Having addressed the healthcare financing system in Singapore, Singaporeans would still want to know the answer to the question –  who pays their medical bills? The straight answer to this is “whether it is the government, Medisave, employers, or insurance, it is ultimately Singaporeans themselves who must bear the burden”. – August 2005, vol. 34 No. 7, page 462, Annuls Academy of Medicine. This situation forms the backdrop of healthcare financing for Singaporeans and thus affects how and to what extent each person should be covered for medical insurance.

The challenge:

“I am already covered by my company, why should I need to buy additional medical insurance ?” The majority of Singaporeans are employed and thus enjoy some form of medical insurance coverage provided by their employers. As such, many Singaporeans have the mistaken impression that if their employers have provided hospitalisation and surgical coverage for them, they consider themselves to be ‘comprehensively’ and ‘fully’ covered, so they do not bother to look at any other medical coverage.

This impression is potentially hazardous as employee hospitalisation and surgical insurance in reality does not provide long term coverage and thus cannot be the foundation of a person’s medical insurance portfolio. Relying on employee medical insurance alone also carries these disadvantages:

Disadvantages:

1. Changing jobs leads to the giving up of medical insurance from the previous employer and the enrolment in the new employer’s insurance scheme. The medical insurer will therefore change accordingly.
   • This inevitably raises the question of whether the person’s health and medical history at the point of changeover could still qualify him/her to be insured at ‘standard’ rates, and at the same terms and conditions. Thus, job moves do create uncertainty in a person’s medical insurance and subject his/her healthcare financing to risk.
2. Employers who manage their health insurance cost would normally accept certain limitations to the policy terms and conditions. They could be in many forms, including sub-limits, deductible and co-insurance.
   • Every employee has to be aware of these limits, but in reality, many employees take them for granted by assuming that their employee health insurance covers everything.
3. Furthermore, as some health policies are incepted without the need to declare medical history, they would automatically exclude all pre-existing illnesses or medical conditions at inception and typically for the 12 months thereafter.
   • This would be detrimental to the employee if he/she has sought medical advice or treatment for any major medical condition before policy inception.
4. Like most private medical insurance, employee health insurance does not insure a person until the ripe old age of 100, thus exposing him/her to financing risk when they need it most during their golden years.
5. Each insurer’s medical plan, coverage and terms and conditions of coverage can be quite different. As a result, each time a person changes employment – and thus their health insurer – he/she has to re-analyse the new insurer’s scope and extent of coverage to see if they still adequately supplement his/her personal medical plans. Owing to the tedious nature of this task, employees usually do away with it, erroneously assuming that their coverage is the same as before.

See full story at www.healthxchange.com.sg