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Co-payment for Integrated Shield Plans

Co-payment for Integrated Shield Plans

Enhancements to GREAT TotalCare

In March 2018, the Ministry of Health (MOH) announced that all supplementary plans to an Integrated Shield Plan (IP) issued from 1 April 2019 will need to incorporate a co-payment of at least 5%. This is to encourage prudent provision and consumption of healthcare services by both healthcare providers and policyholders. As such, we are transitioning all existing IP supplementary plans to a co-payment structure from renewals commencing 1 April 2021.

Get coverage of up to 95% of your total hospitalisation bill

When GREAT SupremeHealth is bundled with GREAT TotalCare, you will be covered up to 95% of your total hospitalisation bill. You will only need to pay a portion of the bills incurred. 

How does co-payment work?

How much co-payment am I required to pay?

(per Period of Insurance)

Maximum

Co-payment

(per Period of Insurance)

Plan

ELITE

(ELITE-P*, ELITE-A, ELITE-B)

CLASSIC

(CLASSIC-P*)

(CLASSIC-A)

(CLASSIC-B)

For Eligible Bills incurred under:

  • Private Hospital / private Community Hospital / private medical clinic with Certificate of Pre-Authorisation; and/or
  • Restructured Hospital / government-funded Community Hospital / Inpatient Palliative Care Institution

5% of the total Eligible Bills

5% of the total Eligible Bills

5% of the total Eligible Bills or the Deductible incurred under GREAT SupremeHealth (where applicable), whichever is higher

$3,000

For Eligible Bills incurred under Private Hospital / private Community Hospital / private medical clinic without Certificate of Pre-Authorisation

5% of the total Eligible Bills orthe Deductible incurred under GREAT SupremeHealth (where applicable), whichever is higher

N.A.

*GREAT TotalCare (Elite-P) and (Classic-P) will also be put on Claims-Adjusted Pricing.

Example:

  With GREAT SupremeHealth
P Plus
With GREAT SupremeHealth
P Plus & GREAT TotalCare (ELITE-P)
With GREAT SupremeHealth
P Plus & GREAT TotalCare (CLASSIC-P)
Hospitalisation Bill incurred under a  private non-panel specialist $10,000
Less: Deductible^ & Co-insurance incurred under GREAT SupremeHealth P Plus

$4,150

[Deductible ($3,500^) + 10% Co-insurance after deductible ($650)]

GREAT SupremeHealth P Plus pays $5,850

GREAT TotalCare (ELITE-P) / GREAT TotalCare (CLASSIC-P) pays

(i.e. Deductible & Co-insurance – Co-payment)

N.A.

$3,650

($4,150 - $500)

$650

($4,150 - $3,500^)

Total Payout from Great Eastern $5,850

$9,500

($5,850 + $3,650)

$6,500

($5,850 + $650)

Co-payment

(the amount that you need to pay)

$4,150

[Deductible ($3,500^) +
Co-insurance ($650)]

$500

[5% of the hospitalisation bill ($500)]

$3,500^

[Higher of 5% of hospitalisation bill ($500) or Deductible ($3,500^)]

^ The Deductible applicable for a Life Assured who is 85 age next birthday and below is $3,500 for Expenses incurred in Private Hospitals, and will increase by 50% when the life assured is above 85 age next birthday.

You can limit your co-payment to $3,000 by seeking treatment at a restructured hospital or obtained pre-authorisation via Health Connect for your treatment with a panel specialist.

Example:

  With GREAT SupremeHealth P Plus and GREAT TotalCare (ELITE-P)
Treatment from private
 non-panel specialist
Treatment from private
panel specialist with
Certificate of Pre-authorisation
Hospitalisation Bill incurred $100,000
Less: Deductible^ & Co-insurance incurred under GREAT SupremeHealth P Plus

$13,150

[Deductible ($3,500) + 10% Co-insurance after deductible ($9,650)]

GREAT SupremeHealth P Plus pays $86,850

Co-payment

(the amount that you are supposed to pay)

$5,000

(5% of the Hospitalisation Bill)

GREAT TotalCare (ELITE-P) pays

(i.e. Deductible & Co-insurance – Co-payment)

$8,150

($13,150 - $5,000)

$10,150

($13,150 - $3,000)

(Note: Co-payment is capped at $3,000)

Total Payout from Great Eastern $95,000 $97,000

Co-payment

(the amount that you have to pay)

$5,000 $3,000

^ The Deductible applicable for a Life Assured who is 85 age next birthday and below is $3,500 for Expenses incurred in Private Hospitals, and will increase by 50% when the life assured is above 85 age next birthday. 

How to maintain affordable premiums in the long run?

We understand that you may require hospitalisation and/or medical treatments and may be concerned on the possibility of increased premium in the following year. Here are some options which can help you decide better:

  • Consider if there is a need for in-hospitalisation stay for minor medical attention. 
  • Consider if your employer has additional health coverage that enables claims or reimbursement from your company’s group insurance employee benefits plan.
  • Consider having your medical treatment supported through Singapore's Restructured Hospitals.

You may also consult our Health Connect team to get a Pre-Approval of your Eligible Medical Expenses with a panel specialist via our Health Connect.

You may ask your panel specialist to request a pre-approval on your behalf when you are at the clinic. Check out the list of specialists.

Our online form

Download the online form and email it back to us at pre-authorisation@healthconnect.com.sg . Once approved, you will be notified through email.

How to maximise benefits from your other insurance plans?

By reducing the claim amount made under your Integrated Shield policy and rider, you can better manage future premium increments. One way to do this is to recover the cost of your medical claims from other insurance plans that you are insured under, such as your company’s group insurance employee benefits plan. By doing so, you can reduce the claim amount made under your Integrated Shield policy and help us keep your premiums more affordable in the long term.

For instructions on how to recover the cost of your medical claims from a third party, please refer to the “GREAT SupremeHealth Integrated Shield Claim Recovery” section here.

For more information, contact your Great Eastern Financial Representative today.

All ages refer to age next birthday of the Life Assured.

These policies are protected under the Policy Owners’ Protection Scheme which is administered by the Singapore Deposit Insurance Corporation (SDIC). Coverage for your policy is automatic and no further action is required from you. For more information on the types of benefits that are covered under the scheme as well as the limits of coverage, where applicable, please contact us or visit the Life Insurance Association (LIA) or SDIC websites (www.lia.org.sg or www.sdic.org.sg).

Information correct as at 1 March 2021.