Friday, 15 May 2015

Health Insurance – Are you fully protected?

We can all agree that health insurance is a pretty important part of life. More-so as we grow older. A great deal of people rely on their employer to provide some type of health insurance in their employment benefit package, but is that insurance always enough? 



There is a wide range of plans available and sometimes employers may just want to select the most affordable for their budget. Being affordable is fine but this may leave an employee open to rude surprises at claim time. Some common pitfalls to look out for:


Plans restricting treatments to certain facilities

Some insurance plans may restrict you to only receiving hospital treatment in a Singapore facility at one of the following: Alexandra Hospital, Changi General Hospital, Khoo Teck Puat Hospital, KK Women & Children's Hospital, National University Hospital, Singapore General Hospital, Tan Tock Seng Hospital as well as these specialist centres: Institute of Mental Health a.k.a. Woodbridge Hospital, National Cancer Centre, National Heart Centre, National Skin Centre and National Eye Centre. It is worth noting that the National Eye Centre also operates a clinic in the private hospital called Gleneagles Hospital but this would not be treated the same way by the insurer as far as a potential claim.

Make sure you read the small prints - it's essential when it comes to insurance

Some insurance plans will contain a surgical schedule. For example, although an insurance policy will say the overall limit is SGD 200,000 for Hospital and Surgical procedures, in the small print it may say 'Subject to Surgical Schedule' and to understand that one must get out the policy wordings and start reading. The surgical schedule will lay out a certain percentage from the overall limit that will be paid out for specific procedures. The policy might indicate that it will pay 100% for a Thoracic Aortic Aneurysm (meaning an abnormal widening of the body's largest artery passing through the chest) but will only pay up to 70% on a Nasal Rhinoplasty.

What happens to my childs insurance after they turn 16?
Some insurance plans impose age restrictions. This should be of special interest to the Expat raising children in Singapore. After the child turns 17, 18 or 19, each insurer handles this differently, they may not be considered a "Dependent" and continue to receive coverage unless they meet specific criteria. Typically an insurer will allow the child to remain a covered dependent if they are not working full time and are enrolled in a full time educational program. If a dependent should marry in their early adult hood that may also be a factor the insurer uses to exclude your child from being an insured dependent. If your child is a full time student and unmarried one should be able to expect coverage as a Dependent to continue until age 25. Always check with the insurer as there may be some variance in the industry on the maximum age a Dependent is defined as.

Some insurance companies will restrict the type of treatment received in a Hospital emergency room, also known as the "A&E." I have come across medical policies that have specified any non physical accident will not be claimable. In other words if I am in a car crash and am admitted to the emergency room I can expect to claim because I was involved in a physical violent accident. If I have a case of food poisoning, provided I am not admitted as an Inpatient and only seen by the staff in the emergency room and then sent home, this would not be claimable.

Do you have any portability cause?

I believe the biggest problem insurance wise facing the Expat and their family is the loss of insurance coverage if the Expat becomes unemployed. There is a chance the insurance coverage the employer has extended contains a portability clause but don't assume this to be a fact without reading the policy wordings and asking the insurer. This is particularly helpful in keeping coverage consistent for you and your family. It's also very good to have if you have developed conditions during the time you were covered by your employer's plan because those conditions are now going to be viewed as "Pre Existing Conditions" by any new insurer you approach for coverage and most likely the condition will not be covered should it reoccur under a new insurer. Depending on how serious the condition is it could even prevent you from getting a new insurance plan. A portability clause in your employer's plan usually must be acted upon within 30 days of leaving employment.



The rational for Top-Up Health Insurance


We live in uncertain economic times with many global changes taking place therefore even if you have health insurance today through your employer do you really want to rely on it solely? 

If you are an Expat from locations such as the UK, Europe, Australia or the USA you should consider getting a personal health insurance plan through an International Insurer and ask specifically if the plan taken will be convertible to your new residence should you leave Singapore and move back to your home country. 

To help defray the costs on premium look into plans that have a Deductible. The higher the deductible the lower the premium will be. I would then recommend not using your personal plan unless absolutely necessary. Always make your medical claims under the plan your employer provides because it is there as your employment benefit and there is no reason to build a claim history on your personal plan if you don't have to. Claim on the plan that you stand a chance of losing if your employment changes. You can always go back to the insurer later and request a change in the Deductible.

Another idea to explore is Hospital Cash plans. The idea behind these plans is that they will pay you in the event of hospitalisation. The hospital cash or income plans pay out a certain dollar amount for every day you are in the hospital, therefore you receive some money even when you are confined to a hospital. Some of these plans may pay more if you are hospitalised in an I.C.U. These plans are separate from medical insurance plans in the sense that they are not designed for you to claim the costs of treatment received in the hospital but only to provide you with income while you are hospitalised.


An International Protection Group Consultant is happy to review your current health insurance and provide a fee free protection review. Let's explore your options today. Please drop us a line at: quoteme@ipg.sg or alternatively complete our quick form by clicking here.

An American Expat's View of Singapore Health Care and the Recent "ObamaCare" changes at home

How up to date are you with the health care back in America? This article outlines the noticable differences between the US & Singapore to bring you up to speed. Enjoy reading!



Most of my life I did not pay attention to healthcare matters in America. At an early age I landed a job within Citibank in the mortgage division. I was given an excellent health insurance plan which I rarely used. Because of my age, healthy status and being an avid gym member for much of my life I didn’t find myself needing to deal with healthcare. I had a major surgery to remove a binomial tumour in 2003. My insurance through the employer paid for it all.

The noticable differences between America and Singapore

Upon moving to Singapore the first big difference I noticed between American & Singapore health care is in Doctor visits. A lot of people in Singapore get sick and go to the doctor automatically for something like common cold, flu. The doctor typically gives anti-biotics. In America the citizens don’t generally do that. I don’t know anyone who goes to the doctor for a flu or cold, unless it's something really bad that goes on for days. We go to our neighbourhood drug store and buy over the counter medicines without a prescription. I’ve been to the doctor a few times in Singapore but only because that's the culture here. If I am sick, apparently everyone wants a doctor’s note to prove it. In America that doesn’t happen, you call in sick, you come back when you are better in 2 or 3 days. No one ever asks for a doctor note. The couple times I’ve had a flu here in Singapore, if I had been back home I just would’ve bought flu medicine from a drug store and stayed in bed. This is one noticeable difference between healthcare in USA and in Singapore.

Healthcare in America has undergone a big change. Until now healthcare in America is something you get from your employer. It’s a common benefit at most companies. We’ve had little intervention in health matters from the government, at least in my humble opinion. A plan similar to what President Obama has signed into law in 2010 was first attempted by President Nixon in 1974 but his plan was never passed. President Clinton had some healthcare reform ideas that went mostly nowhere in the 90’s. One healthcare change that did occur in 1985 under President Reagan was COBRA.

COBRA stood for Consolidated Omnibus Budget Reconciliation Act and what it did was make mandatory insurance coverage for people leaving employment. COBRA imposed an excise tax on employers whose health plan failed to allow its employees to keep their coverage for designated time frame after leaving employment. When I was downsized 10 years ago I had the option of keeping coverage for up to 18 months. However, many people can’t afford the premium after they lose their job so a lot of Americans don’t take advantage of the act. The act that President Obama signed includes a 65% subsidy for employees who are terminated for COBRA enabled insurance for up to 15 months. To qualify the employee’s termination has to be involuntary & they are in no other health insurance program.

The health insurance portability & accountability act, also known as HIPAA became law in 1996 under President Clinton. HIPPA requires the establishment of national standards for electronic health care transactions and national identifiers for providers, health insurance plans, and employers. It’s intended to help people keep their information private. Another goal of this plan was to prevent fraud.

Here is some of what the recent healthcare reform signed into law will do, known as "ObamaCare":

  • Insurance companies are no longer going to be able to drop people when they get sick. 
  • Insurance companies are barred from not covering children for pre existing conditions. 
  • Young adults can stay on their parents plan till age 26. Most plans currently drop them at age 19 or whenever they finish college. 
  • A tax credit is now available for small business to provide healthcare to their workers. 
  • Medicare, a current govt. program will provide 10% bonus payments to physicians and general surgeons 
  • Medicaid which is directed at people in poverty category will undergo a change. A new program under the Medicaid plan for the poor allows states to offer home and community based care for the disabled that might otherwise require institutional care. 
  • The Centers for Medicare and Medicaid Services, which oversees the government programs, begin tracking hospital readmission rates and puts in place financial incentives to reduce preventable readmissions. 
  • Medicare beneficiaries will be able to get a free annual wellness visit and personalized prevention plan service. New health plans will be required to cover preventive services with little or no cost to patients. 
  • All insurers are fully prohibited from discriminating against or charging higher rates for any individuals based on pre-existing medical conditions. 
  • All insurers are fully prohibited from establishing annual spending caps. 
  • Expand Medicaid eligibility; Individuals with income up to 133% of the poverty line qualify for coverage. 
  • Everyone is required to purchase health insurance much like we are required to purchase car insurance. 


How Singapore's system differs...


By contrast, Singapore’s health care system seems to me, to place shared responsibility between the citizen, the employer and the government to make healthcare affordable for all. According to WHO (World Health Organization) Singapore has the world’s highest life expectancy rate and the lowest infant mortality rate. It should be noted however that Singapore is a small country with approximately 3.8 million residents. The rest of Singapore's 5 and a half million population is made up of foreign workers. Singapore has set up Medisave in which a portion of a Singaporean’s income is diverted into an account that is specifically established for healthcare matters. Medisave can be used for hospitalization, day surgery and certain outpatient expenses. Singaporeans can choose between 13 private hospitals or 10 public/government hospitals. This Medisave program is also available to Permanent Residents of Singapore.

If you are a foreign worker in Singapore, depending on your type of employment you will either have (A) medical insurance for up to SGD 15,000 hospitalisation expenses extended to you by your employer or (B) you can buy your own private plan or (C) you have some type of insurance extended to you through an Employment Benefit package.

Something I very much like about living in Singapore is that the doctors here charge less. A typical general practitioner doctor visit with medication has never cost me more than $40.00. In America it’s probably double that to visit the doctor.

10 Questions ...you should be asking yourself as an expatriate


Expatriates often ask us if their insurance policies provide them with enough to cover?

These are our top ten questions that we believe you should be asking to assess whether you are protected before the unexpected happens! 
  1. Do I/we have an adequate cash cushion to cover my/our monthly outgoings during any periods of temporary unemployment/redundancy or to cover other unexpected financial emergencies? 
  2. Do I/we have a suitable health policy that will fully cover any potential medical costs that may arise as a result of an illness, accident or a pregnancy whilst living in Singapore and/or in the event of a future international move? 
  3. If I/we have an existing comprehensive health policy, is the policy transferable in the event that I/we change companies in order to maintain the coverage of medical conditions. 
  4. Do I/we have belongings in our home that we should insure in the event of a mishap, accident or loss? 
  5. In the event that I or my spouse/partner cannot work due to long term sickness or injury, how long will my/their employer continue to pay a full salary and is this something I/we should insure for? 
  6. In the event of my/our death, what happens to our children if my/our appointed guardians live overseas,or in the event that no Will exists? 
  7. Do I/we have adequate assets and life insurance that will adequately provide for the on-going lifestyle costs of my family inclusive of any education fees, a family home, and income in the event of my death or the death of my spouse/partner? 
  8. What would be the financial implications of becoming disabled or suffering a critical illness to me and/or my family? 
  9. If I/we have any existing policies from our home country or another country will these continue to provide us coverage now that we have moved? 
  10. What plans do I/we have in place to achieve our life goals whatever they may be including buying a property, funding education fees and someday having the option to retire?
If any of these questions raise concerns for you please visit us on our website at www.ipg.sg