Changes to Cancer Coverage of Integrated Shield Plan: What You Need To Know

From 1 April 2023, all Integrated Shield plans (IPs) will only cover cancer treatments from a government-approved cancer drug list (CDL). How will this change affect cancer patients undergoing treatment? And how does it affect the rest of us Singaporeans in our quest to ensure adequate cancer protection?

It wasn't that long ago when Singaporeans were advised to top up our MediShield Life coverage with an Integrated Shield plan (IP) for additional hospitalisation coverage.

Now there is further action required to ensure adequate coverage for cancer protection due to recent MediShield Life changes.

What has changed 

There are two main changes affecting cancer coverage - 

1. From 1 April 2023, all IPs will only cover treatments on the approved cancer drug list. The list covers about 90 per cent of cancer drug treatments approved for use by the Health Sciences Authority, which regulates the use of medication here. You may refer to the latest CDL here. 
2. The second change is the splitting of cancer insurance coverage into two categories - cancer treatments and cancer drug services.

Outpatient cancer drug services include consultations, scans, lab investigations, treatment preparation and administration fee, supportive care drugs (e.g., for pain/nausea) and blood transfusions. 

Under the previous MediShield Life coverage, cancer patients can claim up to S$3,000 per month for cancer drug treatments and services. 

The announcement was made in August 2021, following recommendations by the MediShield Life Council that on the national level, spending on cancer drugs was increasing at 20% a year, against 6% for other drugs. 

This was due to the increased number of MediShield Life claimants for outpatient cancer drug treatments by 29%, from around 22,500 in 2017, to 29,100 in 2020.

Based on the current trajectory, cancer drug spending is projected to reach $2.7 billion in 2030. Hence the changes are made to “keep cancer treatments and insurance premiums affordable in the longer term”, according to MOH.

A refresher on Integrated Shield plan 

An Integrated Shield plan (IP) is a private health insurance plan that helps policyholders cover the cost of hospitalisation and surgical bills – the premiums can be paid using our MediSave account. 

Though IPs are not compulsory, they act as an additional layer of insurance on top of our MediShield Life, which provides basic medical expenses coverage.  

For instance, MediShield Life provides coverage for B2/C wards in public hospitals, while IPs provide additional coverage if you choose to stay in B1/A wards or at private hospitals.

IPs also help to cover pre and post-hospitalisation costs and increase our total claim limit beyond the yearly $100,000 provided by MediShield Life.

How will this affect me as a consumer? 

#1 - Review your cancer coverage

Nobody can foresee a critical illness diagnosis but the odds are sobering. In the unfortunate event of a cancer diagnosis, would you rather have the option of seeking treatment in hopes of enjoying a better quality of life?

If you still haven’t gotten an Integrated Shield plan, now is the time to definitely get it. Patients with IPs used to have their treatment costs covered “as charged”, after the mandatory deductible and co-pay portions. 

Using Great Eastern’s SupremeHealth as an example, the standard plan offers up to 3 times the MediShield Life claim limit for cancer drug treatments per month. The higher tier plans are offering up to 5 times the limit, or about $1,500 a month - a sum which some medical experts have said is insufficient without getting a rider.

#2 - Consider a 3rd layer of protection 

With the prevalence of cancer in Singapore and taking into account that the average cost of treatment for late-stage cancer can range from S$100,000 to S$200,000 yearly, it pays to be vigilant to prevent bill shock should circumstances happen. 

That is where you should pay closer attention to your healthcare coverage:

1. Basic coverage - MediShield Life is mandatory hospitalisation insurance for all Singaporeans and PRs. 
2. 2nd layer protection - Integrated Shield plan for coverage beyond MediShield Life limit
3. 3rd layer protection - Cancer coverage beyond the Cancer Drugs List

SingSaver insurance specialist Matthew Sutanto suggests that one way to hedge against bill shock would be to get "a typical cancer insurance policy that provides a lump sum payout", which can be used to finance the bill. 

This is because as medical insurance still requires out-of-pocket expenses, having sufficient lump sum payout ensures that the patients' savings may be untouched, regardless of the bill amount. And if there’s no bill shock, claimants may use the lump sum payout for other expenses. 

Related to this topic: Best Cancer Insurance Plans In Singapore (April 2023)

What else can cancer insurance do?

Cancer insurance plans cover cancer drugs treatments outside of the CDL and can help to offset costs of overseas cancer drug treatments and services. 

One example would be Singlife Cancer Cover Plus, which offers protection against hefty medical bills from cancer treatments.

This medical insurance complements your coverage under existing medical insurance plans (e.g. Integrated Shield Plan and riders) and can be purchased as a standalone plan.  

With this plan, you can significantly reduce your out-of-pocket cancer treatment expenses (medical expenses payable in cash) both locally and overseas.

Singlife Cancer Cover Plus features: 

• Covers cancer treatments within and outside of the CDL, e.g. Proton
  Beam Therapy and Cell, Tissue and Gene Therapy
• Provides as-charged coverage for claims 
• High annual coverage limit of up to S$1.5 million 
• Easy and fast application (no medical check-up needed)
• Covers overseas cancer treatments 

Using the example of a 31-year-old female non-smoker Kate who is undergoing cancer treatment, you can see the breakdown of costs covered by her IP (Singlife Shield) and Singlife Cancer Cover Plus, which resulted in significant reduction of her out-of-pocket expenses.

Do note that the coverage for this plan is based on reimbursement of medical bill without a lump sum payout. 

Who is affected the most 

As most of the drugs on the CDL apply to public hospitals, those who are undergoing treatment at private hospitals may need to fork out more out-of-pocket expenses without a cancer rider. 

For cancer patients undergoing treatment or on cancer drugs that are outside of the cancer drug list, you may wish to discuss with their doctors whether there are suitable alternative treatments on the list. 

If switching to a CDL treatment is not possible, there are other resources such as seeking help from a hospital medical social worker or MediFund. 

Protected up to specified limits by SDIC.

Note: This is only product information provided. You may wish to seek advice from a qualified adviser before buying the product. If you choose not to seek advice from a qualified adviser, you should consider whether the product is suitable for you. Buying an insurance product that is not suitable for you may impact your ability to finance your future healthcare needs.

If you decide that the policy is not suitable after purchasing the policy, you may terminate the policy in accordance with the free-look provision, if any, and the insurer may recover from you any expense incurred by the insurer in underwriting the policy.

Read these next:

Best Integrated Shield Plans in Singapore (2023)

Best Cancer Insurance Plans In Singapore (2023)

9 Things You Should Know About Your MediShield Life

How to Bump Up Your Health Insurance Coverage to Include Certain Conditions

What’s The Difference Between MediSave And MediShield Life: A 2-minute Explainer