Introduced in 2015, MediShield Life provides Singaporean with universal and lifelong basic protection against large hospital bills – with the aim to cover 9 in 10 subsidised bills in public healthcare institution, with the deductible and co-insurance covered by MediSave.
MediShield Life is an integral part of Singapore’s healthcare financing framework: the “S+3Ms” (Subsidies, MediSave, MediShield Life and MediFund). Together, it ensures no Singaporean is denied appropriate healthcare because of an inability to pay for it.
All charts are taken from the MediShield Life 2024 Review Council Report
In general, MediShield Life provides coverage for subsidised bills incurred in Ward B2 and C classes. There will be a pro-ration of the bill for those who receive treatment in private hospitals or Ward A and B1 classes.
Typically patients can receive MediShield Life payouts up to the claim limits for treatments. Any amount above this claim limit have to be borne by the patient in MediSave or cash. For the remaining bill within the claim limit, there is a deductible component and a co-insurance component.
Those who prefer more comprehensive coverage in private hospitals and higher Ward A and B1 classes can get it through private Integrated Shield Plans (IPs).
Read Also: Complete Guide To Buying A Private Integrated Shield Plan
MediShield Life Is Reviewed Every 3 Years
Every three years, the MediShield Life scheme is reviewed by the MediShield Life Council to ensure it remains relevant and provides adequate coverage. This 12-member council is appointed by the Minister for Health and is made up of individuals from diverse backgrounds, including accountancy, insurance, investment, medicine, the law, union and government.
After the latest MediShield Life review was done in 2024, premiums were slated to rise in 2025 – alongside expansion of coverage for Singaporeans, while also considering higher claims amid rising costs.
The review was also timely, as rising medical bills eroded the existing coverage limits to fully cover just 8 in 10 subsidised bills. This is a deviation from a key design feature to fully cover 9 in 10 subsidised bills. As a result, more patients with large bills would have to pay parts of their bills in cash.
In the evolving healthcare landscape, more treatments are shifting beyond hospital settings. Improvement in patient access to safe and affordable outpatient and home-based medical care will be taken into consideration. At the same time, advances in medical technologies have made new potentially life-saving therapies possible, but potentially at a prohibitive expensive cost. Risk pooling for these rare, but high-cost, therapies can provide care to those who need it most.
It is also worthwhile to note that the MediShield Life Fund is operating at a 100% loss ratio across the last 4 years. This means two main things: 1) the government is not making money from the scheme; and 2) any increase in costs and benefits going forward may make the scheme unsustainable.
Read Also: 10 Facts You May Not Know About MediShield Life
How Much Will Singaporeans Have To Pay For Their MediShield Life Coverage From April 2025?
With higher claims and expanded coverage, MediShield Life premiums will also need to increase to keep the scheme sustainable. Nevertheless, the total premium increases will be capped at 35%, and phased in gradually over three years.
From April 2025, MediShield Life premiums will go up – and this is highlighted in the first two columns, after age. The “Current Premiums” is what we are currently paying, and the higher premiums is what the rates will increase to by 2027.
As we can see in the table below, subsidies will be given to lower income groups, and the rise in premiums will also be phased in for all income groups in 2025.
We can also see that initial subsidies provided will decrease MediShield Life premiums for most people from April 2025, except for those in the “High Income” bracket. For reference, the High Income group refers to individual with a monthly per capital household income that is above $3,600. In addition, those living in a home with an Annual Value of above $25,000 will not receive any premium subsidies.
Read Also: Annual Value (AV) Of Your Residential Property: Here’s How Its Calculated And Why It Matters
The table also highlights the additional subsidies given to the Merdeka Generation and Pioneer Generation seniors – as they will pay even lower premiums from April 2025 compared to what they may be paying before that.
Eventually, when higher premiums are fully phased in by 2027, only the highest income group will be expected to foot the full premium, without further subsidies. The table below depicts how lower income groups, as well as the Merdeka Generation and Pioneer Generation seniors, will continue to enjoy subsidies.
For younger Singaporeans, aged 65 and below, all income groups can expect an overall rise in premiums by 2027. Nevertheless, those in lower income groups will progressively pay lower premiums – with only the highest income group paying the full MediShield Life premium increase.
Similarly, Merdeka Generation and Pioneer Generation seniors will see their premiums increase, but not to the full extent. In fact, the Pioneer Generation seniors will benefit from MediSave top-ups that are not taken into consideration within this calculation.
How Will Expanded Coverage On MediShield Life Benefit Singaporeans
Along with the rise in MediShield Life, we can expect an expanded range of benefits on the MediShield Life scheme to benefit all Singaporeans.
There are three main pillars of benefits that Singaporeans can look forward to: 1) Increase In Claim Limits And Refreshed Scheme Parameters; 2) Enhanced Outpatient Coverage; and 3) Expanded Coverage In New High-Cost Treatments That Are Both Clinically-Effective And Cost-Effective.
#1 Increase In Claims Limits And Refresh Scheme Parameters
Claim limits have been raised across various treatments to ensure that 9 in 10 subsidised inpatient and day surgery bills will be fully covered, after the co-payments through MediSave. This provides better assurances to patients who face large healthcare bills.
Some of the key changes include:
– Increasing the daily claim limits for the first 2 days of stay in normal wards to $1,630, from $1,000.
– More than double the daily claim limits to $5,140 for those in ICU wards, from $2,200.
– Increase the claim limits for surgical procedures by up to 50%, to up to $3,900, from up to $2,600.
– The policy year claim limit will also increase from $150,000 to $200,000, to protect those facing prolonged hospital stays.
Alongside this increase in benefits, there will be an increase in patient deductible to sieve out smaller and more affordable bills which can be paid for using MediSave – keeping the coverage focus on larger medical bills. This will also come with higher MediSave Withdrawal limits to offset the higher deductibles.
There will also be a revision on the pro-ration factors to ensure that the bills for those who receive treatment in higher class wards or in private hospitals are comparable to subsidised coverage.
For example, the inpatient and day surgery daily hospital charges will have the following pro-ration.
#2 Enhanced Outpatient Coverage
MediShield Life currently covers a range of selected costly outpatient treatments, such as kidney dialysis, radiotherapy for cancer and immunosuppressants for organ transplant. The claim limits for these treatments will be updated to ensure they continue to fully cover 9 in 10 subsidised bills, with co-payment through MediSave.
The example highlighted in the report is that kidney dialysis, which makes up almost half of all outpatient claims, will have claim limits increase by 60% to $1,750 a month, from $1,100 a month.
There will also be an expanded range of coverage for patients to receive more types of home-based medical care in the comfort of their homes.
With the enhancements to outpatient coverage, there may also be a need to focus on larger outpatient bills to ensure sustainability. As such, there will be a new $500 outpatient deductible per year. This can be offset with any inpatient deductible paid in the year as well.
In the same spirit, outpatient co-insurance will range from 3% to 10%, depending on the claimable amount, instead of a fixed 10%.
#3 Expanded Coverage In New High-Cost Treatments That Are Both Clinically-Effective And Cost-Effective
As with any field, medical technology is continually advancing, and breakthroughs have paved the way for innovative therapies. These have the potential to cure major diseases, including cancers and rare diseases, but are highly costly.
One such breakthrough is CTGTPs or Cell, Tissue and Gene Therapy Products to treat various cancers and rare diseases. One example cited in the report is Kymriah, a type of cell therapy for leukaemia patients who have not responded well to conventional treatments. This treatment is the first on the Ministry of Health’s CTGTP list, and more treatments may be listed over time.
Its prohibitively high cost, however, put these treatments out of reach for most people, and without financing support, many patients may not be able to access these potentially life-saving treatments. Risk pooling through MediShield Life may be a suitable way to finance such treatments which are expensive, but rare.
For a start, MediShield Life claim limits for CTGTPs will be sized to fully cover 2 in 3 subsidised bills instead of 9 in 10 to take a more cautious and prudent approach for this new class of therapies.
Similarly to CTGTPs, there may also be new drugs to improve the quality of life and clinical outcomes of patients for other treatments. Again, they can be expensive, and MediShield Life’s risk-pooling function can help finance these types of treatments.
Better Outcomes For Singaporeans
Taken as a whole, the changes to MediShield Life will improve the protection against large subsidised hospital bills and provide more healthcare assurances. It will take the proportion of subsidised bills that are fully covered by MediShield Life back to 9 in 10, and increase the number of payouts and average payouts.
To keep the scheme sustainable, premiums have to rise. While premiums go up, there will be subsidies to smooth the transition. To ensure we understand why premiums go up, the report also breaks down how the rise in premium will help with the enhanced benefits.
70% of the higher premiums will go towards ensuring the scheme is sustainable because of medical inflation and higher utilization. The remaining 30% will go towards increase in claim limits and new benefits.
MediShield Life Premium Support Measures
To ensure premiums remain affordable, the report also looked at softening the impact of premium increases, especially for vulnerable groups such as those with lower income and the elderly.
The premium increase was capped at 35% for each age band, and the rise in premiums would also be phased in over three years rather than in a single year.
The report also called for enhancements to premium subsidies and support for lower- to middle-income Singaporeans. Additional MediSave top-ups would also offset the rise in premiums, ensuring they can be fully funded from MediSave without using cash. Part of this includes a lifetime annual mediSave top-up for the Pioneer Generation, and special top-ups for other groups of Singaporeans, such as homemakers and informal workers.
Finally, there was a recommendation for premium discounts to be considered for those who lead healthier lifestyles. The launch of Healthier SG in 2023 has placed even stronger emphasis on preventive health and empowered individuals to take charge of their own well-being
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