I was recently admitted to hospital for a bad case of viral infection. My private hospitalisation bill amounted to approx $6500 for a 3 day stay, with $100 pre-hospitalisation GP bills.
Thanks to my Enhanced Incomeshield cover with the Plus rider, I did not have to pay a single cent for the hospitalisation. But that got me thinking – as much as I felt relieved to be covered, was I getting the bang of my buck? So here’s an analysis for me to decide on which plan best suits me at this point in my life.
Round 1: Type of shield plan
Having seen the back end of how the medical industry works, I would definitely like to keep an integrated shield plan for private hospitals for as long as I can afford it because I like the idea of being seen by just a consultant alone (whose clinical skill I (blindly) trust) rather than a group of clinicians ranging from consultants all down to the house officers with little experience (no offence), where not all clinical decisions might be run by the consultants before being made. They might be small decisions, but impactful in many ways to the patient if made wrongly or not as ideally.
Round 2: Insurer
The Medishield Life website also provides a comparison of all the integrated shield plans available in the market by all the insurers in Singapore, which includes NTUC income, AIA, Great Eastern, Prudential, Aviva and AXA. On the basis of personal preference, I would like to eliminate AIA, GE and Aviva. This is mainly because I don’t have contacts of reliable FAs from these companies through close family or friends and for a huge part, my impression of the companies. This leaves me with NTUC income, Prudential and AXA.
Round 3: The details
This leaves me with the NTUC Income’s Enhanced Incomeshield Preferred VS Prudential’s PruShield A Premier VS AXA Shield Plan A. Now… Fight! Here are the differences:
|Pre-hospitalisation treatment limit
(up to 90 days)
(up to 180 days)
(up to 180 days)
|Post-hospitalisation treatment limit
(up to 90 days)
(up to 365 days)
(up to 365 days)
|Subsidised day surgery / short stay wards deductibles
|Unsubsidised day surgery / short stay wards deductibles
|Policy year limit
First place goes to Prudential, followed by AXA and NTUC Income comes in last at this leg of the race.
Round 4: Premium rate for plan without rider
At my current age of 25:
- NTUC Enhanced Incomeshield Preferred: $373
- Prudential PruShield A Premier: $360
- AXA Shield Plan A: $361
Just as above, first place goes to Prudential, followed by AXA and NTUC Income comes in last.
Round 5: The co-pay riders
NTUC Income’s co-pay rider (i.e. Assist rider) requires the insured to co-pay 10% of the hospital bill with a cap at $3000. Prudential’s (i.e. Prushield extra lite) requires the insured to co-pay 50% of the deductible with a cap at $1750. AXA has no such rider.
Premium rate of the plan with co-pay rider:
- NTUC Enhanced Incomeshield Preferred: $373 + $190 = $563
- Prudential PruShield A Premier: $360 + $210 = $570
Using the scenario of my $6500 hospital bill, I will have to co-pay $650 (NTUC) VS $1750 (Prudential).
In order for my co-payment for Prudential to be lower than the cap of $1750, the hospital bill has to be less than the full deductible sum of $3500, which is quite unlikely for a private hospital stay.
Assuming however that my hospital bill is increased to an arbitrary sum of $20,000, I will have to co-pay $2000 (NTUC) VS $1750. At my age, I think the possibility of having a hospital bill that high is slightly lower, as this sum might involve either a much longer stay, a surgery or a very complex medical complaint.
For this round, I think NTUC Income is the winner on the basis of probability at my current age.
Round 6: The full coverage riders
This means no payment at all is required in the event of hospitalisation.
Premium rate of the plan with this:
- NTUC Enhanced Incomeshield Preferred: $373 + $306 = $679
- Prudential PruShield A Premier: $360 + $366 = $726
- AXA Shield Plan A: $391 + $322 = $721
Based on premium rate comparison alone, seems like my current plan with NTUC Income is a wise decision.
Round 7: Which rider should I get?
Just a bit of background, my parents had actually purchased my health insurance since I was age 1.5yrs old. Meaning, the total premium paid till date for the Plus rider is approx $7500. Prior to this, I was hospitalised once before at age 10 and had a surgery done. Same thing, did not need to pay a single cent.
So if I null the premium paid before age 10, my total premium paid for the Plus rider from age 10 to 25 (i.e. 16 years) is approx $4500. If i bought the Assist rider instead, the total premium for the same period would be approx $2800. That is a difference of $1700. So a hospitalisation bill has to be at least $17,000 to “break-even” at this point, for the Plus Rider to make sense. And that is close to the $20,000 arbitrary number I used, which I assumed would involve a much longer stay, a surgery or a very complex medical complaint.
Based on my recent hospitalisation, if I had the co-pay rider, I would have to fork out $650. That would amount to approx 6 years worth ($650 / ($306-$190)) of the additional premium I’m paying for the Plus rider.
My Other Considerations Currently
Because of the nature of my job, I have actually been falling ill pretty frequently. So I suspect I might potentially have multiple small admissions in the future. However, I cannot rule out a potential surgery for things like appendicitis or worse, accidents. (touch wood).
Looking long-term, at age 50 and above, I think that the pre- and post- hospitalisation treatment limits are of utmost importance. Because recovery times tend to be longer than when we’re young and we’re looking at increased possibility of cardiac issues, stroke, etc that requires frequent follow ups for quite a period of time post-discharge. Meaning, Prudential and AXA’s offer of 180 days pre- and 365 days post- would serve as better coverage. Goodbye, NTUC Income.
In the those later years, the premium rate for the shield plans would increase drastically. Although NTUC Income comes at a cheaper premium than Prudential or AXA for private hospitalisation, I doubt I can afford a private shield plan then (approx $400-$500 every month for the plan alone!). I would probably settle for A or B1 class wards. So now, my worry is that if I were to develop a medical condition from now till age 49, and want to change my insurer in the later years, wouldn’t it complicate matters since now I am considered to have a “pre-existing medical condition”?
Just from a short (and maybe not as accurate) check, Prudential’s A Plus plan with extra lite rider would make the most sense in my silver years. Because hospitalisations will occur pretty frequently esp from age 70-100, the cap of $1750 per policy year will make a lot of sense. Moreover, AXA’s rider for full coverage would be substantially more expensive.
My Final Decision
I would probably stick to my NTUC Income plan with the Plus Rider at the moment. However, I will review my insurance again at age 30, with the eventual aim of converting to Prudential’s A Plus plan with the extra lite rider before any “pre-existing medical conditions” set in.