IP for elderly

[ilovetoeat]

Hi all,

I need all of the guru's here help as I am just fresh out to the working world and have not much ideas.

The whole idea is that I am thinking of getting IP for my parents but they are worried that Medisave are insufficient for them to deduct for IP for a very long time. They are 62 (20k in medisave) and 65 (52k in medisave) respectively, clean slate of health. (If the amounts get deducted finish later in their 80s or 90s, they would have 0 left in Medisave essentially but I mean, i can always do a top up for them in the future.)

They currently is on Medishield Life and have stated that they dont mind staying in a B2 or C ward... but I am thinking of persuading them to get at least the minimum level of shield plan with the rationale that the hospitalization costs will be much higher than what medishield life can cover. (Anyone have any rough guage how say, a critical illness would cost in terms of hospitalization)

In this scenario, is it still advisable for them to get a basic IP? I am already covered under IP with rider.

Speaking of which, which company offers the cheapest premiums at the most basic plan for elderly at that age?

Thanks to everyone that help in advance!

 

[BBCWatcher]

Speaking of which, which company offers the cheapest premiums at the most basic plan for elderly at that age?

Due to possible (or even likely) preexisting condition exclusions and the risk of "sticker shock" if an insurance carrier doesn't cover a hospitalization expense, in my view it's prudent to check into public hospital B2+ ward or lower so that MediShield Life (together with Medisave) provide some reasonable coverage. Then consider buying an Integrated Shield plan that coordinates well with public hospital B2 ward....

....And there's only one such option available in the market: NTUC Income's Enhanced IncomeShield C plan. It's the lowest cost Integrated Shield plan available.

They're currently paying $755 (the younger parent) and $815 (the older parent) per year in MediShield Life premiums, less any subsidies they qualify for, and fully Medisave payable. The combined interest paid on their Medisave accounts is presently greater than their MediShield Life premiums, although if the spouse with the lower Medisave balance has not yet qualified for maximum bonus interest, see if that's possible to repair.

Assuming they are both Singaporean citizens, the base Enhanced IncomeShield C plan would cost an extra $193 and $305 at their current ages, also fully Medisave payable. Maximum premium for the base C plan, under the current price schedule, is $2,066 (for those over 100 years old). The Assist Rider (which I think I'd recommend), which must be paid in cash, is $224 and $284 at their ages. The maximum premium for the Assist Rider, under the current price schedule, is $1,492 (for those over 100 years old).

So, what would they get with the C plan and Assist Rider? Fairly decent "as charged" coverage, actually, including some pre-/post-hospitalization coverage for outpatient care related to the hospitalization (+/- 90 days), a bump in the annual coverage limit up to $150K (from $100K), a little bit of overseas emergency medical coverage (but not suitable for high medical cost countries), coverage up to B2+ ward level (if pre-existing condition exclusions don't apply -- B2+ is air conditioned, and it's available/advertised at KK Hospital and might be available elsewhere), and a 10% co-pay with a cap of $1,500 per year (Assist Rider), and much/all of the $1,500 is often Medisave claimable.

 

[ilovetoeat]

I am actually looking at the Basic - Income plan, without any riders. I have calculated that if they continue to work until 75, they can afford the medisave deductions until 100+ which their medisave runs out. That should be more than sufficient right? In the future, I will do medisave top ups for them or pay from my medisave when possible as well.

Now the only worry that they have is that they do not have enough medisave left after paying the premiums but I mean, if you have IP, you wouldnt even need to worry about how much left in your medisave as pretty much after one major illness, all your medisave wouldn't be left much? (actually, that is why I would like to understand hospitalization costs to gauge if they even need IP)

 

[soulblader_89]

if ur parent gt some existing illness it will be exempted from the insurance plan

which is quite jialat

my insurance say it is bo hua to get if that is the case

 

[BBCWatcher]

I am actually looking at the Basic - Income plan, without any riders.

I wouldn't, for multiple reasons. First, Enhanced IncomeShield Basic is not the best "as charged" public hospital B1 ward Integrated Shield plan. Great Eastern probably has the best such plan right now. Second, there's a potential "sticker shock" problem. The insurance carrier has the right to deny coverage for any claims related to pre-existing medical conditions -- conditions that existed (and should have been reasonably known) any time during the first >60 years of their lives, up until their sign-ups. If they check into B1 ward, and if the insurer then denies the claim (due to a preexisting condition), they're stuck with a big medical bill that MediShield Life doesn't cover too well. And there's a big jump between B2 (or even B2+) and B1 ward charges. A B2/B2+ Integrated Shield plan is better coordinated with MediShield Life's ward classes. It can fill in some MediShield Life gaps financially, but it doesn't try to upgrade to a ward that might be financially risky given pre-existing medical condition exclusions.

Beyond that, they've already told you they're content with B2 or C wards. A stay in B2+ would be a bonus, but that's enough bonus. If they don't value B1 ward, then they shouldn't be paying for it. Instead, it's better to focus precious premium dollars on reducing financial risk, and that "Assist" rider seems reasonable in the circumstances.

It's also quite likely that we'll see some higher medical inflation in B1 ward versus B2, and that'll tend to push the B1 plan premiums up faster.

 

[ilovetoeat]

I wouldn't, for multiple reasons. First, Enhanced IncomeShield Basic is not the best "as charged" public hospital B1 ward Integrated Shield plan. Great Eastern probably has the best such plan right now. Second, there's a potential "sticker shock" problem. The insurance carrier has the right to deny coverage for any claims related to pre-existing medical conditions -- conditions that existed (and should have been reasonably known) any time during the first >60 years of their lives, up until their sign-ups. If they check into B1 ward, and if the insurer then denies the claim (due to a preexisting condition), they're stuck with a big medical bill that MediShield Life doesn't cover too well. And there's a big jump between B2 (or even B2+) and B1 ward charges. A B2/B2+ Integrated Shield plan is better coordinated with MediShield Life's ward classes. It can fill in some MediShield Life gaps financially, but it doesn't try to upgrade to a ward that might be financially risky given pre-existing medical condition exclusions.

Beyond that, they've already told you they're content with B2 or C wards. A stay in B2+ would be a bonus, but that's enough bonus. If they don't value B1 ward, then they shouldn't be paying for it. Instead, it's better to focus precious premium dollars on reducing financial risk, and that "Assist" rider seems reasonable in the circumstances.

It's also quite likely that we'll see some higher medical inflation in B1 ward versus B2, and that'll tend to push the B1 plan premiums up faster.

Hmm.. if at this point, to the best of their knowledge, they have a clean slate, would you still advice them to go for the GE plan instead? Hmm what you say does make sense...

Another question, does sticking with the lowest shield plan of NTUC income exclude them from this sticker shock?? And why the recommendation for the assist rider?

Thank you so much! You've been a great help! Are you an insurance broker? You seem very knowledgeable of the entire insurance market!

 

[swordsly]

They should be on ElderShield right?

My folks are also roughly in the same situation.
My insurance friend told me it's not worth it as premiums are costly for their age and also the presence of pre-existing issues being excluded.

Correct me if I am wrong, anyone.

 

[JuniorLion]

I would certainly get IP for my parents, regardless of age.

 

[BBCWatcher]

Hmm.. if at this point, to the best of their knowledge, they have a clean slate, would you still advice them to go for the GE plan instead?

Not if they're satisfied with B2+ ward or below, which is a perfectly reasonable attitude. It's insurance, not a spa indulgence.

If they want a higher level ward than B2+, different story.

Another question, does sticking with the lowest shield plan of NTUC income exclude them from this sticker shock?? And why the recommendation for the assist rider?

If the carrier denies the claim then they fall back to MediShield Life coverage levels. But they fall back from B2+ ward class or below (where they've checked in), so the "sticker shock" is hugely lessened.

The Assist Rider would cap their annual out-of-pocket costs for insurance-covered services, subject still to the per year annual coverage maximum ($150,000 for that C plan). I think that's a reasonable thing to do if they're concerned about wealth/retirement income preservation. Any Integrated Shield base plan has a deductible and co-pays.

Are you an insurance broker? You seem very knowledgeable of the entire insurance market!

Heck no.

 

[ilovetoeat]

Not if they're satisfied with B2+ ward or below, which is a perfectly reasonable attitude. It's insurance, not a spa indulgence.

If they want a higher level ward than B2+, different story.


If the carrier denies the claim then they fall back to MediShield Life coverage levels. But they fall back from B2+ ward class or below (where they've checked in), so the "sticker shock" is hugely lessened.

The Assist Rider would cap their annual out-of-pocket costs for insurance-covered services, subject still to the per year annual coverage maximum ($150,000 for that C plan). I think that's a reasonable thing to do if they're concerned about wealth/retirement income preservation. Any Integrated Shield base plan has a deductible and co-pays.


Heck no.

Ahh I see. So the whole idea behind the rider is to make it so that all they need to pay per annum is just the premium costs?

I will consider it... if without rider, wouldn't the deductible/ co-payment be capped regardless? Meaning at most that's the max you pay per year.

My concern here is premium with rider vs co payment/ deductible. They are not so willing to spend so much on insurance, more so explaining the idea of a rider to them.

 

[BBCWatcher]

Ahh I see. So the whole idea behind the rider is to make it so that all they need to pay per annum is just the premium costs?

No, not quite. The Assist Rider is designed to cap their annual costs (for covered/insured services, and assuming no pre-existing condition exclusion on the claim). The Assist Rider does not drop their annual costs for hospitalization to zero. That would not be a prudent thing to do since one dollar, or even one thousand, is not devastating, especially when they have fairly good Medisave balances. Insurance is for defending against risks that the policyholder cannot reasonably defend against him/herself. A $1,500 medical bill (partially or largely Medisave payable) is not a calamity. A bigger bill might be, and that's what the Assist Rider tries to solve, to cap the bill pretty firmly.

Anyway, I think Plan C+Assist is a better insurance value for them, in their situation, than a "naked" B1 plan. It's not what I personally do. I'm different. I'm OK with uncapped co-pays. I can defend against that financial risk. I wouldn't be happy about that -- who's happy with even one dollar of medical bills? -- but it's a reasonable approach for my different insurance needs.

I will consider it... if without rider, wouldn't the deductible/ co-payment be capped regardless? Meaning at most that's the max you pay per year.

No. Co-pays are unlimited when you only have the base plan. You always pay at least 10%. Some of that 10% might be Medisave payable.

Note that it is possible to drop the rider in the future, or (hypothetically) to downgrade to a less generous rider if the insurance carrier offers one in the future. In fact, as they get older (and nearer expiration, as it were), and if their Medisave balances and other savings are holding up well, it could be reasonable and logical to drop the rider completely. But if you're going to cap annual out-of-pocket costs with a rider, it's probably best to do it earlier rather than later, including for pre-existing medical condition reasons again.

I don't recommend going past/above the Assist Rider. That'd be "too much."

 

[ilovetoeat]

No, not quite. The Assist Rider is designed to cap their annual costs (for covered/insured services, and assuming no pre-existing condition exclusion on the claim). The Assist Rider does not drop their annual costs for hospitalization to zero. That would not be a prudent thing to do since one dollar, or even one thousand, is not devastating, especially when they have fairly good Medisave balances. Insurance is for defending against risks that the policyholder cannot reasonably defend against him/herself. A $1,500 medical bill (partially or largely Medisave payable) is not a calamity. A bigger bill might be, and that's what the Assist Rider tries to solve, to cap the bill pretty firmly.

Anyway, I think Plan C+Assist is a better insurance value for them, in their situation, than a "naked" B1 plan. It's not what I personally do. I'm different. I'm OK with uncapped co-pays. I can defend against that financial risk. I wouldn't be happy about that -- who's happy with even one dollar of medical bills? -- but it's a reasonable approach for my different insurance needs.


No. Co-pays are unlimited when you only have the base plan. You always pay at least 10%. Some of that 10% might be Medisave payable.

Note that it is possible to drop the rider in the future, or (hypothetically) to downgrade to a less generous rider if the insurance carrier offers one in the future. In fact, as they get older (and nearer expiration, as it were), and if their Medisave balances and other savings are holding up well, it could be reasonable and logical to drop the rider completely. But if you're going to cap annual out-of-pocket costs with a rider, it's probably best to do it earlier rather than later, including for pre-existing medical condition reasons again.

I don't recommend going past/above the Assist Rider. That'd be "too much."

Thank you so much BBCwatcher, you've been more than a great help! Really appreciate your inputs. I think I might proceed with your recommendation since that was what I had in mind right from the beginning. Cheers. It's definitely not an ideal situation and its a pity that I only know of IP when my parents were much older. At least for now, I want to do something for them to cover against gigantic medical costs.