Why Raffles Shield’s High Deductible Option is Great for Working Adults?

Many employees often overlook the fact that Employee Benefit Schemes (EBS) usually include some form of medical coverage. Most employers in Singapore offer basic health insurance coverage under what is known as a Group Insurance Plan. This coverage can complement an Integrated Shield Plan (IP) employees might also be under, as is the case with the Raffles Shield High Deductible option.

Before considering this option, a useful question to ask would be: Do I know what medical expenses I am covered for under my Employee Benefit Scheme?

If the answer to this is no, perhaps it’s time to change that! It’s helpful to be aware of the benefits you are entitled to, as it allows you to make informed choices when selecting other insurance plans you might want to have. Employee health benefits vary with each employer, and include different claim limits and eligible benefits. Some policies’ claim limits go by admission, while others have annual limits.

Check up on your company’s health policy, ward class entitlement and claim limits if you are not familiar with them, as this information will be important to have on hand when you read through this article and the examples that follow. A copy of the policy should have been provided to you by your HR upon employment. If this copy has disappeared into the depths of the unknown, you can always approach your HR for another copy!

Why should I get an Integrated Shield Plan if I have an Employee Benefits Scheme?

An Employee Benefit Scheme will cover you only as long as you are, well, an employee. If you are no longer with a company, you will not be protected against hospitalisation expenses under an EBS. This is where your personal Shield Plan will come in to cover your medical expenses. It is wise to have a portable plan that stays with you regardless of your employment status.

In addition, you will need to declare any medical conditions you have each time you start with a new employer. Conditions you already have will be considered ‘pre-existing’, and might not be covered under your new Employee Benefits Scheme. Getting a Shield plan early means that you will only undergo medical underwriting once at the point of purchase. Any health conditions you might develop subsequently will be covered by your Shield plan, allowing you to transition between jobs without worrying about your health coverage.

Will I have overlapping coverage if I get a Shield Plan on top of my Employee Benefits Scheme?

Having a Shield Plan with your EBS can actually save you some out-of-pocket expenses as they plug each other’s gaps in coverage. It’s encouraged to tap on your EBS first, which is your entitlement as an employee, before using your personal Shield Plan to cover for hospitalization or medical expenses.
  • This reduces how much you have to pay
  • Your Employer will cover for components of your bill that cannot be claimed under your Shield Plan (e.g. Deductible and Co-Insurance)
  • Allows you to preserve the Yearly Limits on your personal Shield Plan
  • By using your EBS first, you do not utilize your yearly entitlements under your Shield Plan, and can save the amount for future use, if required.
Before delving into more detail about Raffles Shield High Deductible option, here is a quick overview of the base plans available under Raffles Shield:

 

Ward Entitlement

Raffles Shield Standard

B1 at Government Restructured Hospital (GRH)

Raffles Shield B

B1 at GRH

Raffles Shield A

A at GRH

Raffles Shield Private

A at GRH and Private Hospitals

 

Along with the base plans, Raffles Shield also offers 2 Riders and 2 Options:

 

 

Key Rider

Replace the deductible and co-insurance with a 5% co-payment on every claim

Premier Rider

Additional benefits such as Accommodation expenses for immediate family member, Post-hospitalisation home-care, TCM, etc.

RH Option

Add on to Raffles Shield ‘A’plan to have the choice of staying at Raffles Hospital, a Private Hospital, with no co-payment.

(Read more about this option here – https://www.raffleshealthinsurance.com/products/raffles-shield/learn-more/raffles-shield-plans/)

High Deductible Option

 

Option to increase deductible to $10,000 and lower monthly premiums paid. This option can be removedwithout additional underwriting.

 

Note: High deductible option cannot be purchased with Key Rider.

The High Deductible Option can be added on to Raffles Shield A, B and Private Plans. To understand how this Option works, it is important to understand the concept of deductibles in health insurance. A deductible is basically a set amount that has to be paid before an Insurance Policy will cover your medical expenses.

Example:

Admission to a GRHClass A Ward with an IP Final Bill Amount: $10,000 IP Deductible: $3,500* Amt Payable by Insured: $3,500 (Before Co-Insurance**) Eligible Bill Amount: $6,500Amt Payable by IP: $6,500 (Before Co-Insurance**)
*Varies depending on age and Ward Class.
**Co-Insurance applies to every claim made, even after Deductible has been fulfilled.

In the case above, the Final Bill is $10,000, but the Eligible Bill to be paid by an IP insurer is $6,500. As the Deductible applies to each Policy Year, assuming that there have been no prior claims in the Policy Year, the deductible of $3,500 and co-insurance (on top of the deductible) is borne by the insured. However, if you are covered under an Employee Benefits Scheme, you can claim this $3,500and co-insurance from your employer (subject to each company’s policy benefits).

In this same school of thought, Raffles Shield High Deductible Option complements an EBS by allowing you to utilise your EBS to cover for the higher deductible amount while offering lower premiums in return. Under this Option, your yearly deductible is raised to $10,000, but your IP premiums are lowered by an average of 30% (not inclusive of MediShield Life Premiums). This allows you to save on premium payments, while not worrying about the annual deductible, which will be covered by your employer.

Let’s allow some numbers to do the talking below. This scenario shows a bill size of $12,000 and an Employee Benefits Scheme with a Yearly Hospitalisation coverage of up to $15,000.

 With High Deductible OptionWithout High Deductible Option

Yearly Premiums*

(IP component)

$237$339
Yearly Hospitalisation Coverage by Employer$15,000$15,000
Admission to GRH Class A Ward with IP

Final Eligible Bill: $12,000

Deductible: $10,000

(Payable by Employer)

Co-Insurance (10%):$200

(Payable by Employer)

IP Payable: $1,800

(Can be reimbursed by Employer)

Insured Payable: $0

Final Eligible Bill: $12,000

Deductible: $3,500

(Payable by Employer)

Co-Insurance (10%):$850

(Payable by Employer)

IP Payable: $7,650

(Can be reimbursed by Employer)

Insured Payable: $0

Assuming 1 Admission in 5 Years)

Amt Paid in Premiums: $1,185

Amt Paid for Admission: $0

Total paid for admission: $1,185

Amt Paid in Premiums: $1,695

Amt Paid for Admission: $0

Total paid for admission: $1,695

*The yearly premiums for the example above is based on the premiums for a 31 year old individual.

The example above shows how you can save more than $500 by choosing the Raffles Shield High Deductible option. It also illustrates how the Deductible being raised to $10,000 affects the subsequent division of the bill between your Employer and IP plan. Your IP would pay much less with the High Deductible option compared to without it. However, as mentioned previously, it’s still best to maximise the amount claimed from your Employer so that the Yearly Limits of your Shield Plan are preserved.

If you’re considering getting an IP, why not choose one that can give you savings as well? The High Deductible option is tailored for working adults, to be the most cost-effective health insurance plan. As we understand that employment situations can change as well, this option has the added flexibility of having no additional underwriting should you decide to remove it and revert to the base plan without a High Deductible option.

To find out more about how you can save on your Yearly Premiums with the Raffles Shield High Deductible option, Contact Us here.

Enjoy greater protection at no additional cost with our

Raffles Shield 2+2 Coverage Booster

Free outpatient coverage for all Raffles Shield plans

2 x teleconsultation via Raffles Connect
2 x GP visits at Raffles Medical Clinics
CUSTOMER CARE CENTRE CLOSURE NOTICE: Please be informed that our Customer Care Centre located at Raffles Hospital (Level 1) will be closed until further notice. For enquiries related to Raffles Shield or Raffles Elite Care, kindly contact us here or call our Customer Care Hotline at 6286 9988.