Integrated shield plans

[JoeyStingray]

Deciding between AXA or NTUC Income ISP

Hi all,

I'm a young adult in my 20s, and I am looking to invest in a decent ISP that is affordable and provides decent coverage. I understand the notion of you get what you pay for, but I am also unwilling to excessively splurge on ISPs. Have been looking at the policy documents of various ISPs, and am currently inclined to the AXA Basic Care Plan B, or NTUC's Basic Enhanced Incomeshield plan.

Would like to seek the opinions here on what are your takes on the ISPs? Or do you think the abovementioned are complete trash, and you have something better to recommend. If there are previous discussions about this, I would appreciate it if you could link me up as well.

Thank you very much.

JoeyStingray

 

[moejoseph]

Hi all,

I'm a young adult in my 20s, and I am looking to invest in a decent ISP that is affordable and provides decent coverage. I understand the notion of you get what you pay for, but I am also unwilling to excessively splurge on ISPs. Have been looking at the policy documents of various ISPs, and am currently inclined to the AXA Basic Care Plan B, or NTUC's Basic Enhanced Incomeshield plan.

Would like to seek the opinions here on what are your takes on the ISPs? Or do you think the abovementioned are complete trash, and you have something better to recommend. If there are previous discussions about this, I would appreciate it if you could link me up as well.

Thank you very much.

JoeyStingray

I personally feel ISP is important. Let me know if you need more info on AXA plan as well

 

[tangent314]

I'm a young adult in my 20s, and I am looking to invest in a decent ISP that is affordable and provides decent coverage. I understand the notion of you get what you pay for, but I am also unwilling to excessively splurge on ISPs. Have been looking at the policy documents of various ISPs, and am currently inclined to the AXA Basic Care Plan B, or NTUC's Basic Enhanced Incomeshield plan.

Would like to seek the opinions here on what are your takes on the ISPs? Or do you think the abovementioned are complete trash, and you have something better to recommend. If there are previous discussions about this, I would appreciate it if you could link me up as well.

AXA Plan B is an A ward plan, while Income Basic is a B ward plan, so maybe not directly comparable. Generally all the various ISPs are fine, it just depends on what ward class (private, A, B, or C) that you want to be covered for. Decide that first then compare between the insurers their offering for that ward class.

I would recommend going for a rider that is compliant with MOH's new guidelines - either 5% or 10% with a cap that you are comfortable with. Only a few of the insurers have released such riders, Income is one of them.

 

[BBCWatcher]

AXA Plan B is an A ward plan, while Income Basic is a B ward plan, so maybe not directly comparable. Generally all the various ISPs are fine, it just depends on what ward class (private, A, B, or C) that you want to be covered for. Decide that first then compare between the insurers their offering for that ward class.

I agree with this.

Among public hospital A ward plans, I still prefer Prudential's (PRUshield Plus), but AXA and Raffles Shield also look good. All three of these insurers have 180/365 day pre-/post-hospitalization coverage windows, and a long coverage window is quite important.

Among public hospital B ward plans, and assuming you're a citizen, Great Eastern still looks best to me.

 

[JoeyStingray]

I agree with this.

Among public hospital A ward plans, I still prefer Prudential's (PRUshield Plus), but AXA and Raffles Shield also look good. All three of these insurers have 180/365 day pre-/post-hospitalization coverage windows, and a long coverage window is quite important.

Among public hospital B ward plans, and assuming you're a citizen, Great Eastern still looks best to me.

AXA Plan B is an A ward plan, while Income Basic is a B ward plan, so maybe not directly comparable. Generally all the various ISPs are fine, it just depends on what ward class (private, A, B, or C) that you want to be covered for. Decide that first then compare between the insurers their offering for that ward class.

I would recommend going for a rider that is compliant with MOH's new guidelines - either 5% or 10% with a cap that you are comfortable with. Only a few of the insurers have released such riders, Income is one of them.

Hi thank you so much for your responses! Really appreciate it.

Judging from some of your comments, it seems to me that some of your key considerations are pre/post-hospitalisation coverage, and co-payment % cap. Are there any other key features that you will look out for?

Thanks again!

JoeyStingray

 

[BBCWatcher]

Judging from some of your comments, it seems to me that some of your key considerations are pre/post-hospitalisation coverage, and co-payment % cap.

Yes, a longer pre-/post-hospitalization coverage window is quite important. That helps a lot with outpatient and rehabilitative care, and those bills can add up pretty quickly.

With the new rule compliant riders the co-pays are capped at $3,000 (the minimum the new rule allows), although Raffles Shield offers a high deductible option which is interesting for some. The co-pay percentage on the way to the cap really doesn't matter much (5%, 10%, or whatever), so I'd just pick the higher co-pay percentage with the lower premium if there's a choice.

Are there any other key features that you will look out for?

Yes. Look across the benefit tables to spot any/all differences when comparing plans, but these are the other differences that tend to weigh heavily when I draw comparisons:

* The annual policy limit (higher is better)

* Any cap on the number of days of community hospital care (no limit is better)

* Transplant coverage terms, which may vary slightly

* If you're a PR or foreigner, whether there's a proration factor added to any ward class that doesn't apply to citizens (not good if you're a PR or foreigner)

* Whether the carrier offers an "as charged" plan in the next lower ward class, as a possible future downgrade option (not guaranteed though since the carrier could drop that plan)

* The proration factor applied to the next higher ward class beyond the plan design (higher is better, if you think you might "dabble" in that next higher ward class)

Once you've narrowed down your choices, you should still obtain and read the complete policy letters very carefully before making a final decision.

 

[bladez87]

Yes, a longer pre-/post-hospitalization coverage window is quite important. That helps a lot with outpatient and rehabilitative care, and those bills can add up pretty quickly.

With the new rule compliant riders the co-pays are capped at $3,000 (the minimum the new rule allows), although Raffles Shield offers a high deductible option which is interesting for some. The co-pay percentage on the way to the cap really doesn't matter much (5%, 10%, or whatever), so I'd just pick the higher co-pay percentage with the lower premium if there's a choice.


Yes. Look across the benefit tables to spot any/all differences when comparing plans, but these are the other differences that tend to weigh heavily when I draw comparisons:

* The annual policy limit (higher is better)

* Any cap on the number of days of community hospital care (no limit is better)

* Transplant coverage terms, which may vary slightly

* If you're a PR or foreigner, whether there's a proration factor added to any ward class that doesn't apply to citizens (not good if you're a PR or foreigner)

* Whether the carrier offers an "as charged" plan in the next lower ward class, as a possible future downgrade option (not guaranteed though since the carrier could drop that plan)

* The proration factor applied to the next higher ward class beyond the plan design (higher is better, if you think you might "dabble" in that next higher ward class)

Once you've narrowed down your choices, you should still obtain and read the complete policy letters very carefully before making a final decision.

What is the community hospital care for?

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[BBCWatcher]

What is the community hospital care for?

The Ministry of Health explains that here.

 

[bladez87]

The Ministry of Health explains that here.

So In terms of coverage priority, I should be looking for pre post hospitalization as #1? Currently looking at GE.

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[exterminazn]

So In terms of coverage priority, I should be looking for pre post hospitalization as #1? Currently looking at GE.

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Don’t quite get it, as GE only has 120 days Pre and 180 days Post coverage, and you have to add the cash rider to have this coverage.

The rest such as Pru, AIA and AXA have 180 Pre and 180 Post without having the need to add on cash rider

 

[BBCWatcher]

So In terms of coverage priority, I should be looking for pre post hospitalization as #1?

I think that factor is quite important, yes. There are plenty of chronic medical conditions requiring ongoing, expensive care. None of the Integrated Shield plans are particularly good at covering long-term chronic medical conditions — it’s a problem in Singapore — but the ones with the longer pre-/post-hospitalization coverage windows at least help somewhat. The minimum allowed is 90 days/90 days. The longest available is 13 months/13 months (AIA Gold Max A but with medical provider limits). Among Integrated Shield plans designed for public hospital A ward coverage, 180/365 day coverage windows are available from multiple carriers.

Really any sub-limit is worth some thought. As another example, some plans include a 45 day stay limit in community hospitals. But there are some cases when longer stays are required for rehabilitative care, so the plans with no such sub-limit are better, other things being equal.

The total annual coverage limit can matter. There are a couple carriers that offer a higher annual limit but only for specific medical conditions. That’s a gimmick. A higher limit no matter what the disease or ailment is obviously better than a higher limit only for specific diseases/ailments, other things being equal.

If you’re a Permanent Resident or foreigner, watch out for special pro-ration factors that increase your out-of-pocket costs.

Reasonable deductibles and/or co-pays, preferably subject to an annual cap, are perfectly fine and can help cut down on premiums. Raffles Shield offers an interesting high deductible option as a notable example. You really want insurance to handle the big stuff that would be tough or impossible for you to handle on your own. If you’re paying for insurance that covers the small stuff, then all you’re really doing on average is paying insurance company overheads and profits and your own small medical bills yourself. That’s not a smart, efficient way to pay your small medical bills. Just focus on the big stuff.

 

[bladez87]

I think that factor is quite important, yes. There are plenty of chronic medical conditions requiring ongoing, expensive care. None of the Integrated Shield plans are particularly good at covering long-term chronic medical conditions — it’s a problem in Singapore — but the ones with the longer pre-/post-hospitalization coverage windows at least help somewhat. The minimum allowed is 90 days/90 days. The longest available is 13 months/13 months (AIA Gold Max A but with medical provider limits). Among Integrated Shield plans designed for public hospital A ward coverage, 180/365 day coverage windows are available from multiple carriers.

Really any sub-limit is worth some thought. As another example, some plans include a 45 day stay limit in community hospitals. But there are some cases when longer stays are required for rehabilitative care, so the plans with no such sub-limit are better, other things being equal.

The total annual coverage limit can matter. There are a couple carriers that offer a higher annual limit but only for specific medical conditions. That’s a gimmick. A higher limit no matter what the disease or ailment is obviously better than a higher limit only for specific diseases/ailments, other things being equal.

If you’re a Permanent Resident or foreigner, watch out for special pro-ration factors that increase your out-of-pocket costs.

Reasonable deductibles and/or co-pays, preferably subject to an annual cap, are perfectly fine and can help cut down on premiums. Raffles Shield offers an interesting high deductible option as a notable example. You really want insurance to handle the big stuff that would be tough or impossible for you to handle on your own. If you’re paying for insurance that covers the small stuff, then all you’re really doing on average is paying insurance company overheads and profits and your own small medical bills yourself. That’s not a smart, efficient way to pay your small medical bills. Just focus on the big stuff.

thanks. Will keep a lookout on the others. Should I sign before or after the new plans come into effect?

I read that the new plans are worse, and the premiums jumped significantly.

Personally on income, thinking of switching but want to avoid the exclusion clause. Not sure if that is possible when switching because I been to specialist clinic for investigative Consultation.

Need to sign up for pr wife also

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[Lewis.T]

thanks. Will keep a lookout on the others. Should I sign before or after the new plans come into effect?

I read that the new plans are worse, and the premiums jumped significantly.

Personally on income, thinking of switching but want to avoid the exclusion clause. Not sure if that is possible when switching because I been to specialist clinic for investigative Consultation.

Need to sign up for pr wife also

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New plans should be less expensive as they introduce co-payment options, however the current plans can still give you up to first dollar coverage.

You are free to downgrade in future without medical underwriting so my suggestion is to be get covered as soon as possible. It also makes more sense when sickness doesn't wait for you to get covered before it strikes.

 

[BBCWatcher]

thanks. Will keep a lookout on the others. Should I sign before or after the new plans come into effect?

I agree with Lewis.T: get covered if you aren’t already.

“First dollar” coverage doesn’t make financial sense. If you want a rider (still with a deductible and/or co-pays), and if you like the new rider better, then get the base plan now (March, 2019) and add the new rider on April 1, 2019 (when available). If you want a rider, and if you like the current “legacy” rider with a deductible and/or co-pays (“Assist,” “Saver,” “Lite” — it’ll have a name like that, probably), then get both the base plan and rider now. Bear in mind that you’ll still have to switch to the new rule compliant rider by April 1, 2021.

I read that the new plans are worse, and the premiums jumped significantly.

It varies by carrier. I wouldn’t read too much into that, though, since premiums aren’t guaranteed and since any rider you choose now will still have to transition to a rule compliant rider by April 1, 2021.

Personally on income, thinking of switching but want to avoid the exclusion clause. Not sure if that is possible when switching because I been to specialist clinic for investigative Consultation.

Whenever you switch carriers you’re subject to a pre-existing condition reset. There’s one possible exception: Raffles Shield sometimes covers a few pre-existing conditions.

Need to sign up for pr wife also

Watch out for pro-ration factors that apply to PRs. A lot of the public hospital B1 ward plans (and below) have such pro-ration factors. Note that you’re certainly allowed to have different plans within a household. Women have access to KK Hospital, and that’s one reason why coverage decisions might be different.

 

[McFadden]

What is the community hospital care for?

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does medishield cover community hospitals?

 

[BBCWatcher]

does medishield cover community hospitals?

Yes, MediShield Life provides some community hospital coverage. For citizens in public community hospitals in subsidized wards the MediShield Life coverage is decent. Otherwise....

Community hospital stays are also MediSave payable, capped at $250 per day and $5,000 per year.

 

[bladez87]

I agree with Lewis.T: get covered if you aren’t already.

“First dollar” coverage doesn’t make financial sense. If you want a rider (still with a deductible and/or co-pays), and if you like the new rider better, then get the base plan now (March, 2019) and add the new rider on April 1, 2019 (when available). If you want a rider, and if you like the current “legacy” rider with a deductible and/or co-pays (“Assist,” “Saver,” “Lite” — it’ll have a name like that, probably), then get both the base plan and rider now. Bear in mind that you’ll still have to switch to the new rule compliant rider by April 1, 2021.


It varies by carrier. I wouldn’t read too much into that, though, since premiums aren’t guaranteed and since any rider you choose now will still have to transition to a rule compliant rider by April 1, 2021.


Whenever you switch carriers you’re subject to a pre-existing condition reset. There’s one possible exception: Raffles Shield sometimes covers a few pre-existing conditions.


Watch out for pro-ration factors that apply to PRs. A lot of the public hospital B1 ward plans (and below) have such pro-ration factors. Note that you’re certainly allowed to have different plans within a household. Women have access to KK Hospital, and that’s one reason why coverage decisions might be different.

With the benefit of kk woman hospital, I should sign up my wife for a ward A to get the best value for my money?

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[BBCWatcher]

With the benefit of kk woman hospital, I should sign up my wife for a ward A to get the best value for my money?

That ought to be up to her, correct? (Have you asked?)

Since she’s a Permanent Resident she doesn’t get the best (citizen level) public hospital subsidies, and therefore the Integrated Shield plan benefits and premiums reflect that. So yes, the public hospital A ward Integrated Shield plans tend to work pretty well for PRs.

Raffles Shield has an interesting rider called the “Raffles Hospital Option.” With that option, plus their public hospital A1 ward plan (“Raffles Shield A”), the “as charged” coverage is for all public hospitals plus Raffles Hospital. The premium cost is somewhere between a public hospital plan and a private hospital plan. Personally I don’t think it’s necessary, but it’s an interesting choice for those who insist on having coverage for at least one private hospital. I think it’s the future or private hospital plans in Singapore, actually.

 

[bladez87]

That ought to be up to her, correct? (Have you asked?)

Since she’s a Permanent Resident she doesn’t get the best (citizen level) public hospital subsidies, and therefore the Integrated Shield plan benefits and premiums reflect that. So yes, the public hospital A ward Integrated Shield plans tend to work pretty well for PRs.

Raffles Shield has an interesting rider called the “Raffles Hospital Option.” With that option, plus their public hospital A1 ward plan (“Raffles Shield A”), the “as charged” coverage is for all public hospitals plus Raffles Hospital. The premium cost is somewhere between a public hospital plan and a private hospital plan. Personally I don’t think it’s necessary, but it’s an interesting choice for those who insist on having coverage for at least one private hospital. I think it’s the future or private hospital plans in Singapore, actually.

she doesn't bother. That's why after so many years, she still uninsured. Sigh

So basically the raffles plan is a 1 private, and public plan as compared to a many private and public plan.

Where does the list of pre existing conditions come from and how would the new insurer get it? Would we be sent for a health check up when switching?

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[BBCWatcher]

she doesn't bother. That's why after so many years, she still uninsured. Sigh

No, she has MediShield Life since she’s a Permanent Resident. Plus MediSave dollars, presumably. She’s not uninsured, but she’s probably underinsured. (MediShield Life doesn’t work too well for PRs.)

These decisions are still hers to make. You cannot force Integrated Shield coverage on her. She signs the application and declaration, or she doesn’t. Her choice.

Where does the list of pre existing conditions come from and how would the new insurer get it? Would we be sent for a health check up when switching?

Plan applicants fill out and sign a health declaration. However, regardless of whether the pre-existing condition is declared or not, the insurance carrier is within its rights to deny coverage for a pre-existing medical condition. Also, beyond the fact that it could be insurance fraud not to declare, the carrier is within its rights to terminate the policy of somebody who didn’t make a truthful declaration.