Many people in Singapore pay for an Integrated Shield plan for years without knowing exactly what it does. That is understandable. The policy documents are long, and the answer to "am I covered?" is almost always "it depends". This guide explains what it depends on.
The basics
An Integrated Shield plan has two layers. MediShield Life is the basic national cover everyone has. On top of that, a private insurer adds extra cover, which can include treatment in private hospitals and with private specialists, depending on the plan you chose.
Integrated Shield plans are mainly built for hospital treatment: a stay in hospital, surgery, and day procedures. That is the most important thing to understand, because it explains most of the surprises.
What is, and isn't, often covered
Often covered
- Surgery and day procedures that are medically necessary
- Your hospital stay, up to your plan's ward type
- Related visits and tests shortly before and after a hospital stay
- Some specific outpatient treatments, such as certain cancer treatments
Often not covered
- A specialist visit on its own, with no hospital treatment
- Screening when you have no symptoms
- Cosmetic procedures
- Conditions excluded because they started before your policy
The words that decide what you pay
Deductible. The amount you pay first each year before the plan starts paying.
Co-insurance. The share of the bill above the deductible that you still pay.
Rider. An optional add-on that reduces what you pay out of your own pocket. Newer riders usually still leave you paying a small share of each bill.
Panel and pre-authorisation. Many insurers have a list of specialists they work with. Using one of them, and getting approval before treatment, can change how much you pay. Our guide on panel and non-panel specialists explains why.
Where it gets specific
Two people with plans from the same insurer can pay very different amounts for the same operation. The plan tier, the rider, the specialist, the timing and the paperwork all matter. That is the part we do for you.
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