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FINANCING HEALTHCARE 1-6 (Lesson 5 (Medifund (Eligibility (Singaporean…

- - - - CHAS green
      - CHAS orange
      - CHAS blue
    - - covers illness such as cough/flu/fever
      - selected dental services e.g. dentures
      - health screenings
      - 20 chronic illnesses e.g hypertension/stroke/dementia/osteoporosis
  - - - Singapore = 0%
        PR = 0%
        LTVP+ holders = 0%
    - - Singapore = 20%
        PR = 10%
        LTVP+ holders = 10%
    - - Singapore = 50%
        PR = 25%
        LTVP+ holders = 25%
    - - Singapore = 65%
        PR = 40%
        LTVP+ holders = 40%
    - - Singapore = 50%
        PR = 40%
        LTVP+ holders = no subsidy
    - - Singapore = 80%
        PR = 55%
        LTVP+ holders = 55%
    - - Singapore = 50%
        PR = 25%
        LTVP+ holders = no subsidy
    - - All the same for all patients
  - - - 50% off medication listed under SDL or MAF
        
        Enjoy subsidies at participating GPs and dental clinics under CHAS
  - - - NR pays sur-charge
- - - - long-term care insurance
        
        pays a fixed monthly amount for long term nursing treatment upon the insured's inability to perform ADL
      - Covers major illnesses where the associated medical cost is substantial
    - - if a person is covered under 1 more than 1 healthcare insurance policy, total medical claims made will be equal to the total medical expenses incurred
        
        Claim processing rules requires submission of original bills
  - - - Better protection
        
        Protection for SG and PR
        
        Covers Singapore citizen and PR who were previously not cvered under Medishield
        
        limits payouts / patient co-payment
      - Covering through their lives
        
        affordable premiums
        
        deductibles
  - - - MedishieldLife
      - Private medical insurance coverage
    - - Disadvantages
        
        Company coverage exclude all pre-existing illnesses or medical conditions at inception and typically for the 12 months thereafter
        
        Does not insure a person after their retirement or unemployment, exposing them to financial risk when they need it for retirement
      - Careshield
        
        Lifetime cash payouts
        
        Payouts increase overtime
        
        Subsidies to make it affordable
        
        Can be fully payable by Medisave
      - Letter of Guarantee
        
        by a business entity to undertake the medical bills of the patient(s)
        
        HIC scheme
      - Civil Service Medical benefits
        
        CCS (comprehensive co-payment scheme)
        
        MSO (Medisave cum subsidised outpatient scheme)
        
        CPW (co-payment on ward charges scheme)
- - - - approved chronic conditions
        
        approved vaccinations
        
        approved health screenings
  - - - Protect against Diseases
        
        Go for recommended screening
        
        Chronic diseases
        
        Starting a Family
        
        Repeated Treatments
        
        Medical scans and old age treatment
        
        3 more items...
        
        Renial Treatment $450 per month per patient
        
        1 more item...
        
        $6000, $5000, $4000 for first second third respectively
        
        Welcoming your little baby
        
        1 more item...
        
        Under CDMP like hypertension, stroke, diabetes, dementia
        
        Selected screening tests such as hearing test / metabolic screening / thyroid function test
        
        Approved vaccinations
      - For outpatient preventive care and chronic disease treatments
- - - - Up to 80% subsidy in public hospital
    - - Medical savinhospitalisationgs account for self and family's
    - - Government's catastrophic illness insurance
    - - Means-tested safety net for the poor
    - - Disability insurance for long term care
- - - - Singaporean (SC)
        
        Received treatment as subsidized patient . B2 or C inpatient or subsidized outpatient
        
        Treatment from Medifund approved institution
        
        Unable to pay healthcare bills despite receiving government subsidies
  - - - the patient itself
        
        all immediate family members
        
        all other non-immediate family members staying in the same household
    - - Income guidelines
        
        Medifund (General)
        
        Household income less than or equal to $A
        
        Household income $A to $B
        
        Amount of assistance
        
        Up to 100% eligible bill
        
        up to 0%-100% eligible bill
        
        Medifund Silver
        
        Amount of Assistance
        
        Up to 100% eligible bill
        
        From 0% -100% eligible bill
        
        Household income less than or equal to $B
        
        Household income $B to $C
  - - - Only class C patients enjoy 100% Medifund Assistance
        
        NR and PR are not assisted by Medifund
  - - - Medifund level 1 - 3
    - - Medifund level 1: Pre qualified class (auto)
        
        Medifund level 2: Straight forward applications (FS)
        
        Medifund levek 3: Non-straight Forward applications (NSF)
  - - - Applicant should have first made withdrawals from his medisave and the medisave of his immediate family members
        
        Subject to relevant claim limits and Medisave balances
        
        Claims should be also made from employer -provided medical benefits and other third party payors if relevant
    - - Family members use their Medisave if patient is a PA or MFEC recipient and is warded in the lowest class ward
        
        The parents use up their Medisave; if the parents themselves have aged
  - - - Only medical intervention scenarios will receive Medifund assistance
  - - - Size bill incurred
        
        Outstanding Amount
        
        Definition household
  - - - Focus on selected clinically effective medications that may be expensive
        
        Provide more flexibility than Medifund framework
    - - Clinical evaluation
        
        Evidence of efficacy
        
        Favorable safety profits
        
        Ethical considerations
      - Adult checks for MAF
        
        Data will be submitted to MOH
        
        check on application and approval
  - - - Deducted first before using Medisave or Medifund
    - - Expanding MAF to include NSDL Drugs
        
        a documented history of non-response or serious side effects; OR No other clinical drug alternatives
- - - - Choice of class, private or subsidized
      - to proceed or not to proceed with treatment
      - seek alternative treatment at other institutions
      - Standard or non standard treatment
    - - For example, inpatient treatment, day surgery and expensive SOC treatment
    - - to avoid all medical bills that are potentially financial crippling (include SOC)
    - - Subsidized charges is based on 100% subsidies or informed before means testing is performed respectively
      - Obtain authorization from patient before means testing or patients income is private and confidential information
        
        Inpatient admission (individual) and inpatient downgrading (household) respectively
      - Patient signs admission financial counselling form // obtain acknowledgement from patient