Integrated shield plans

[happy_bear]

Hi all,understand that there are much discussion on ISP but i would like to seek advice on my case.

I brought the ISP around 10 years ago ( then mid 20s) and was asked by my agent to go for the highest tier plan ( private hospital with no deductible and co insure) as it was considered cheap (MS plus cash top up $100 plus per yr)at that time.

But i realised the escalating cost over the past few years with now my plan is costing around (1k per year in total payment, MS+ Cash)


I have considered downgrading my plan or switching insurer but was told by friend and read that it is not advisable as i will not get the same deal or coverage as my current plan which is bought 10 yrs ago.

Judging from my current situation, any advice that i should my plan or downgrade ?i currently have a term plan and anothe CI plan ( no prexisiting condition)


TIA.

 

[dendii]

Downgrading will not affect your coverage except for the fact that you can only use the service up to your downgraded plan. Eg, Private to Government. Government will cover everything including still even if there is any condition, given that there is no exclusions from your plan.

Switching insurer is not advisable though.

 

[tangent314]

Of course you won't "get the same deal or coverage" as your current plan.

1. The deal has already worsen, because the premiums have all gone up, thanks to the 'buffet syndrome'
2. The government has set a minimum 5% co-pay (optionally capped at $3000 or higher), and this will take effect from 2021 and will apply to all existing plan. So even if you stick with the same plan, when 2021 comes you will also not get the same coverage.

If you do have a pre-existing condition that is still covered by your old plan, then yes, it may be a good idea to stick with it.

Otherwise, you should highly consider shopping around and look at what the available plans are and decide which one is the best for yourself.

 

[xtwis7]

If you haven’t claimed before and there’s no pre-existing conditions, you MAY consider switching to another provider of your choice.

As Tangent mentioned, curbs are coming in hard to prevent abuse of healthcare so unfortunately for those who genuinely need it, they would need to pay more for the services administered in future.

 

[dendii]

The 5% co-payment will not affect existing customers till further notice. So unless there's confirmation of this, I don't see it as beneficial to switch.

All the 6 insurers have pretty similar coverages and the premium is not of a great difference, and neither can it be taken as it is. Reason being it changes every year (Base on history so far).

Only real great difference in premium lies with NTUC in my opinion. It is the lowest for majority of the ages.

Of course you won't "get the same deal or coverage" as your current plan.

1. The deal has already worsen, because the premiums have all gone up, thanks to the 'buffet syndrome'
2. The government has set a minimum 5% co-pay (optionally capped at $3000 or higher), and this will take effect from 2021 and will apply to all existing plan. So even if you stick with the same plan, when 2021 comes you will also not get the same coverage.

If you do have a pre-existing condition that is still covered by your old plan, then yes, it may be a good idea to stick with it.

Otherwise, you should highly consider shopping around and look at what the available plans are and decide which one is the best for yourself.

 

[happy_bear]

Thanks for the replies so far..
From what i gathered, since i havent claim before and have no pre existing conditions, i may consider to switch or downgrade plans or even chg insurer

So judging from the price i pay now for private hospital ($1.2k per year, 12 year old ntuc isp plan ,mid 30s), may i know it is worth the price i am paying or in fact there will be not much difference if we are talking about similar level plans ( pte hospital) . While i have the earning power now to pay the premiums now, my concerns will be for later years when the premiums are beyond financial means (premium is creeping up ave 20% per year for past 5 year with this year a whooping 42%- is it normal?).


And if i downgrade or switch plans,will it be better to do it now or when 2021 comes.



Thanks again

 

[cherry6]

The 5% co-payment will not affect existing customers till further notice. So unless there's confirmation of this, I don't see it as beneficial to switch.

All the 6 insurers have pretty similar coverages and the premium is not of a great difference, and neither can it be taken as it is. Reason being it changes every year (Base on history so far).

Only real great difference in premium lies with NTUC in my opinion. It is the lowest for majority of the ages.

I think that it is already well proven BEYOND REASONABLE DOUBT that co-payment does prevent unnecessary claims and that as a cohort, full coverage riders are a very bad claims experience for insurers (and even CPF managing the basic medishield-life insurance component too).

Full coverage riders annual premiums will thus have no other reasonable alternative (save the near impossible occurrence of goverernment bail out) but to have exponential subscription price INCREASE because need to return the insurance scheme to profitability and even recuperate some of the large insurance $$$ losses experienced in recent years.

The tide will turn where all insurers obscenely increase rider premiums in tandem for all plans providing 100% co-payment waiver (100% no questions cover) since all insurers will have the same MOH pressure release hach of the 5% co-insurance riders.

Just as the sky is the limit for 1st class and business class seats, many currently from 1st class will eventually downgrade to business and from business to premium economy so on and so fourth.

The writing is on the wall.

So, unless one is anticipating a promotion or juicy salary raise in future, I see plan downgrades as an eventuality for most people in their 30s and expecting to live at least 40yrs life more because the price of 1st class will exponentially rise and like someone with a close relative or family abroad which one has to visit annually without fail, there will come a time when a lower class airline passenger seat will be the annual norm.

Unless of course one owns a gold mine and has unlimited funds.

Therefore, if TS is certain that he will not make a claim within the next 5 years, and anticipating a definite, sustained if not exponential increase in premiums, especially for full coverage riders, then he ought to opt for an immediate downgrade to a partial coverage rider (or even lower), being conservative about his ability to pay for all the premiums expected to be paid up annually in full, over the next 40 yrs.

PS, I am no insurance expert. However, I do not that in these hospitalization insurance covers, there is some specifications about treatments covered. This means that yet undiscovered treatments may not be covered in future and may also require special rider purchase for cover. For this reason, it may be prudent to keep some of one's powder dry (e.g. keep savings in bank, invest etc and not excessively spend on current day insurance schemes because when the time comes and one needs the novel treatment, it might not be covered because the insurer may be slow to update the coverage range and thus having the insurance may not be much better than having no insurance at all to begin with).

 

[Maeda_Toshiie]

Thanks for the replies so far..
From what i gathered, since i havent claim before and have no pre existing conditions, i may consider to switch or downgrade plans or even chg insurer

So judging from the price i pay now for private hospital ($1.2k per year, 12 year old ntuc isp plan ,mid 30s), may i know it is worth the price i am paying or in fact there will be not much difference if we are talking about similar level plans ( pte hospital) . While i have the earning power now to pay the premiums now, my concerns will be for later years when the premiums are beyond financial means (premium is creeping up ave 20% per year for past 5 year with this year a whooping 42%- is it normal?).


And if i downgrade or switch plans,will it be better to do it now or when 2021 comes.



Thanks again

A point to note when switching coverage, if you have suffered any conditions, the new provider will NOT provide the coverage on those conditions. Meanwhile, keep in mind that the likelihood of having any condition will rise as you age*.

Secondly, be careful of any gap in coverage when you switch because it takes time for the new plan to kick in.


*I'm not arguing for you to switch now. Rather, I'm just pointing out a tendency among human beings.

 

[maple96]

Thanks for the replies so far..
From what i gathered, since i havent claim before and have no pre existing conditions, i may consider to switch or downgrade plans or even chg insurer

So judging from the price i pay now for private hospital ($1.2k per year, 12 year old ntuc isp plan ,mid 30s), may i know it is worth the price i am paying or in fact there will be not much difference if we are talking about similar level plans ( pte hospital) . While i have the earning power now to pay the premiums now, my concerns will be for later years when the premiums are beyond financial means (premium is creeping up ave 20% per year for past 5 year with this year a whooping 42%- is it normal?).


And if i downgrade or switch plans,will it be better to do it now or when 2021 comes.



Thanks again

If u have ntuc isp pte plan with plus rider (100% cover), u should not switch insurer. Switching will result in losing the 100% cover under the new govt rules/policy.

U can downgrade to a lower ward isp (eg B) and still retain the 100% cover, u can double confirm with NTUC. So u pay lower premiums.

If u think u still can afford to pay premiums for your current isp, u can always downgrade in future when u no longer can afford the escalating premiums.

I have B from NTUC with 100% cover and I plan to drop the cover in future when I think it is too expensive and govt give me higher hospital subsidy by age. I never believe in paying for A.

 

[BBCWatcher]

Maintaining a "zero dollar" rider simply doesn't make sense for a healthy adult with a MediSave balance. A rider that caps annual out-of-pocket (largely MediSave payable) costs for covered services is perfectly fine.

It's very odd, to say the least, to pay increasing amounts of unrestricted cash to try to defend against tapping compulsorily saved funds that can only be used for qualified medical spending.

As far as a carrier switch, that's an interesting decision. NTUC happens to rank at or near the bottom in terms of the benefits in its Integrated Shield plans. But they are generally the price leader, by a few dollars per year. You get what you pay for, generally. I would prefer that base Integrated Shield plans (and MediShield Life) offer broader coverage, including more outpatient care and prescription drugs, as notable examples. So I'm highly inclined to pick the plan that has the most generous coverage terms at or below a particular ward class, even if that means a few dollars a year more in premiums.

Aviva offers something called "moratorium underwriting," meaning they'll cover many declared pre-existing medical conditions after a waiting period. So it might be possible to switch to them without a lifetime pre-existing condition reset. Or, if you don't actually have any pre-existing conditions to worry about, you can probably safely switch to any carrier. Over time that won't be true (if true) since practically everybody eventually develops a pre-existing medical condition of some sort, so if you're going to hop to another carrier, sooner is better than later.

I'm quite happy with the public restructured hospitals, so I insure to that level. Interestingly you can "dabble" in private hospital care even when you have an Integrated Shield plan designed for public hospital coverage. There are two ways to dabble. One is to get Raffle Shield's public hospital A ward plan with the Raffles Hospital rider. That combination costs less than anybody else's private hospital Integrated Shield plan, but it only provides full, non-prorated coverage when you get your care from any public hospital or from Raffles Hospital specifically. Another option is to get a public hospital A ward plan with the highest available proration factor (70%) for private hospital care. That means the plan will provide some coverage for private hospital care should you choose to get it, but the proration factor will raise your deductible/co-pay ... which is then largely or fully MediSave payable. Anyway, both these approaches let you "dabble" in the private medical sector, but at a lower premium cost.

 

[happy_bear]

Thanks for the constructive discussion. I was not insistent to get private hospital plans but somehow coerced by my agent 12 years also to take it up since it was "cheap" then , just $100 plus ms plus $173 cash outlay per year and it remained that for another 5~6 year . No complaints.

However, price increase got out of hand in the recent 5 years and this year went up by 42% which is hard to stomach and i certainly worry about the years to come.

Im geared to staying with ntuc but downsizing to B or C . Just curious what are the yearly increment quantum for B and C plans ? Is that that steep like private plans?

Ps , my plan is enhanced incomeshield preferred with plus rider -

 

[BBCWatcher]

Assuming you're in your late 30s now (age next birthday), and a citizen, here are the annual base plan premiums for NTUC's Enhanced Income Shield polices, not including the obligatory MediShield Life premiums:

Advantage (public hospital A ward): $128
Basic (public hospital B1 ward): $81
Enhanced C (public hospital B2+ ward): $37

Preferred, the private hospital plan, is at $392/year now, which is not fully MediSave payable, which probably got your attention.

Now let's suppose you instantly age to 100, and you're paying today's premiums for those same plans. Here are the current premiums at age 100+:

Preferred: $8,289
Advantage: $4,985
Basic: $3,395
Enhanced C: $2,066

There's always a big drop in premiums when you cut out the private hospitals, and that premium gap is getting wider as private hospital prices run well ahead of inflation.

I don't recommend Enhanced C if you're male. KK Hospital seems to offer B2+ ward consistently, and B2+ ward is air conditioned while B2 and C wards are not. (Big difference!) KK Hospital doesn't serve male adult patients, and unfortunately other public hospitals don't seem to offer B2+ ward consistently. So if you want air conditioning in your hospital room, which seems pretty basic to me, you'll want to be careful to avoid Enhanced C if you're male. Kudos to NTUC for offering it, though -- they're the only ones offering an "as charged" plan for B2+/B2 ward.

You can cut the premium rather a lot by picking a more sensible (in my view at least) rider, specifically what NTUC calls the "Assist" rider. The Assist rider caps (but doesn't zero out) your annual unreimbursed cost for covered medical services, and then most or all of that remaining amount is MediSave payable. That'd be the first area I'd look for cost savings, since presumably you have some MediSave dollars stashed away by now. "Zero dollar" coverage isn't something you actually need. A $1,750 medical bill, for example, wouldn't ruin you, I assume. Insurance should be well aimed at mitigating true calamities, and a $1,750 bill (mostly or fully MediSave payable) isn't a calamity.

 

[happy_bear]

Assuming you're in your late 30s now (age next birthday), and a citizen, here are the annual base plan premiums for NTUC's Enhanced Income Shield polices, not including the obligatory MediShield Life premiums:

Advantage (public hospital A ward): $128
Basic (public hospital B1 ward): $81
Enhanced C (public hospital B2+ ward): $37

Preferred, the private hospital plan, is at $392/year now, which is not fully MediSave payable, which probably got your attention.

Now let's suppose you instantly age to 100, and you're paying today's premiums for those same plans. Here are the current premiums at age 100+:

Preferred: $8,289
Advantage: $4,985
Basic: $3,395
Enhanced C: $2,066

There's always a big drop in premiums when you cut out the private hospitals, and that premium gap is getting wider as private hospital prices run well ahead of inflation.

I don't recommend Enhanced C if you're male. KK Hospital seems to offer B2+ ward consistently, and B2+ ward is air conditioned while B2 and C wards are not. (Big difference!) KK Hospital doesn't serve male adult patients, and unfortunately other public hospitals don't seem to offer B2+ ward consistently. So if you want air conditioning in your hospital room, which seems pretty basic to me, you'll want to be careful to avoid Enhanced C if you're male. Kudos to NTUC for offering it, though -- they're the only ones offering an "as charged" plan for B2+/B2 ward.

You can cut the premium rather a lot by picking a more sensible (in my view at least) rider, specifically what NTUC calls the "Assist" rider. The Assist rider caps (but doesn't zero out) your annual unreimbursed cost for covered medical services, and then most or all of that remaining amount is MediSave payable. That'd be the first area I'd look for cost savings, since presumably you have some MediSave dollars stashed away by now. "Zero dollar" coverage isn't something you actually need. A $1,750 medical bill, for example, wouldn't ruin you, I assume. Insurance should be well aimed at mitigating true calamities, and a $1,750 bill (mostly or fully MediSave payable) isn't a calamity.

Very informative! Thanks for the analogy.
In fact I am comfortable with the price of advantage or basic, as compared to preferred which is way too high!

One thing I was told is that it is easy to downgrade but if to upgrade, you will be subjected to medical screening for pre existing condition checks. While I dont have any know exisitng condition, that is one of my consideration for any downgrade.

 

[ELKYme]

Was considering to downgrade my existing integrated shield plan because of the increase in premiums but was told the same thing (subject to health screening) if want to upgrade back.

Very informative! Thanks for the analogy.
In fact I am comfortable with the price of advantage or basic, as compared to preferred which is way too high!

One thing I was told is that it is easy to downgrade but if to upgrade, you will be subjected to medical screening for pre existing condition checks. While I dont have any know exisitng condition, that is one of my consideration for any downgrade.

 

[dendii]

Yes that is true. Downgrade does not require anything. Only the process of upgrading, should there be any conditions, you will be subjected to health screenings or checks specifically for those conditions.

But if healthy, upgrading will not be an issue.

Anyway regardless, at the rate premiums are going, a lot of people might be looking at downgrading. Just don't switch till the 5% co-payment is confirmed even for existing clients, and if you have pre-existing conditions.

Was considering to downgrade my existing integrated shield plan because of the increase in premiums but was told the same thing (subject to health screening) if want to upgrade back.

 

[Advisor13]

Hi all,understand that there are much discussion on ISP but i would like to seek advice on my case.

I brought the ISP around 10 years ago ( then mid 20s) and was asked by my agent to go for the highest tier plan ( private hospital with no deductible and co insure) as it was considered cheap (MS plus cash top up $100 plus per yr)at that time.

But i realised the escalating cost over the past few years with now my plan is costing around (1k per year in total payment, MS+ Cash)


I have considered downgrading my plan or switching insurer but was told by friend and read that it is not advisable as i will not get the same deal or coverage as my current plan which is bought 10 yrs ago.

Judging from my current situation, any advice that i should my plan or downgrade ?i currently have a term plan and anothe CI plan ( no prexisiting condition)


TIA.

Firstly, which service do you wish to get from a govt or private hospital?

If you wish to get a private hospital service and you deem that your current plan is too expensive for you. Downgrade your rider to Assist rider (Pay 10% of the claimable amount, subject to a maximum co-payment each policy year). You will be able to reduce your rider premium by up to 50%.

ISP covers your hospital bills only. As for your CI plan do you think the coverage is able to tide you over for 5-10 years if you're unable to work?

Wha does your term plan covers? Death and TPD only or?

 

[dendii]

Doesn't make sense at all to have private coverage with co-payment of 10%. The end result will be your bill might still be quite abit since it is private hospital.

Might as well downgrade to government to enjoy the full coverage.

Firstly, which service do you wish to get from a govt or private hospital?

If you wish to get a private hospital service and you deem that your current plan is too expensive for you. Downgrade your rider to Assist rider (Pay 10% of the claimable amount, subject to a maximum co-payment each policy year). You will be able to reduce your rider premium by up to 50%.

ISP covers your hospital bills only. As for your CI plan do you think the coverage is able to tide you over for 5-10 years if you're unable to work?

Wha does your term plan covers? Death and TPD only or?

 

[mazz36]

I read somewhere that insurers do not conduct any checks on your declaration when you apply. Only conduct checks when you claim. Is this true?

 

[xtwis7]

If one is thinking to not declare anything, that’s on the insured’s own risk when he or she needs to claim, insurer pays $0.

There’s always medical records here which you may think are private but think again.

I read somewhere that insurers do not conduct any checks on your declaration when you apply. Only conduct checks when you claim. Is this true?

 

[dendii]

True but doesn't make a difference in any case.

If you don't declare at the start, when you want to claim then it was found out that you had pre-existing condition, your claim will still be rejected, worse case your policy voided.

I read somewhere that insurers do not conduct any checks on your declaration when you apply. Only conduct checks when you claim. Is this true?