Hospitalisation Insurance In Singapore: The Essentials
If you are searching for reliable information on hospitalisation insurance Singapore, you are not alone. With recent announcements from an insurer about the decision to stop issuing pre-authorisation certificates for a few major hospitals in Singapore, many patients are left confused about their insurance coverage really works. This guide will clarify how hospitalisation and health insurance, panel doctors, pre-authorisation, and Letters Of Guarantees (LOG) fit together, and what you need to know before your next hospital visit.
The Structure Of Hospitalisation Insurance In Singapore
Singapore’s healthcare financing system combines government schemes with private insurance coverage:
- MediShield Life: A compulsory basic health insurance for all Singaporeans and Permanent Residents. It covers large hospital bills and select costly outpatient treatments in public hospitals.
- Integrated Shield Plans (IPs): Private insurance plans that supplement MediShield Life, offering additional coverage for private hospitals, Class A/B1 wards in public hospitals, and more flexibility in choosing your doctor.
- Rider Plans: Optional add-ons to IPs that can reduce or eliminate deductibles and co-insurance. Many rider plans require the use of panel doctors and pre-authorisation for full benefits, including LOG eligibility.
What Are Panel Doctors?
Panel doctors are specialists who have agreements with insurance companies to provide medical care at pre-approved rates. Choosing a panel doctor offers several benefits:
- Lower Medical Bills: Panel doctors charge within insurer-approved fee ranges, reducing total costs.
- Reduced Co-Payments: Out-of-pocket expenses are often significantly lower.
- Direct Billing: The insurer can pay the hospital or doctor directly, reducing your paperwork and upfront payments.
- Eligibility For LOGs And Riders: Using a panel doctor often satisfies conditions required by rider plans, allowing cashless admissions and full reimbursement.
What Is A Pre-Authorisation Certificate
A pre-authorisation certificate is a prior approval by an insurer of eligible medical expenses arising from the treatment the patient intends to undergo. This means:
- The treatment must be reviewed and approved before admission.
- The insurer will assess the necessity, estimated cost, and may affect eligibility for LOG coverage.
Pre-authorisation does not eliminate co-payment obligations, nor does it cover non-claimable items.
Failing to get a pre-authorisation certificate may lead to rejection of the LOG or reduced reimbursement, even if the doctor is an insurance panel doctor.
What Are Letters Of Guarantee
A Letter of Guarantee (LOG) is a document issued by the hospital, waiving fully or partially the need for the patient to pay an upfront deposit for the treatment (subject to maximum caps). LOGs however, do not guarantee payment of the insurance claim.
Recent Changes: Pre-Authorisation Certificates Issuance And Hospital Choice
One of the insurers in Singapore had recently announced that it had temporarily stop issuing pre-authorisation certificates for Mount Elizabeth and Mount Elizabeth Novena hospitals from 17 Jun 25. What happens if you do not have pre-authorisation due to this, or any other reason?
- If your insurer does not issue a pre-authorisation certificate for your chosen hospital, you must pay the deposit and bills upfront, even if your doctor is on the insurer’s panel.
- Pre-authorisation certificates are tied to the hospital, not the doctor. If the hospital is not approved, you cannot get a pre-authorisation certificate even with a panel doctor.
- You can still claim reimbursement after treatment, but it may involve more paperwork and waiting.
Non-issuance of a pre-authorisation certificates does not mean your bill is unclaimable. Be sure to keep all itemised bills and documents for post-treatment reimbursement.
Hospital Fees Vs. Doctor And Surgeon Fees
It is important to understand that hospital and doctor fees are billed separately:
- Hospital Fees: Charges for room and board, nursing, medication, equipment, and general hospital services.
- Doctor And Surgeon Fees: Charges for the professional services of your surgeon, anaesthetist, and attending doctors.
Insurance policies often have separate limits and claim processes for each category. Bills are itemised, and insurance may only cover hospital fees up to a certain amount.
Hospitalisation Insurance In Singapore – How Does It All Fit Together?
Navigating hospital insurance in Singapore involves multiple moving parts. Here’s how everything works together:
- Choose Your Hospital And Doctor Wisely: For full benefits, choose both a panel doctor and a panel hospital.
- Check LOG And Pre-Authorisation Requirements: Always confirm whether a LOG can be issued and if pre-authorisation is needed for your specific procedure.
- Consider Rider Coverage: If you have a rider plan, using a panel doctor and getting pre-authorisation may grant you cashless admission with minimal or no co-payment.
- Admission And Billing: With a pre-authorisation certificate, your insurer pays the hospital directly. Without it, you must pay upfront and claim reimbursement later.
- Claims And Documentation: Ensure you understand how your insurance splits between hospital and professional fees, and keep all receipts and discharge summaries for claims.
Our Preferred Financial Consultant
If you are looking for a financial consultant in Singapore to help with your health and hospitalisation insurance, or financial planning, you can consider:
Key Takeaways For Patients
- Always check whether your hospital and doctor are both on your insurer’s panel.
- Confirm LOG eligibility and pre-authorisation needs before admission.
- Having a rider plan doesn’t guarantee cashless service. It may depend on panel use and pre-approval.
- Even if a LOG isn’t issued, your bills may still be claimable, so retain all supporting documents.
- Understand your policy’s separate coverage for hospital vs doctor/surgeon fees.
- Consult your insurer or a Financial Consultant to maximise your policy benefits.
Disclaimer: This article has been contributed by Health365. The article’s contents have no association or affiliation with its referral partners.
Stay informed and plan ahead to make the most of your hospital insurance in Singapore. If you have questions, reach out to a trusted Financial Consultant for professional advice.
Preferred Financial Consultant: Eljin Lee
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Disclaimer: 365Asia aims to provide accurate and up-to-date information, our contents do not constitute medical or any professional advice. If medical advice is required, please consult a licensed healthcare professional. Patient stories are for general reading. They are based on third-party information and have not been independently verified.