MediShield Life provides universal basic health insurance coverage for Singaporeans and Permanent Residents, from birth. This is a crucial coverage, as even young and fit individuals can face unexpected medical conditions and injuries.
For the benefit of this coverage, we have to pay a MediShield Life premium – which can be fully paid from our MediSave Account savings. Many of us can enjoy subsidies as well as added protection if we cannot afford the premiums, so no one in Singapore will go without basic healthcare coverage due to inaffordability.
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What Is MediShield Life?
MediShield Life is a mandatory health insurance plan that provides basic protection to all Singaporeans and Permanent Residents against large hospital bills and selected costly outpatient treatments for life.
The definition is pretty packed with meaning, so here’s what each key word means.
Mandatory: This means that MediShield Life is compulsory for all Singaporeans and Permanent Residents, with no option to opt out, and no requirement to apply. This also means all Singaporeans and PRs have to pay their MediShield Life premiums.
Health insurance plan: MediShield Life covers large hospitalisation bills and selected outpatient treatments, and typically not for broad-based General Practitioner visits. Coverage is also provided on an as-charged basis, so you don’t get cash payouts for other expenses.
basic protection: MediShield Life is meant to give Singaporeans a basic safety net against large hospital bills, with deductibles and co-insurance components. It is by no means a substitute for private insurance and integrated shield plans. Claim limits are sized for subsidised treatment in government hospitals.
all Singaporeans and Permanent Residents: MediShield Life covers everyone, regardless of age or any pre-existing conditions.
for life: You are covered for life, and there is no expiry for MediShield Life coverage.
MediShield Life is enacted under the MediShield Life Scheme Act and administered by the Central Provident Fund (CPF) Board, with oversight from the MediShield Life Council and in close partnership with the Ministry of Health.
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When Can You Make MediShield Life Claims?
You must stay in an approved medical institution for at least 8 hours or be admitted for day surgery to make a MediShield Life claim.
One common misconception is that if you are admitted in a private hospital, you cannot make MediShield Life claims. This is incorrect – and you are still covered under MediShield Life. As MediShield Life payouts are pegged to bill sizes for treatment at public hospital B2 or C wards, if you choose to stay in a private hospital or a B1 and above ward in a public hospital, there will be a pro-ration factor to reduce the bill size to the equivalent of a Ward B2/C bill. In essence, you will need to pay a larger portion of the bill in MediSave, cash, or private insurance payouts.
MediShield Life also covers selected outpatient treatments, including Kidney Dialysis, Radiotherapy for Cancer, and, from April 2025, will also be extended to more outpatient and home-based medical care, that includes Paediatric Home Care (PHC), Negative Pressure Wound Therapy (NPWT) and others.
Read Also: Here Are 5 Common Misconceptions Singaporeans Have About Private Hospitals
How Much Can You Claim Under MediShield Life?
There is a three step process to calculate how much of your hospital bill can be claimed under MediShield Life.
Medishield Life Claim Limit: For each person, there will be an annual claim limit of $200,000 per year from 1 April 2025, but no lifetime limit on claims. Thus, the maximum amount claimable is $200,000 minus the amount you already claimed under MediShield Life for each year.
Deductible: Depending on your age, there is a deductible that you need to pay each year (in MediSave or cash), before MediShield Life kicks in. This means that if you were hospitalised once and paid the full deductible, you do not need to pay again if you are hospitalised later that year.
From 1 April 2025, the deductible will increase to sieve out smaller, more affordable bills which can be paid for by MediSave.
Source: Ministry of Health
A $500 deductible will also be introduced for outpatient treatments from 1 April 2025.
Insurance Co-Payment: This is the percentage of the claimable amount that you have to pay, which ranges from 3% to 10%. In general, as the bill size gets larger, the co-insurance payable percentage is smaller. So, after paying the deductible (if applicable), the (C) is the portion of your bill that you still need to pay for.
1 Inclusive of deductible
Source: MOH
From 1 April 2025, a the co-insurance for outpatient treatments will also range from 10% to 3%, depending on the size of your bill.
MediShield Life Benefit Payouts: Since MediShield Life benefits are sized to cover subsidised bills at Class B2/C wards, there are limits to how much MediShield Life will cover for each procedure. According to the Ministry of Health, these limits are reviewed regularly, and 9 in 10 patients will not exceed these limits.
Source: Ministry of Health
There are also outpatient claims that you can make:
From 1 April 2025, there will also be a revision in some of the coverage levels:
MediShield Life Exclusions
Aside from the above claim restrictions, there are certain line items and procedures not covered by MediShield Life, such as ambulance charges, maternity fees, and fertility-related procedures. You can refer to the Ministry of Health website for the full list of exclusions.
Paying MediShield Life Premiums
MediShield Life premiums can be fully paid using your MediSave Account savings. The government has committed to keeping premiums affordable, and there are various subsidies and schemes (like Pioneer Generation subsidies and MediSave top-ups) available to help those who face difficulties paying premiums. It has been emphasised that no one will lose MediShield Life coverage due to their inability to afford the premiums.
MediShield Life premiums start at $200 for newborns and rise with age up to $2,826 for those above 90 years.
Source: MOH (from April 2025)
To find out more about your premiums payable and amount of eligible subsidies, you can use the MediShield Life premium calculator.
Those with pre-existing conditions will need to pay 30% more in Additional Premiums for the 10 years, after which they will pay the same premiums as everyone else in the cohort.
Read Also: Your Complete Guide To Healthcare Financing In Singapore
How To Make A MediShield Life Claim
Hospital staff are equipped and trained to help you file a claim with MediShield Life, so you just have to request for their help and authorise them to do so.
If you do not have a private integrated shield plan (IP): The hospital will submit the claim for you and the CPF Board will settle the portion of the bill you’re eligible for. You can then pay the rest using MediSave and/or cash.
If you have an IP: Inform your insurer (you don’t necessarily have to involve your financial adviser), and they will make the full bill amount covered by your IP plan on your behalf. You will then pay any balance using MediSave and/or cash. Behind the scenes, your insurer will reclaim the portion of the bill that is covered by MediShield Life.
Enhancing Your MediShield Life Coverage
As mentioned at the start, MediShield Life provides basic coverage and benefits.
Those who want more benefits on top of MediShield Life can purchase a private integrated shield plan (IP), which complements and enhances your MediShield Life policy. However, note that private insurers can (and most likely will) exclude covering claims due to pre-existing conditions. IPs allow for larger claims, with plans that cover treatments at B1 and A class wards in a public hospital or private hospitals.
For more details on choosing an IP, you can refer to our complete guide to buying a private integrated shield plan.
Read Also: Complete Guide To Buying A Private Integrated Shield Plan
It is also worth noting that when you are unwell and require hospitalisation, your hospital bills are just one financial concern. You may incur a loss of income, require additional assistance and rehabilitation, as well as purchase medicines, supplements and equipment to assist in your recovery. Thus, you might want to consider if critical illness policies, disability insurance and other health insurance policies might be important to you.
Read Also: Working Adult Guide: Health Insurance In Singapore, And Why You Should Consider Buying Them
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