The healthcare system in Singapore
The philosophy of the Ministry of Health in Singapore is to provide quality and affordable medical services for all while promoting healthy living, as well as advocating preventive health programs. The structure of the health system is such that it strives to offer access to healthcare in a timely and cost-effective manner. The country is home to many private clinics, polyclinics, 14 public hospitals, as well as several specialized healthcare centers.
Even though this is the last thing we'd like you to experience, a visit to a public hospital would be no different from what you'd experience in a western hospital, if not better. In fact, wealthy people from all over Asia and beyond tend to congregate in Singapore to take advantage of the professionalism and quality of healthcare services.
The public healthcare system in Singapore consists of four main elements: MediSave, MediShield Life, MediFund, and ElderShield. On top of these services, many Singaporeans also elect to have supplemental private health insurance, and it's highly advisable that you check with your employers whether such provisions are present in your employment contract.
Workers and visitors who aren't classified as permanent residents don't benefit from subsidized access to healthcare, even though they pay similar levels of tax to the government. Although they're able to use primary facilities such as GPs and polyclinics, it's often difficult for newcomers to identify appropriate service providers. Inpatient services are also costly, and it's therefore important that foreigners ascertain that they have adequate insurance coverage while in Singapore.
MediSave
MediSave is a type of compulsory health coverage offered to employees in Singapore. It's intended to cover any personal or dependents' medical needs, as well as any healthcare you may need in your old age.
Employees contribute 8% to 10.5% of their monthly wages to a Medical Saving Account (MSA), which is subsequently used to finance any healthcare expenditure, minus any refunds carried out by the government. The contribution levels are based on age, and the maximum amount that can be saved within the fund is fixed. When the holders of the MSAs pass away, they can transfer the accounts to their heirs.
Here are the things you can use MediSave for.
Premium payments
If you or your approved dependents have health insurance payments, you can use MediSave to pay for these. In addition, you can fully cover MediShield Life, ElderShield, and CareShield Life premiums with MediSave. If you've got an Integrated Shield Plan or ElderShield Supplement payments, you can use MediSave to pay for these premiums (up to the withdrawal limits).
Inpatient care
If you or an approved dependent needs an inpatient procedure done, you can use MediSave. The amount you can claim is the total of your daily hospital charge limit and the surgical limit.
The daily hospital charge limit will apply if you need to stay in the hospital for at least eight hours. And the surgical limit will depend on the specific surgery you're getting; more specifically, its complexity.
Outpatient care
There are certain types of outpatient care you can use MediSave for. If you're with the MediSave500 or MediSave700 scheme, you can use up to S$700 per patient yearly if you have complex chronic conditions. The limit is S$500 for some other treatments, such as childhood and adult vaccinations, asthma treatments, and health screenings (like mammograms).
Long-term care
Should you need inpatient hospice palliative care, day rehabilitation, or home palliative and day hospice care, then you can use MediSave for these things. If you're severely disabled and over the age of 30, you can withdraw up to S$200 per month for long-term care.
For more information on any of the above public healthcare programs, check the MOH's website.
MediShield Life
MediShield is a compulsory health coverage system for all Singaporeans and permanent residents. Its goal is to finance expenditures associated with more serious diseases, heavy surgeries, or long-term treatments that wouldn't be covered by MediSave. This ensures that if you have large healthcare bills (which is rare, but can happen), you won't go bankrupt if you're seriously ill. More specifically, MediShield Life will pay for some expensive outpatient treatments, for example, if you need chemotherapy for cancer.
MediShield Life pools your payments together with others in a similar age group. That way, there are smaller premiums, especially for those who are in the lower to middle-income bracket. If you'd like additional coverage, then you can get the Standard Integrated Shield Plan.
If you don't have enough money in your MediSave account, or you don't have an account at all, then you can have family members help pay for your premiums. Otherwise, you can apply for Additional Premium Support.
You won't be arrested for not paying your premiums. However, the government says you can't leave Singapore unless you pay the amount, and if you try to leave anyway, you'll be arrested, so be aware of this.
MediFund
If you ever find yourself in trouble with medical bills, then don't worry too much. The government's set up MediFund for people who are in need; it's considered a safety net you can use if you still have medical expenses after using government subsidies and all other avenues, such as MediSave and MediShield Life. Within MediFund are two subcategories: MediFund Silver (for the elderly) and MediFund Junior (for the young).
Do note that MediFund is only applicable to Singapore citizens. You must also be a subsidized patient and receive/need treatment from a MediFund-approved institution. The amount you receive will depend on your personal financial situation, as well as your medical bill amount.
To apply for MediFund, you'll need to ask the medical social worker at the institution you visit.
ElderShield
ElderShield is an insurance scheme that's focused on critical disability during old age, which insures against the cost of private nursing homes and other related expenses. Introduced in 2002, it's a basic long-term insurance scheme that also provides cash payouts of up to S$400 a month, for up to 6 years. Prior to 2007, ElderShield only allowed for cash payouts of S$300 a month for up to 5 years.
Until 2019, MediSave account holders who were Singapore citizens or permanent residents were automatically enrolled in ElderShield when they turned 40. Of course, they had the choice to opt out if they wanted to.
However, as of 2020, the auto-enrollment of ElderShield stopped. For those turning 40 that year, or 30 (whichever was later), they were enrolled into CareShield Life instead.
CareShield Life
CareShield Life is a similar program to ElderShield in that it's intended as a long-term care insurance program. If you become severely disabled and need care for a long period, especially if you're a senior, then CareShield Life will cover you.
Just like with ElderShield, you'll be auto-enrolled, but you can opt out if you want.
Private health insurance in Singapore
Expats can also subscribe to private international health insurance before moving to Singapore. There are many insurance companies to choose from, according to your needs and budget.
Some of the leading health insurance providers are:
Consider having a look at their offers according to your needs and get a free quote on Expat.com's Health Insurance for Expatriates in Singapore page.
Healthcare for visitors to Singapore
Permanent residents of Singapore can register with MediSave, MediShield Life, MediShield Life Plus, or MediFund. The registration process needs to be done through the Central Provident Fund (CPF) board. Visitors who aren't permanent residents, workers under expatriate contracts, and students need to register for private insurance services. There are a number of excellent providers, including AON and AXA, but in general, your employer or institution of higher education should provide you with details of relevant insurers.
Public vs private healthcare
If you're having trouble deciding between using public or private healthcare, then here are some key things you should know.
Doctors
As we've mentioned before, Singapore is well-known for its high standards when it comes to healthcare. So whether you go to public or private hospitals, you can count on being seen by top-quality doctors.
However, there are typically less-experienced doctors in public hospitals, as they tend to seek work in these facilities right after medical school. So if you're more comfortable with more experienced doctors, you'll mostly find them in private hospitals instead.
Also, if you speak a foreign language other than English, you might have a better chance of finding a doctor who speaks your language at a private hospital. Many of the GPs at these medical facilities will have received medical training overseas, which increases the chances of them knowing other languages. The staff is also more likely to speak your language in private hospitals since they're more used to receiving foreign tourists who have come to Singapore for medical tourism.
Medical equipment
You can rest easy knowing that both public and private hospitals in Singapore have very modern and working medical equipment. But if you want the very best, of course, you'll find it in private hospitals. They have more funding and freedom to purchase the latest technology, and they'll be able to replace and update their equipment more often.
Wait times
As with pretty much all healthcare systems in the world, you'll experience longer wait times in public hospitals. While the service is still excellent, wait times are higher because more people have access to these facilities. The wait times for Singaporean hospitals vary drastically, from under an hour to up to seven hours. Even the famous Changi General Hospital has an average wait time of over five hours.
So if you want peace of mind and want consistently short wait times, it's better to go to private hospitals. It's safe to assume that you'll be seen within an hour when visiting these facilities.
Appointments
In addition, public hospitals are run on a “first come, first served” basis. So if you need to be seen by a doctor, it's up in the air as to how quickly you'll get in. On some days, there will be barely any people in the public hospital, so you'll be seen within minutes, while on other days, it can be packed full of people and take hours for you to see a doctor.
Whereas with private hospitals, you can make appointments. And when you show up for your appointment time, it won't take long for the doctor to call you in.
Privacy
If privacy is of the utmost importance to you, then public hospitals won't suit you. Even if you opt for a more expensive hospital room, expect to share it with at least three other people. Of course, you can choose the A-class wards for private rooms, but this will be very expensive, and most of your stay won't be subsidized. So most Singaporeans opt for the B2 class or lower wards to save some money.
Of course, private hospitals aren't subsidized at all, so you'll have to foot the entire bill yourself. However, these rooms will have the best and most modern amenities, which will have you feeling like you're staying in a resort.
Convenience
As of May 2022, there are 14 public hospitals and 9 private hospitals in Singapore. They're scattered all throughout the nation, so chances are, you're located near a few of them.
It'll be up to you to research which facilities are nearby to your home and work. That way, you can determine which choices are acceptable for the best convenience possible.
Medical prescriptions
Note that medical prescriptions issued in other countries aren't recognized in Singapore. To renew your prescriptions, you need to consult with your local general practitioner and request a new prescription. It's best to show your GP your old prescription so that they can prescribe the same medication or alternatively, a suitable replacement. Pharmacies can be found in supermarkets, as well as in shopping areas.
Useful link:
Last update on 01 June 2022 13:40:59