3 Reasons Why Singaporeans Can’t Switch from Private to Subsidised Healthcare

Switching from private to public hospitals can help you save medical expenses, but your appeal may fail due to these 3 reasons.

It’s a common conundrum in Singapore - you used to go to a private specialist for treatment, but now the costs have started to hurt more than your illness. So you try and switch to public, subsidised healthcare instead... only for it to be denied.

What’s going on, and how does this work? Here’s what you need to understand.

1. You Fail the Medical Social Worker Review

If you start off with private health care services (e.g. you go to a private hospital for treatment, instead of a public one), you could be stuck there. For you to switch back from private to public (read: subsidised) healthcare, your case has to be reviewed by a medical social worker.

This is to prevent an influx of people switching from private to public care, and increasing waiting times for needy Singaporeans.

Bear this in mind when you first approach a doctor (e.g. go to a polyclinic instead of a private clinic), and rethink your decision to use private healthcare even if your insurer provides for it.

For example, your insurer may pay for your Class A ward in the immediate sense - but for illnesses like stroke, you will need constant treatment even after you leave the hospital. Once that happens, the lack of subsidies can seriously hurt your wallet.

Your attempt to switch back to subsidised healthcare might be foiled if the review finds you capable of continuing to pay private healthcare rates.

2. Your Treatment Costs are Seen as "Affordable"

One of the main considerations, in letting you switch back to subsidised health care, is your income level. A key factor to note is that, even if treatment costs are putting a severe dent in your finances, they may not be deemed unaffordable.

For example, say you have a chronic condition, which requires around S$1,000 per month to treat. Your monthly income is S$5,000. Now, given that this takes up around 20 per cent of your monthly income, this can have a drastic impact on your financial goals - 20 per cent, for instance, is the amount you’re supposed to saving, not spending on healthcare.

However, it’s plausible that 20 per cent of your income will be deemed affordable; especially if you have no dependents, or few outstanding debts. This sort of logic will be cold comfort to you, when you see your financial aspirations go up in smoke - but you might just have to live with it.

So try to stay healthy and please, opt for public healthcare first if possible. If for some reason your income decreases (e.g. retrenchment), speak to a medical social worker for help immediately.

3. Your Medical Condition May Not be Deemed Suitable 

Different medical conditions have different costs. On top of that, the costs can change over time (as your health deteriorates further, your medical bills tend to increase).

Note that, in some cases, you’ll be unable to switch back to subsidised treatment until the costs climb to a certain amount. For instance, the early stages of cancer treatment tend to cost less - you may not be eligible to switch back to subsidised treatment at this point, until your condition worsens and costs go up.

This is a judgement call on the part of the medical social worker, supported by documents provided by your doctor. But don’t be surprised if someone you know is able to switch back to subsidised care for renal failure, whereas you can’t switch back despite early stage cancer.

There’s no universally applied, one-size-fits-all system.

What You Can Do to Reduce Your Costs

So your application to switch to subsidised rates have been rejected, stranding you with significantly more expensive private care. In such a case, there are still steps you can take to reduce your medical expenses.

For a start, opt for a subsidised ward if you require a hospital stay. Even if you have to continue to pay for private outpatient treatment, you can ask for a referral to be admitted to a public hospital, and opt for a lower class ward for the duration of your hospitalisation.

Doing this can also help you generate cash, especially if your Integrated Shield plan has a hospital allowance rider. Depending on your plan, you can claim several hundreds of dollars a day just for staying in a lower ward.

Another thing you can do is to repeatedly appeal to switch back to subsidised healthcare. Just because your earlier attempt was refuted, doesn't mean you can't try again. Afterall, no one wants to you keep paying high medical fees, and you might catch a lucky break on a second, third or even fourth appeal.

What this means is it may just take you a little bit longer to bring your medical expenses down. Hence, it will also be helpful if you have an emergency fund you can draw on.

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