What is MediShield Life, and why are claim limits and premiums going up?

MEDISHIELD Life, introduced in 2015, is Singapore’s national health insurance scheme.

It provides universal, lifelong coverage to help citizens and permanent residents manage large hospital bills and selected outpatient treatments.

Unlike private insurance, MediShield Life covers all Singaporeans – regardless of pre-existing conditions.

From April 2025, claim limits and premiums will rise, with the government providing S$4.1 billion in subsidies and MediSave top-ups over the next three years to help Singaporeans manage the increased costs.

These support measures are expected to fully offset premium increases for more than 90 per cent of Singaporeans during this period.

What are the changes to claim limits?

• The policy year claim limit will increase from S$150,000 to S$200,000 to provide greater protection for patients facing exceptionally high medical bills.
• Daily claim limits for normal ward stays for the first two days will rise from S$1,000 to S$1,630, while limits for intensive care unit stays will more than double, from S$2,200 to S$5,140 per day.
• Claim limits for outpatient treatments such as kidney dialysis will also be raised, increasing from S$1,100 to S$1,750 per month.
• For the first time, cell, tissue and gene therapy products (CTGTPs) will be covered under MediShield Life, allowing patients access to these advanced therapies.

What are the changes to deductibles and proration?

• The inpatient deductible for ward C stays will increase by up to S$1,500, phased in over two stages – April 2025 and April 2027.
• A new annual outpatient deductible of S$500 will also be introduced in January 2026.
• The proration factor will be revised downwards, although there will be some exceptions, meaning policyholders opting for private care will generally have to pay more.

Deductibles represent the amount a patient must pay before MediShield Life begins covering medical costs. These changes are intended to focus MediShield Life payouts on larger bills, allowing smaller, more affordable expenses to be covered by MediSave.

The proration factor, meanwhile, adjusts claims from unsubsidised treatments, such as those in private hospitals or A/B1 wards in public hospitals, to the equivalent cost level of subsidised care.

This ensures that policyholders receive comparable payouts, regardless of their choice of hospital or ward.

What are CTGTPs, and why are they important for coverage?

CTGTPs are advanced medical treatments derived from human or animal cells, tissues, or synthetic genetic material.

These therapies are used to diagnose, treat, or prevent conditions such as cancer and genetic disorders. Often administered as one-off treatments, CTGTPs have shown significant promise in treating various cancers and rare diseases.

However, their high cost makes them inaccessible to most patients without financial support.

Starting in October 2025, MediShield Life and MediSave will begin covering CTGTPs listed by the Health Ministry.

Currently, the only treatment on the list is tisagenlecleucel, marketed under the brand name Kymriah, with more expected to be added over time.

MediShield Life and MediSave limits will initially cover two in three subsidised patients for these costly treatments.

Why are claim limits and premiums increasing?

Rising healthcare costs have made the current MediShield Life claim limits inadequate.

Between 2020 and 2023, MediShield Life payouts grew by 9.8 per cent annually, while the average payout per claim increased by 3.4 per cent per year.

Initially designed to cover nine in 10 subsidised healthcare bills, the scheme now fully covers just under eight in 10 due to escalating medical expenses.

To restore full coverage and ensure Singaporeans are adequately protected, claim limits need to be increased. In parallel, premiums must rise to support these higher payouts.

Who pays for MediShield Life?

MediShield Life premiums are paid by all Singaporean citizens and permanent residents.

These premiums are typically covered through MediSave, the mandatory health savings account under the Central Provident Fund (CPF) system.

As at Dec 31, 2023, the MediShield Life Fund held S$14.2 billion in assets, based on CPF’s financial statements.

For those who need additional assistance, the government offers various subsidies, particularly for lower and middle-income households, as well as seniors from the Pioneer and Merdeka generations.

Additional premium support is available for individuals with limited MediSave balances, ensuring that no one is denied coverage due to inability to pay.

When was the last review?

MediShield Life is typically reviewed every three years to ensure the scheme remains sustainable and responsive to healthcare needs.

However, the current review was delayed due to the Covid-19 pandemic.

The previous review in 2020 led to an average premium increase of 25 per cent.

The latest review, conducted by the 11-member MediShield Life Council, is chaired by former nominated member of parliament Fang Ai Lian, who also led the 2020 review.