the scheme.
Following this review, the government implemented changes to MediShield Life’s outpatient cancer coverage in 2022. This comes on the back of rising cancer prevalence and the higher cost of cancer drug therapies. The intention is to help cancer patients pay less for clinically proven and cost-effective cancer drug treatments, as well as keep the MediShield Life premiums affordable for all.
#1 Only Treatments Listed On The Cancer Drug List Are Covered Under MediShield Life, MediSave, And Integrated Shield Plans
Previously, cancer patients were able to make MediShield Life claims of up to $3,000 per month for all outpatient cancer drug treatments and related services. This led to an unintended effect of raising cancer drug prices in Singapore as claim amounts were often maximised. Left unchecked, this may have potentially impacted the affordability of healthcare insurance premiums in Singapore.
As part of the recommended changes, the Ministry of Health (MOH) created a list of clinically proven and cost-effective outpatient cancer drug treatments. Since September 2022, MediShield Life and MediSave only cover treatments listed on the Cancer Drug List . Private Integrated Shield Plans (IPs) were also aligned to the Cancer Drug List from 1 April 2023.
This change means cancer treatments that have insufficient clinical evidence of improving overall survival or duration of response will not be covered under MediShield Life, MediSave, or Integrated Shield Plans.
There are also more incentives for clinically proven treatments to be negotiated to be cost-effective since it is a criteria for inclusion in the Cancer Drug List. The previous $3,000 monthly claim limit provided little incentive for drug manufacturers to offer better prices.
This will enable more targeted coverage, including for higher claim limits where the treatment is clinically appropriate and cost-effective.
The Cancer Drug List will be updated every four months to keep up with medical advancements.
Note that IP riders which are fully paid with cash will not be affected by these changes, leaving an option for those willing to pay more to obtain additional coverage for cancer drug treatments.
#2 Separate Claim Limit For Outpatient Cancer Drug Services
Under the new changes, a separate claim limit for cancer drug services was introduced. This covers the costs that might be incurred over the course of one’s cancer drug treatment, including scans, blood tests, doctor consultations, and supportive care drugs.
The MediShield Life claim limit for cancer drug services was also enhanced to $3,600 in April 2023, from the previous limit of $1,200 set in September 2022. This was a result of feedback that some patients required more frequent tests to monitor their disease progression or more supportive care drugs to manage side effects.
There is no change to the MediSave withdrawal limit of $600 per calendar year.
#3 Medication Assistance Fund (MAF) Subsidies Extended To More Singaporeans
Singaporeans with a per capita household income (PCHI) between $2,800 and $6,500 per month enjoy MAF subsidies today. Prior to September 2022, only those with PCHI of under $2,800 enjoyed these subsidies.
| Monthly PCHI | Subsidy Tier (Singapore Citizens) | |
| Prior to Sep 2022 | Current | |
| $0 to less than $2,000 | 75% | |
| $2,000 to less than $2,800 | 50% | |
| $2,800 to less than $3,300 | 0% | 50% |
| $3,300 to less than $6,500 | 0% | 40% |
| $6,500 and above | 0% | 0% |
Source: MOH
Upon appeal, MAF may be extended to those who do not qualify for the subsidies.
#4 Adjustments To MediSave Withdrawal Limits
In tandem with the MediShield Life changes, MediSave withdrawal limits will also be adjusted.
| Prior to Sep 2022 | Current | |
| MediShield Life | – $3,000 per month for all cancer drug treatments and services | – Between $200 and $9,600 for treatments under the Cancer Drug List – Additional $3,600 per year for cancer drug services |
| MediSave | – $1,200 per month for all cancer drug treatments and services – Additional $600 per year for cancer scans. |
– $1,200 per month for cancer drug treatments with MediShield Life claim limit above $5,400, and $600 per month for other treatments on the Cancer Drug List. – Additional $600 per year for cancer drug services and/or other cancer scans. |
What Happens To Patients Whose Treatments Are Not Covered Under the CDL?
Initially, patients undergoing treatment using drugs not on the CDL continued to receive coverage under their Integrated Shield Plans, since they were only aligned in April 2023.
Private insurers committed to preserving IP coverage for policyholders until at least 30 September 2023, as most patients would have completed any existing treatment with non-CDL drugs by then.
While IP coverage only covers drugs on the CDL today, its relevance is reviewed every four months. The number of treatments covered under the CDL has expanded to 340 as of 1 February 2023 from 270 when it was first published in August 2021. This represents 90% of all Health Sciences Authority (HSA)-approved treatments. The remaining 10% of treatments are not covered under the CDL as prices do not yet justify their effectiveness and suppliers are not willing to moderate prices.
Beyond this, doctors and patients can consider shifting towards CDL treatments that are clinically proven and more cost-effective to retain coverage under MediShield Life, MediSave, and their Integrated Shield Plan.
If non-CDL treatments continue to be needed, patients may still be covered by private insurance, such as IP riders that are paid in cash and/or standalone cancer plans. They may also be covered under critical illness (CI) policies.
Finally, patients who require non-CDL treatments and face affordability constraints may opt for subsidised care at Public Healthcare Institutions, where they can apply for additional support such as MediFund.
How Standalone Cancer Coverage Can Protect You Against Large Medical Bills
When you are diagnosed with a severe illness like cancer, the last thing you want is to worry about your finances. Your objective should be to recover and be able to continue spending time with your loved ones.
With your recovery a priority, you may be unlikely to continue working. At the same time, you may have to fork out for costly medical treatments that can spiral into the hundreds of thousands each year. That’s where insurance can act as your safety net.
MediShield Life, MediSave and Integrated Shield Plans will continue to be your first layer of protection. However, with the recent changes, you may not be able to claim for certain outpatient cancer treatments. Your claim limits may not be sufficient to fully cover the cost of cancer treatments.
A standalone cancer coverage, such as the Singlife Cancer Cover Plus, can supplement your existing MediShield Life and private Integrated Shield Plans – which typically do not apply to early stage cancer diagnosis. The problem with this is that cancer is not just the leading cause of death in Singapore, but also that your chances of recovery are best if cancer is diagnosed at the early stage.
Beyond a base level of cancer coverage, you can also opt for the Singlife Big 3 Critical Illness plan which gives twice the sum assured for the “Big 3” killers in Singapore: cancer, heart attack, and stroke as well as also 13 other heart and neurological conditions. This includes early, intermediate and severe stages of covered conditions.
Another plan, the Singlife Multipay Critical Illness provides a total payout of up to 900% of your sum assured for critical illnesses across early, intermediate and severe stages of critical illnesses including cancer coverage, in multiple payouts. It also provides coverage against specified recurrent critical illnesses. This is especially relevant for certain common cancers, such as stage 3B breast cancer where the chance of recurrence is up to 70% to 90% within 10 years.
While no one can allay fears of cancer recurrence, which is up to 4 times higher in Singapore compared to international studies, it can still be financially reassuring to know that you are covered on your CI plan even after making a claim on it.
Boost Your Cancer Coverage With Singlife Cancer Cover Plus
Using Singlife Cancer Cover Plus as an example, we can see how the plan covers outpatient cancer drug treatment and services that are both on and not on the Cancer Drug List. This includes innovative and advanced cancer treatments such as Proton Beam Therapy and Cell, Tissue and Gene Therapy.
With this, you can reduce your out-of-pocket expenses and opt for cancer treatments that are best for you, with a coverage limit of up to $1.5 million per policy year for your medical bills.
Source: Singlife
Moreover, you don’t have to be limited with your cancer treatment in Singapore. You can receive support for overseas cancer treatments if that is best for you.
To learn how standalone cancer plans work into the equation, we can look at the example of 31-year-old Kate, who is diagnosed with lung cancer – one of the most common types of cancer among both males and females.
Source: Singlife
In the event that she selects treatment that is on the CDL for 4 months and receives treatment at a private hospital, her total medical bill will come up to $140,000.
On top of her Integrated Shield Plan (Singlife Shield Plan 1), she is also protected with standalone cancer coverage via Singlife Cancer Cover Plus. Her total payout from MediShield Life and Integrated Shield Plan only comes up to $36,000 – or a quarter of her total medical bill.
Without the additional protection provided by her standalone cancer coverage, disbursing $90,000, she would unlikely be able to receive her preferred treatment at a private hospital.
As Kate is protected by Singlife Cancer Cover Plus, she only has to pay 10% co-insurance on her bill, amounting to $14,000. This reduces her out-of-pocket expenses by 87%. If she had required treatment that is not on the Cancer Drug List, her out-of-pocket expenses would have been much higher and even out of reach.
Find out more about Singlife Cancer Cover Plus and how you can have the assurance of comprehensive cancer coverage today.
Footnote:
Terms and conditions apply. This policy is underwritten by Singapore Life Ltd. Dollars and Sense is not an insurance agent or intermediary and is not allowed to solicit any insurance business or give advice on or recommend any product nor be involved in any discussions, negotiations or the arrangement of any insurance contract between you and Singapore Life Ltd. Please direct all enquiries to Singapore Life Ltd. This material is published for general information only and does not have regard to the specific investment objectives, financial situation and particular needs of any specific person. You should read the Product Summary and seek advice from a financial adviser representative before making a commitment to purchase the product. As buying a life insurance policy is a long-term commitment, an early termination of the policy usually involves high costs and the surrender value, if any, that is payable to you may be zero or less than the total premium paid. Buying a health insurance policy that is not suitable for you may impact your ability to finance your future healthcare needs. This advertisement has not been reviewed by the Monetary Authority of Singapore. Protected up to specified limits by SDIC. Information is accurate as at 31 October 2023.
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