What Are Your Options When You Can’t Pay Your Medical Bills?

We explore 5 options Singaporeans can consider if you have no cash or Medisave funds for your medical bills.

One of the great things about Singapore is that, regardless of your financial situation, you cannot be denied basic medical treatment. However, this does result in certain complications. Sometimes the cost of healthcare is just too much to bear, no matter how you budget.

Here, we explore the kinds of options that are open to Singaporeans who are short on cash for medical bills.

A Word on Medifund and Medical Officers

Singapore has a Medifund scheme, which caters to those who cannot pay their healthcare even after the use of Medisave or other subsidies. The people who can access Medifund are:

• Singapore citizens
• Subsidises patients (e.g. those who are in C class wards)
• Receiving medical care from a Medifund-approved institution
• Also unable to pay after receiving help from family (e.g. use of a family member’s Medisave)

How Medifund is employed varies between needy individuals. There is no rigid process as healthcare in unique to each patient: different people can afford different amounts, and they need varying levels of care.

As such, the medical officer at the hospital will speak to you if you have financial difficulties. They will often present a range of options (we explain some of these below), depending on your specific needs.

However, there is no guarantee that you will receive all of the options below. If it is decided that you can afford treatment and don’t need them, for example, they may not be made available.

It’s necessary to ensure each person pay what they can, so that the people who are truly needy can receive greater subsidies for care. Here are your options in case Medifund isn't available to you.

1. Use a Family Member’s Medisave

In the event that you run out of Medisave, you can use a family member’s Medisave instead. This tends to happen with the elderly, who may have already used up a lot of their Medisave, or who received fewer contributions in the early days of the CPF scheme.

However, there are some parents who also use their Medisave to help their working-age children. We suggest you avoid this except as an absolute last resort. As you get older, you are more likely to require your Medisave, and more likely to use it in greater amounts. Only use yours for your children if they’re absolutely unable to afford it.

Later on, you can repay your family members, who can make voluntary CPF contributions to top up their Medisave again. For example:

Say you need S$7,000 for hospitalisation costs after a prolonged illness. Your Medisave has run out. You could use your mother’s Medisave to make up the S$7,000, and then pay her back in instalments of S$500 a month for her to put back in her CPF. You can check how to do this on the CPF website.

While your first instinct is probably to waive off the need to repay the Medisave funds (you’re family after all), do keep in mind that everyone’s Medisave needs to be topped up and healthy.

2. Pay What You Can, But Negotiate a Discount for the Balance

The hospital may or may not agree, but if you can make close to the full amount (say 80%), then it’s worth asking.

For example, say you owe S$10,000, after subsidies, for an operation; but S$8,000 is all you have. You could ask if, instead of having to make instalments, you could pay the S$8,000 upfront and have the rest discounted. This would ensure that the hospital gets a guaranteed amount, as there is no risk you will have to skip or default on payments later (which may be a very real possibility if money is tight, and you are expected to keep paying for another few years).

Note that, even if you have this option, it is only best to choose it if you are certain of your income over the next few months. Do not empty out all your savings if you have no guaranteed income source, as you will be unable to sustain yourself later.

3. Ask for Interest-Free Instalments

This is the most common option that a hospital will grant. If you do not have the cash on you, and do not qualify for a bank loan (or a bank loan would be too onerous), you may be asked to make instalment payments at no interest.

We recommend that you try and keep the repayment, along with any other outstanding debts, to under 50 per cent of your monthly income (see point 2). If you would have to pay more than this, ask if your can stretch out the loan tenure (pay over more months).

4. Get a Bank Personal Loan

You can use a bank personal loan for medical bills as a last resort, due to the interest rate involved. This is around 4 - 9% p.a. However, do raise the issue with the medical officer, if such an interest rate would be a severe financial burden.

One sign is if your debt servicing ratio (the amount of your monthly income that goes into debt repayment) would go past the 50% mark, after taking the loan. For example, if you make S$2,000 a month, any loan that would drive your monthly repayments beyond S$1,000 is likely to be too much. You should discuss that with the credit officer.

If you must use a bank loan, but are confident you can make full repayment in 6 months or less, we suggest you use a balance transfer, as these tend to be interest-free for 6 months.

But overall, we suggest avoiding the bank and negotiating harder.

5. Ask to Defer Payment, but Pay the Full Amount at Once

If you work on a contract basis or are awaiting payment for a project, this is an alternative you can ask for. Rather than pay in instalment loans, you might want to ask for the full amount to be deferred (say for a month, or six weeks). After that, you will make payment in full.

This is useful if you don’t have enough to pay everything, and also no immediate source of income for the next few months (e.g. you are medically unfit to work). This will get you time to raise the funds, or just time to wait while payment comes in, if any.

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