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Integrated Shield Plan does not cover certain types of treatments
21 Apr 2022 (304 views)  

Mr. Tan,
Can I have your comments about the decision of the insurer to reject certain types of treatment under an integrated Shield plan? See this report

Is this fair, as the consumers has to pay a much higher premium to be covered under an integrated plan?

Reply
It is necessary for the insurer to define what are covered and what are excluded under the integrated plan.

Some treatments may be very expensive and their efficacy may not be proven. The policy conditions have probably stated that the drug and treatment must be approved by the relevant government agency.

If the insurer does not apply this restriction, the insurance claims can escalate beyond control. Already, the premium under an integrated plan is much higher than a basic plan. If there is no control over the treatment cost, it can increase further.

The integrated plan is more expensive than a basic plan because it provides a wider range of hospital wards and the ability to choose the doctors to take care of the treatment. It does not provide access to expensive treatments that are not approved by the authority or the insurer.

The patient may get proper care under a basic plan, if they are willing to be treated in a subsidized ward and do not insist of selecting the doctor for treatment. The premium for a basic plan is much lower than for an integrated plan.

I suggest that older people should opt to be covered under a basic plan, if they find the premium under an integrated plan to be too expensive. They will receive adequate care under a basic plan anyway.

Tan Kin Lian


Integrated Shield Plan does not cover certain types of treatments
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Mr. Tan,
Can I have your comments about the decision of the insurer to reject certain types of treatment under an integrated Shield plan? See this report

Is this fair, as the consumers has to pay a much higher premium to be covered under an integrated plan?

Reply
It is necessary for the insurer to define what are covered and what are excluded under the integrated plan.

Some treatments may be very expensive and their efficacy may not be proven. The policy conditions have probably stated that the drug and treatment must be approved by the relevant government agency.

If the insurer does not apply this restriction, the insurance claims can escalate beyond control. Already, the premium under an integrated plan is much higher than a basic plan. If there is no control over the treatment cost, it can increase further.

The integrated plan is more expensive than a basic plan because it provides a wider range of hospital wards and the ability to choose the doctors to take care of the treatment. It does not provide access to expensive treatments that are not approved by the authority or the insurer.

The patient may get proper care under a basic plan, if they are willing to be treated in a subsidized ward and do not insist of selecting the doctor for treatment. The premium for a basic plan is much lower than for an integrated plan.

I suggest that older people should opt to be covered under a basic plan, if they find the premium under an integrated plan to be too expensive. They will receive adequate care under a basic plan anyway.

Tan Kin Lian