It is enough, it seems (if you are not "choy suay" - super unlucky). Lets go through them one by one.
First, operations/ procedures
https://www.moh.gov.sg/content/moh_web/home/costs_and_financing/hospital-charges/Total-Operation-Fees-By-procedure.html
I went through all the procedures listed, the highest Subsidized cost of operations is for Vitreous, at 75% it is $1976. $2K surgery claim is enough. The rest are well below 2K at 75 percentile. Only operations with more than 30 case studies are published.
Verdict:
Passed, and adequate, as long as you dun "chow suay" and dun belong to the above 75% percentile.
Next Average bill test.
Above illustration for Public hospital-surgical specialties. With the exception of KKH and NHC, all are covered by $700 room and board insurance provided by Medishield. By average, I assume it is 50 percentile. Average total bill would include surgical costs, it is rather blurry here as it would depend on the number of stays in the hospital. I would think using 90% percentile would be quite a safe bet. Assume 3 days inpatient stay and 1 day in ICU, insurance would cover up to 5K, assume 4 days inpatient and 2 days ICU it would cover up to 6K. I would go through the procedures that required longer days and most operations take only 1 -4 days. So looking at the 90 percentile, you would be safe at long as you dun go SGH.
Verdict:
Passed, and adequate, as long as you dun "chow suay" and dun belong to the above 95% percentile.
Next long stay treatment with stays above 7 days.
They are:
1)Back problems (Serious)
2) Diabetics with serious implications
3) Stroke with and without serious implications
4) Lungs infections/ cancer
5) Kidney and urinary infections
6) Hip replacement
7) Heart Surgery
You can down the excel form this website The following conditions will be inadequate as subsidized surgery would already exceed 2K :
Condition:
|
Heart
angiography (Coronary angiography) - overnight stay
|
|||
Condition
Description:
|
Admission
for heart angiography procedure (with no occurrence of Heart Attack in this
admission) and without cardiac ablation; no serious complications
|
|||
Ward
B2
|
||||
Hospital
|
Volume1
|
Average
Length Of Stay (days)2
|
50th
Percentile Bill Size ($)3
|
90th
Percentile Bill Size ($)4
|
CGH
|
69
|
3.0
|
2,001
|
3,119
|
KTPH
|
69
|
3.3
|
1,713
|
3,163
|
NHC
|
256
|
2.7
|
2,448
|
3,484
|
NUH
|
111
|
2.9
|
1,818
|
2,653
|
TTSH
|
113
|
2.9
|
1,488
|
2,470
|
Ward
C
|
||||
Hospital
|
Volume1
|
Average
Length Of Stay (days)2
|
50th
Percentile Bill Size ($)3
|
90th
Percentile Bill Size ($)4
|
CGH
|
104
|
2.5
|
1,358
|
2,554
|
KTPH
|
77
|
3.2
|
1,460
|
2,683
|
NHC
|
227
|
3.0
|
1,729
|
3,229
|
NUH
|
199
|
3.0
|
1,345
|
2,070
|
TTSH
|
140
|
2.8
|
1,075
|
2,839
|
Day
Surgery (Subsidised)
|
||||
Hospital
|
Volume1
|
Average
Length Of Stay (days)2
|
50th
Percentile Bill Size ($)3
|
90th
Percentile Bill Size ($)4
|
NHC
|
114
|
1.0
|
1,989
|
3,935
|
Condition:
|
Heart
angioplasty (Coronary angioplasty)
|
|||
Condition
Description:
|
Percutaneous
Transluminal Coronary Angioplasty (PTCA); procedure to enlarge a narrowing in
a heart vessel with a stent; no serious complications
|
|||
Ward
B2
|
||||
Hospital
|
Volume1
|
Average
Length Of Stay (days)2
|
50th
Percentile Bill Size ($)3
|
90th
Percentile Bill Size ($)4
|
CGH
|
87
|
1.8
|
5,222
|
7,105
|
KTPH
|
38
|
1.9
|
6,288
|
7,757
|
NHC
|
174
|
2.3
|
7,570
|
11,871
|
NUH
|
79
|
2.2
|
5,157
|
8,039
|
TTSH
|
80
|
2.2
|
8,383
|
14,423
|
Ward
C
|
||||
Hospital
|
Volume1
|
Average
Length Of Stay (days)2
|
50th
Percentile Bill Size ($)3
|
90th
Percentile Bill Size ($)4
|
CGH
|
175
|
1.5
|
4,050
|
5,914
|
KTPH
|
85
|
1.7
|
5,768
|
10,486
|
NHC
|
195
|
2.5
|
6,309
|
10,526
|
NUH
|
185
|
1.8
|
3,425
|
5,163
|
TTSH
|
106
|
1.9
|
7,986
|
12,463
|
Day
Surgery (Subsidised)
|
||||
Hospital
|
Volume1
|
Average
Length Of Stay (days)2
|
50th
Percentile Bill Size ($)3
|
90th
Percentile Bill Size ($)4
|
NHC
|
551
|
1.0
|
7,708
|
12,173
|
This would be a nightmare for those under Medishield
Condition:
|
Stroke
with serious complications
|
|||
Condition
Description:
|
Admission
for stroke, with serious complications and/or comorbidities
|
|||
Ward
B2
|
||||
Hospital
|
Volume1
|
Average
Length Of Stay (days)2
|
50th
Percentile Bill Size ($)3
|
90th
Percentile Bill Size ($)4
|
CGH
|
85
|
15.4
|
3,917
|
10,728
|
KTPH
|
82
|
13.8
|
4,364
|
8,366
|
NUH
|
91
|
11.8
|
3,761
|
8,971
|
SGH
|
107
|
13.3
|
4,627
|
11,936
|
TTSH
|
197
|
18.9
|
6,323
|
13,733
|
Ward
C
|
||||
Hospital
|
Volume1
|
Average
Length Of Stay (days)2
|
50th
Percentile Bill Size ($)3
|
90th
Percentile Bill Size ($)4
|
CGH
|
336
|
17.2
|
3,602
|
8,152
|
KTPH
|
324
|
17.2
|
3,972
|
8,004
|
NUH
|
204
|
16.0
|
3,798
|
11,025
|
SGH
|
164
|
18.2
|
6,041
|
13,786
|
TTSH
|
446
|
22.8
|
4,251
|
10,254
|
The Expenses look scary but it should be covered by the room and charge, 10 days of ICU care would already allow you to claim up to 12K
Verdict:
I looked through all 81 excel sheets and only found 1 condition that would bust the mediashield coverage, however, do note that some conditions state the surgery costs are not reflected.
Conclusion:
I believed Mediashield is meant to cover as much people at a as low possible cost as possible, so some outlayers are excluded.
So, the biggest item that could throw your plan to disarray is surgery, so if money is really not too much of an issue to you, go for the lowest IP plan that covers surgery as "per charged", and you get a upgrade to B1 ward.
Please note that I am excluding private care totally as an option here.
Sillyinvestor,
ReplyDeleteCome, I give you a bear hug!
Now that's what I call verifying for ourselves and making an informed decision based on facts :)
Medishield Life is like flying economy class - good for the majority of the people; and that's where big daddy should focus subsidies on. And they did.
If we want extras, we can "upgrade" ourselves to economy plus or business class within public hospitals.
Prefer First Class stay at private hospitals? Well, if we can afford it, why not?
No one stopping anyone, just as long we pay our own way. Just don't expect others to subsidise you ;)
Chris' post was a gentle reminder to not treat our Medisave account as "funny money".
They are those who are ill-equipped to afford Integrated Policies but went ahead anyway. Only to find out they can't keep up the premiums when they retired...
It's a bit like that young man at his early 20s who bought a car with $2K salary and found out he can't afford to maintain it.
Imagine downgrading your health insurance policies at 60 due to insufficient CPF Medisave funds - just when you probably need it the most?
That's the main thrust of Chris' post - all these segregation of accounts like Skills Future, Edufund, Medisave; etc - may lull people into making frivolous decisions since we can't "see" the money anyway...
And that's where snake oils like to lurk. Spend it all before big daddy moved the goal posts again.
Hi SMOL,
DeleteYa, I apologized to CHris... A bit agaited, as I am a strong believer of IP. Regarding you analogy:
"Medishield Life is like flying economy class - good for the majority of the people; and that's where big daddy should focus subsidies on. And they did."
It is not the same. Budget or First Class, they get you to your destination. NO way they send you somewhere else unless you super duper chow suay and meet with air flight accident.
We want insurance to pay our bills. If I tell you, you fly budget there is one out of 81 chance that it will not get your destination, and there is a 5% probability everytime too, that the flight might not get you to your destination.
Will you still fly budget??
Sillyinvestor,
DeleteChris wrote a thought provoking post and you zeroed in on one insignificant mention of "wards". Glad you apologized to Chris.
Now you swinging your bat at me?
........
Still agitated? Is "budget airline" the trigger word? I never even mention it.
Once you have calmed down, look within.
Explore why you are so "agitated" with budget, economy, basic, plain vanilla; etc.
You have already said it - insurance is just to pay bills.
Insurance is not buying "immunity" from death.
If "suay suay" contracted a terminal illness, whether budget, economy or first class, we will still face the same ultimate fate...
HI SMOL,
DeleteIt's ok, there will be times we dun see eyes to eyes.
I totally agree,when air accident happen, it does not matter budget or first class
It is true I might not be able to see what is within, because I am looking outwards when I wrote this post.
U can't see what I saw, I can't see what you saw.
A spade is a spade.
No wonder they said we see what we want to see. The blindness is mutual
DeleteHi mike,
ReplyDeleteCan be Insurance Agent Liao. Haha.
Well, I am not qualified to any insurance plan, I wish I could be insured.
My Husband company employee insurance scheme includes spouse and children. So my last time hopsital bill is fully covered.
You could if you are a singaporean, just does not cover existing conditions
DeleteIs it? I tried but not successful.
DeleteYeh, in that case, you might want to take a look at whether you are adequately covered if your husband decides to quit his job. Most of the time, it is good that the company has insurance scheme for family, but if we rely too much on the company and forget to get our own personal one, you will suffer the most when the company folds or when the employee leaves the company.
Deletegood post.
ReplyDeletemedishield is enough IF you don't need to be referred.
it is the most basic contingency plan.
for the really "touch wood" straight path of medical treatment where all the medical treatments works and you don't hit any (even minor) exceptions.
Actually SMK
DeleteThe one phrase that keep appearing as I go through MOH website is "without serious complications"
Well....
MOH can only give the numbers to a certain degree of accurateness if there are no serious complications. Because if a complication occurs, it will usually prolong the stay and intensity of the care. E.g. patient may require High Dependency or ICU or more surgeries to stabilize the situation. Hence the ministry can only publish to much information as not all situations are the same.
ReplyDeleteActually I think it is already there, IW.
DeleteIt showed only until 95% percentile, it is very obvious the complications are those above 90% percentile.
50% is typical
75% is conservative
90% is chow suay
Above 95%, you just hope you die within one year, not because of money, but because of suffering.
Why do people think they can pull they plug and be Siao sai about death?
It's one thing to be fearless about death or perhaps look forward to it, nothing scary about death actually if u ask me.
I just happen to know too many real life examples of zombies of several years.
Can we really let zombie die?
My Libarian's dad, 2 years imobile , my colleague's mum Parkinson's problem for 8 years. I ask my colleague, so what's next, he told me it will still compressing against it vital organs then ... Lucky nvm go to that stage.
My school attendant who is 60 with a mum with stroke for 10 years.
All visit hospitals like nobody busines...
I still remember very Vividly, my mum last few weeks and days after my dad discharged.
DeleteWhat is their biggest wish? One is to have strength to stand, the other not to fall.
that's the thing. it is always painfully agonizing for the family members to decide during the holding on by the skin of their teeth phase.
Deletebut even before that, it may be a bo bian lan lan phase.
"Can we really let zombie die?
My Libarian's dad, 2 years imobile , my colleague's mum Parkinson's problem for 8 years. I ask my colleague, so what's next, he told me it will still compressing against it vital organs then ... Lucky nvm go to that stage.
My school attendant who is 60 with a mum with stroke for 10 years.
All visit hospitals like nobody busines... "
I'm very sorry for your loss.
Delete"I still remember very Vividly, my mum last few weeks and days after my dad discharged.
What is their biggest wish? One is to have strength to stand, the other not to fall.
"
No worries SMK,
DeleteI am ok ... Just that during the teething period, the last thing u want to worry about is cost of hospitalization.
After that, u have rehabilitation to worry about. Insurance only cover until 90 days except for some treatment like kidney dialysis or whatever...
What if many recommended a doctor that is from private practice?
That is why I always ask people to think twice about plain vanilla
Dun be too cocky about treatment and overestimate your comfort tolerant and underestimate your children wishes
I understand how you may feel. In fact, I see this nearly everyday. Families who are sandwiched between letting their loved ones go or continue hoping for miracles.
DeleteThe information on the MOH website looks to only cater to a limited number of procedures which looks common. In real life, the situation is not that simple and anything can happen. Yes, even a simple operation can turn out to have complications. The data only shows up to 95th percentile, but do we really want to place our hopes that we will be below the 95th percentile section? Suay is not just a consequence, it is the embodiment of not being sufficiently prepared for worse case scenarios and having to pay for it.
Given the morbid state of this post, I find that we should all convey our thoughts to our loved ones and inform them on the conditions at which point they should let us go without any suffering.
DeleteYes there is nothing scary about death (we don't even know whats on the other side), but if we do not let them know how we want to live or die, then we are also giving them a burden when they are faced with decision to either pull the plug or continue persevering without an end in sight.
Overall, we need to determine our own quality of life.
Is it good being alive but not able to move for the rest of your life?
Is it good being alive but without consciousness for the rest of your life?
Is it good being alive but dependent on machines (dialysis or ventilators)?
Hi Investing Wolf,
DeleteThere is no much "choice" actually. The only 2 opportunities is 1) prior to a surgery. U refused surgery. 2) when the stage is Pallative care, then we can decide if we want tube feeding Blar...
Assuming it is stroke and there is no "failure" and death is not imminent, there is no choice. I am doing about legal choices not "homocide"
Hi Sillyinvestor,
DeleteThere is always a choice. We sometimes refuse to see the other side because we deemed it as unacceptable but it doesn't mean that the choice isn't there. Depending on the situation, sometimes surgery does not improve your quality of life or situation. The misconception about palliative care... it is the continued care of the patient with greatest comfort in mind while allowing the family and patient to accept that death is coming soon.
In terms of stroke, there are various degree of the illness. The common ones you see on TV are the minor ones and may not affect the lives. I can tell you that the severe versions of stroke may lead to severe brain damage or brain death (in which case, you are legally dead in terms of the law but your heart is still beating). Singapore does not allow Euthanasia (which means intentionally ending a life)
Hi investing wolf,
DeleteI guess u are more informed in this area than me. I only have personal experiences. I know about brain dead. The most severe.
Seriously, u dun need to get there. Half paralysis? Can last 10 years ...
Maybe my eyes are tainted. When u at hospital, when there is an implication, they advice u this this this to save the patient, would u not accept?
After the surgery, this say need to do this test that test. Would u say no?
U worried u bust the bill u also lan LAN and ok ok ok ...
Need another procedure ( my wife sis did 3 procedures in total) u also ok ok ok ... Isn't it?
While it is true that the doctors advise you on medical issues, they do so because they need you to know what you are getting into. Some procedures are necessary to save lives (these are the ones where doctors will make the decisions unless otherwise stated by the family or patient), some procedures just prevent further complications and some just prolong the situation because the family continues to hope that the patient will recover one day. We need to know which procedure belongs to which category and know that we have the right to refuse any surgeries to prevent more sufferings.
DeleteUnfortunately I see the above situation almost everyday so i know when the prognosis is grim.
Yes, they can tell you that the procedure can save the patient's life. But they would also have to explain to you what happens when that life is saved... will he be able to talk, walk, eat or do anything meaningful in the future? If there is little chance to regain acceptable quality of life, will you still choose to go ahead with the procedure?
DeleteI have seen families who are willing to take care of their loved ones who will never regain consciousness again and families who grant them peace and freedom from sufferings by withholding interventions, allowing them to pass away peacefully.
These are my experiences.
Hi investing wolf,
DeleteThanks for your input. Indeed very informative. Are u from the Heath sector. The choice is very "illusion" my wife's grandma was 80. Her intensitine was suspected to have been "blocked" or twist.
So because of her age, the family was rather hesitant for her to do surgery and go under the knife.
The doctors said she can' really eat if we don't do surgery...
Is there really a choice? Well in the end,
The operation was a success, but the grandma passed away in ICU
Yup, I'm from the health sector. There is still a choice but there are trade offs.
Delete1. You go for surgery and hope for the best.
2. You refuse surgery and go for comfort care. Not being able to eat is 1 issue but there are IV nutrition for someone who cannot eat through stomach. Sometimes, the risk and complications of surgery can be too much for an elderly to handle.
Hi IW,
DeleteThanks, glad I have this conversation with u. I am right, u are indeed in the Heath sector, guess u are a doctor. I guess that Doctor is not as ethical as u. The options are not made known to us, I guess he is more eager to earn surgical fees than anything else.
I will defintely ask for alternatives when my turn comes
Also on the thought of hospital bills, most of the bill comes from surgeries.
ReplyDeleteThanks for the informative article! waiting for your next post.- insurance for newborn
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