Lesson 5: Medifund, Medication Assistance Fund & Medication Assistance Fund (Plus)
Key Principles of Medifund Assistance
Personal Responsibility
Patient expected to co-pay to his ability
Medical Necessity
Based on necessity exclude the non-essential choices (Class A, cosmetic surgery, beauty things)
Family Responsibility
use immediate family member's Medisave where possible
Many Helping Hands
Medifund to complement not replace charity fund
encourage philanthropy to provide additional asssitance
Medifund Eligibility Criteria
Singaporean (SC)
Received treatment as subsidized patient (Class B2 or C for inpatient/subsidized outpatient)
Received treatment from Medifun-Approved instituitions
Unable to pay healthcare bills despite receiving government subsidies or etc.
Medifund SIlver
set up a capital sum of $500 million (launched in November 2007 in restructured hospitals and institutions)
Ageing population - decided to carve out a portion of Medifund as Medifund Silver to deliver assistance to needy elderly patients in more targeted manner
Singaporeans 65 years or above
Calculation of Household Income
Sum up the income (including allowances and bonuses but after deducting CPF contributions)
patient himself
immediate family members (parents, spouse, children - regardless of whether they are living together or apart
non-immediate family members staying in the same household
Household Income (HI) = Monthly Per-Capita Household Income (Gross income net of CPF contributions)
Medifund & Medifund Silver Income Guideline
If household income falls below minimum level, patient is eligible for 100% assistance
Maximum Medifund Assistance
Only Class C patients enjoy 100% Medifund Assistance
Medifund Approval Level
Level 1: Pre-Qualified Cases (Auto)
Level 2: Straight Forward Applications (SF)
Level 3: Non Straight Forward Applications (NSF)
Medication Assistance Fund (MAF)
Help lower income (not under Level 1 or 2)
Focus on selected clinically-effective medications that may be expensive
Financial coverage for non-standard drugs
Maximum subidy level f 75% upon assessment by Medical Social Service
Per capita Income of $1,500 or less
MAF Eligibility Criteria
Clinical Evaluation - clearly documented in the form
Evidence of Efficacy
Favorable safety Profile
Ethical Consideration - No off label indications and HFA approved indications only
Audits & Checks for MAF
Data will be submitted to MOH
Clinical audits to check on application and approval process
Medication Assistance Fund Plus
Ecpand MAF to cover non-standard drugs
Increase maximum subsidy level from 50% to 75% upon assessment by Medical Social Service
Deducted first before Medisave or Medifund
MAF Plus Eligibility Criteria
Expanding MAF to include NSDL Drugs (MAF+)
Clinically appropriate and deemed clinically necessary for treatment
Qualify for subsidy, patient must have: documented history of non-response or serious side effects to SDL drugs & no other clinical drugs alternatives
Audits & Checks for MAF Plus
Data will be submitted to MOH
Clinical audits to check on application and approval process
All applications are reviewed by MAF Plus Panel and approved by CMB (Chief of Medical Board)