In Singapore, many companies offer a health insurance to their employees. However, this insurance might not completely cover the employee’s needs. Some insurance will offer basic hospital insurance benefits without any protection for general practitioner or specialist consultations. Others will offer a very good coverage that can include dental or maternity but with no option to protect other members of your family.
This article will help you understand your employer’s insurance contract and its limits.
Group hospital and surgical coverage: I am covered for hospitalization only
If you only have an “inpatient” or a “hospital and surgical” coverage on your contract, it means that you are only covered for hospitalizations. You will not be reimbursed for routine care and specialist consultations.
Hospital and surgical limits: I am covered for hospitalization up to a limited amount
Every insurance policy has limits. It is essential to know the limits of your health insurance contract and the maximum amount it allows.
Type of hospital
Some insurances will provide a different coverage depending on the hospital. In some cases, it will only cover treatments at public/government/restructured hospitals and not at private hospitals.
If you need a consultation or hospitalization it is important to be aware of the hospitals covered by your insurance.
Limit per disability
Health insurance plans offered by companies usually cover inpatient with a limit per disability. This means that the reimbursement is limited to a fixed amount per disability. In Singapore, the limit usually ranges between S$10,000 and S$25,000.
However, the cost of a hospitalization in Singapore can get quite expensive. For example, a surgery without complications at Raffles Medical, will cost approximately S$21,000.
With your current health insurance, the difference between your limit per disability and the price of the operation would be yours to pay:
As hospitalization coverage can be limited, intensive care unit, pre hospitalization and post hospitalization can also be very limited. It is important to verify these limitations in your insurance contract as these costs can also be very important depending on the treatment you will need.
When your plan contains a limit per disability, your insurance can provide you a “major medical” option. Depending on your insurance specifications, this option will top up the limit per disability to increase your cover in case of major illness or hospitalization.
Your health insurance plan can also cover you with an annual limit.
For example, your insurance can cover you for any hospitalization with an annual limit of S$250,000 based on a “as charged up to a limit of”. This means that you are 100% covered for inpatient up to the limit of S$250,000 of accumulated expenses per year. Once this limit reached, any other impatient expenses will be yours to pay.
Outpatient limits: I am covered for certain types of consultation only
Optical and dental care
General Practitioners (GP) and Specialists consultations can be included in your health insurance contract. However, you shall take a special care of optical and dental coverage as they are usually not included in the general “outpatient” coverage. If they are included in your policy, they will be distinctly specified.
Annual deductible and co-payment
General Practitioners and Specialists coverage can be limited with annual deductible or co-payment.
An annual deductible is a fixed amount that you will have to pay before your insurance takes in charge the rest of the amount due.
If a co-payment is specified, it means that for some of your treatments and medicals visits you will have to pay a percentage of the expenses from your pocket.
To know more about these options, you can refer to our dedicated article.
Some companies do not cover specialists but give “flexibenefit” to their insured. In that case, your insurance company will offer you a fix amount that you can use for certain types of consultations, specified in your contract.
For example, your company will give you S$2,000 flexibenefit per year that you will be able to use for dental care or optical care. In some cases, this amount can also be used to pay the premium of your private top up cover.
Territorial limits: I am covered in Singapore only
When the health insurance is provided by the employer, the area of coverage is often limited to Singapore. We strongly advise you to check out if emergencies and repatriation are covered abroad.
If you often travel for work purpose, you might have a business travel insurance. This insurance will usually cover your business trips but not your personal trips.
My dependents are not covered
While some companies do not cover the dependents, others can offer to cover your spouse/husband and children or give you the possibility to add them to your plan at your own expenses. It is important to understand what coverage will apply to your dependents as theses plans can be quite limited. In some cases, it can be more advantageous to take a separate cover.
With all these information, you should be able to understand how your current employer’s insurance covers you! In order to consider if it really meets your needs, you can have a look at UEX advice to fully understand what you really need to cover.
If you feel like you might need additional coverage, you can always purchase an additional protection, called top-up. Check out our Health Guide here to find all information at a glance.
To find out more about healthcare topics in Singapore you can check our articles. To understand how your health insurance plans cover the healthcare costs, you can approach UEX’s happiness team by email or by phone for more information and guidance – and the good news is that they are super nice!
With UEX, you can obtain a quote for a health insurance contract customized to your needs and requirements – all in less than a minute!