Keeping Private Medical Bills Affordable & How to Estimate Your Out-of-Pocket Costs

This post was written in collaboration with IHH Healthcare Singapore. While we are financially compensated by them, we nonetheless strive to maintain our editorial integrity and review products with the same objective lens. We are committed to providing the best recommendations and advice in order for you to make personal financial decisions with confidence. You can view our Editorial Guidelines here.

Medical costs are typically thought of as expensive, especially when it involves hospitalisation, long-term care and surgery for major conditions.

Choosing government-subsidised public healthcare seems to be the most obvious choice, especially since the standard of healthcare in Singapore is pretty up there — so why do many still opt for private hospitals and how can they afford it?

You see, with everything, it’s always a tussle between opting for the most cost-effective option but sacrificing creature comforts such as privacy, waiting time and so on. While public hospitals can provide basic healthcare, non-tangibles such as the “premium” service at private hospitals can make all the difference.

Some examples:

Waiting to get an appointment slot, or getting to see a specialist within the next day and surgery within 48 hours
Would you rather choose your doctor, or just have anyone attend to you?
What kind of environment would you want to recover in? A big room with 7 other patients or to have your own air-conditioned room to yourself so you can recuperate in peace and quiet?

Especially for those who want to beat an illness and get back to normal life ASAP, the ability to choose an experienced doctor and seek treatment soonest can definitely help.

What does your coverage look like?

In Singapore, we have these main hospital-related insurance plans:

There’s MediShield Life, a basic health insurance plan that is administered by the Central Provident Fund (CPF) Board. MediShield Life helps to pay for large hospital bills and selected costly outpatient treatments, such as chemotherapy for cancer and dialysis. All Singapore Citizens and Permanent Residents are covered for life, including those who have pre-existing conditions. The coverage by MediShield Life depends on the type of hospital and ward you are in (favours B2/C-types wards; those in A/B1 or in a private hospital will receive lower coverage).

Another government scheme is MediSave, in which a certain amount of money is set aside from your salary each month in your CPF account. These savings can be used to pay for surgery, hospitalisation, health screenings, medical insurance and more, for both yourself and your family members. Hence, what is not covered by MediShield Life could be further topped up with your MediSave before you need to use cash.

Going back to MediShield Life, this can be combined with an Integrated Shield Plan (IP) bought through a private insurer. This means that out of the covered amount, a portion (depending which hospital/ward you’re in) comes from MediShield Life and the remainder is covered by the insurer (according to the plan purchased). Just so you know, IPs in Singapore are not allowed to cover 100% of your entire hospital bill, you’ll need to pay a lump-sum deductible and the co-insurance/co-payment portion. IP premiums can be paid for using your MediSave monies (this also applies to your MediSave Life premiums).

Finally, you have IP Riders. These are added on to your Integrated Shield Plan IP riders and typically focus on reducing the deductible and the co-insurance/co-payment portion of your hospital bill. The aim is to keep your out-of-pocket costs aka cash as low as possible. Depending on your insurer, some riders may offer extra benefits, such as hospital cash benefits, medical coverage and even ambulance rides. Unfortunately, the premiums for IP Riders can only be paid with cash.

Sounds straightforward, but we still have concerns, for example:

How are the above plans actually applied in a real-world situation? When facing an urgent medical condition, not having an idea of the costs involved can add to uncertainty, fear and other worries.
Having an IP Rider is an out-of-pocket cost. Couple this with the 2018 ruling of mandatory 5% co-payment for new policies issued (the old plan with IP riders was able to cover 100% of the co-payment amounts) and you’re probably wondering what’s the point of having the IP Rider anyway? Also, should you just do away with IPs altogether and rely solely on MediShield Life/MediSave, or downgrade your private hospital plan?

But wait! Let’s not be hasty and look at some costs first before we make a decision — once you downgrade or cancel, should you suddenly change your minds, it can be irreversible or even costlier to get back the same amount of coverage (we’d advise you to have a lengthy discussion with your agent on this).

How much would you actually pay with an Integrated Shield Plan?

As the cost differs according to the type of medical procedure involved, we’ll use 5 common procedures as examples.

Estimated out-of-pocket costs for 5 common procedures at a private hospital in Singapore

Procedure
Without IP
With IP, no rider
With IP and Co-Pay Rider (5% Co-Payment)#

Removal of breast lump (day surgery)
$6,615
$3,811.50
$330.75

Colonoscopy (diagnostic) with polyp removal; with 2 days’ stay
$6,799
$3,829.90
$339.95

Cataract surgery (day surgery)
$9,362
$4,086.20
$468.10

Heart angioplasty with stenting (1 vessel); with 2 days’ stay
$36,045
$6,754.50
$1,802.25

Knee replacement surgery (one side); with 5 days’ stay
$40,897
$7,239.70
$2,044.85

Source: Mount Elizabeth Hospital

Disclaimers

The out-of-pocket estimates provided are based on existing insurance policy information as of 1 April 2021, with pre-authorisation from your insurer. We recommend that you contact your insurer
to request for pre-approval of your medical bill before hospitalisation or surgery.
The estimated bill and average length of stay are calculated based on historical data and serves only as guide. The bill size will differ depending on the severity of condition and other factors. 
IHH Healthcare disclaims any and all liability, attributed to the use of this bill estimator
Estimated bill is taken at the 50th percentile (which means that 50% of the patients are charged below the amount).

#Note: All riders sold from March 8 2018 have a co-payment element of at least 5% of the hospital bill. Most insurers are also be transiting full riders to co-pay riders from April 2021 so upon your renewal of your rider plan this year, you will be subject to a 5% co-payment. We’d advise you to speak to your agent to find out more. 

You may be wondering how much does this 5% account to? The total amount a policyholder has to pay can be capped at $3,000 a year. The cap is contingent on (1) policyholders being treated by doctors on the insurer’s panel, or (2) policyholders having had pre-authorisation from the insurer to seek treatment from doctors not on the panel.

You can also reduce this 5% out-of-pocket costs by using your corporate insurance (if you have) and Medisave (subject to claim limits) to offset the amount.

If you’ve done your sums and getting an IP with an IP Rider seems to make perfect sense to you, another cost to consider is the price of these IP and IP Rider premiums. Here’s another table of ballpark figures for you to peruse:

Integrated Shield comparison 2021: Private hospital IPs & IP Riders

Insurer
Annual premium*(payable by Medisave)
Rider premium*
Annual claim limit

AIA
$610
$459
$2 million (panel doctors)

Aviva
$710
$912
$2 million (panel doctors)

AXA
$596
$312
$1 million

Great Eastern
$596
$415
$1.5 million

NTUC Income
$685
$632
$1.5 million

Prudential
$627
$502
$1.2 million

*For Singapore citizens aged 35

Source

Note: These are just estimated figures. Some insurers’ premiums may increase over time. Do check directly with your insurer for the updated and accurate figures for your individual premium.

Benefits of seeking treatment at IHH SG private hospitals

In addition to the useful hospital bill estimator tool, there are also other helpful cost and financing resources.

For example, on the Mount Elizabeth Hospital website, you can also get a good look at hospital room rates for greater transparency, including day rates, nursery rates, the intensive care unit and all available room types.

There’s even a guide to using your insurance to pay hospital bills, and helpful tips to learn more about the integrated shield plans and achieve minimal bills. 

Parkway Insurance Concierge

At IHH SG hospitals, patients can also seek help through the recently launched Parkway Insurance Concierge via WhatsApp or Call @ 9834 0999. The platform serves to answer queries related to the coverage of patients’ insurance plans, panel doctors, estimated out-of-pocket costs, and can help patients make an appointment. Summary of services:

No third party fees
Appointments booked within 45 minutes
Referral to relevant senior specialists 
Panel doctors
24-hour service

Getting an Integrated Shield Plan is quick and easy

Don’t yet have an Integrated Shield Plan? You can check out the individual insurers’ websites and plans, or visit our MoneySmart Health Insurance Plans page for a consolidated view for easier comparison of benefits and cost of premiums.

With adequate insurance coverage, you can get the best treatment money can buy but won’t need to pay sky-high bills. Private hospitals are actually affordable with the right Integrated Shield Plan and IP Rider — an out-of-pocket fee of $500 is comparable to a one-night luxury hotel staycation, a round-trip plane ticket to Hong Kong, or an omakase meal for 2. Why not use this $500 for peace of mind in a private hospital instead of spending months feeling stressed and worried?

Not sure if you have an Integrated Shield plan and/or IP Rider? Do check with your insurance agent on the coverage you have to estimate your hospital bills more accurately.

Find out how affordable private healthcare can be via Gleneagles Hospital, Mount Elizabeth Hospital, Mount Elizabeth Novena Hospital, and Parkway East Hospital bill estimators or via the Parkway Insurance Concierge hotline at 9834 0999 (call/WhatsApp). Know your options.