Refuse to pay MediShield Life premiums? You could be jailed

Tough stance to address shortfall caused by those who can afford to pay but do not
By Salma Khalik, Senior Health Correspondent, The Straits Times, 21 Jan 2015

SINGAPOREANS or permanent residents who refuse to pay MediShield Life premiums once the universal health insurance is launched later this year could find themselves behind bars if they try to leave the country.

The premiums will be compulsory - not just for people living here but also those who are living overseas for long periods - under proposals introduced in Parliament on Monday by Health Minister Gan Kim Yong.

Singaporeans and PRs living overseas will be entitled to coverage should they fall sick in the future and decide to return here for treatment.

The Bill also gives the insurance administrator the power to have money from a defaulter's wages and bank accounts diverted to pay the premiums.

The maximum penalty for defaulters who try to flee the country, spelt out in the MediShield Life Scheme Bill, is a fine of up to $5,000 and imprisonment of up to a year, or both.

The person would be allowed to leave the country on payment of the outstanding premium to an immigration officer or the police.

But he might also have to pay a 17 per cent penalty for late payment, as well as any costs incurred in recovering the money.

The planned tough stance is to cover the shortfall caused by people who can afford to pay their premiums but refuse, resulting in a heavier burden on other policyholders.

The MediShield Life scheme provides everyone with protection against huge subsidised hospital bills for all their life, and reflects a caring society where everyone pulls together to help those in need.

But such penalties would not apply to people who have difficulty paying the annual premiums, which range from $130 for the young to $1,530 for people older than 90.

Most people will not have a problem paying the premiums as they can be deducted in full from their Medisave funds.

People from families with a per capita income of $2,600 or less - that is, a total income of $13,000 a month for a family of five - will also receive subsidies.

The lower the family income, the higher the subsidies - which range from 15 per cent to 50 per cent.

Pioneer Generation residents who were aged 80 or older last year will have their premiums covered fully by subsidies and Medisave top-ups.

Younger pioneers - those 65 and older last year who have been citizens since 1986 - regardless of their incomes, will also get heavy subsidies and top-ups that should cover more than half the cost of their premiums.

People who still have difficulty paying their premiums on top of these discounts can apply for additional help from the Government.

The Ministry of Health has stressed that penalties are intended only for those with the means but are recalcitrant about paying their premiums.

The MediShield Life Scheme Bill will be debated at the next sitting of Parliament.

The scheme is due to launch by the end of the year.

MediShield Life Scheme Bill: Government to have access to medical records
By Valerie Koh, TODAY, 19 Jan 2015

When universal health insurance scheme MediShield Life comes into force later this year, authorised public servants will have access to medical and financial records, and the Government will be able to impose penalties – as a last resort – on those who default on paying premiums.

Under new laws tabled in Parliament on Monday (Jan 19), authorised public servants – from the Central Provident Fund (CPF) Board and the Ministry of Health (MOH) – will be able to tap into various Government and administrative databases to carry out eligibility checks for premium subsidies. Details such as one’s residential address and monthly income are available in these databases.

This would also facilitate the identification of those with pre-existing medical conditions, who will be covered under MediShield Life at an additional premium of 30 per cent for a decade, said the MOH. Individuals can restrict access to their medical and financial records, should they be uncomfortable with sharing confidential information.

The MOH stressed that there will be safeguards in place to prevent the abuse of the databases, and only authorised people can access them for the purpose of administering the scheme. Anyone who accesses, uses or discloses the information without permission may be fined up to S$5,000, jailed up to a year, or both.

Under the MediShield Life Scheme Bill, penalties of up to 17 per cent of outstanding premiums and interest on late premiums will be slapped on those who default on payment. These recovery measures are meant to clamp down on wilful defaulters with the means to pay their premiums, and are adapted from existing income tax legislation, said the MOH.

Other steps include sending warning letters to remind defaulters of their outstanding bills and appointing agents - such as one’s employer, bank or tenant - to make payment from funds due to the defaulter. As a final, drastic measure, defaulters may be sued. More details will be spelt out in the second reading of the Bill, which is expected at the end of the month.

A MediShield Life Council – consisting members from the public and private sector – will be set up to review and make recommendations to Health Minister Gan Kim Yong on policy and scheme parameters. The Council will also review the administration of the scheme and advise the minister on related matters.

Following the enactment of these new laws, it will become an offence to provide false or misleading information, or omit key information deliberately. Those convicted of doing so may be fined up to S$5,000, jailed a maximum of one year, or both. They may also be required to pay penalties pegged to undercharged premiums or overpaid benefits.

MediShield Life: How will you benefit from it? Some examples
The Straits Times, 20 Jan 2015

The universal health insurance scheme MediShield Life, announced by Prime Minister Lee Hsien Loong during his 2013 National Day Rally, will kick in later this year. On Jan 19, Health Minister Gan Kim Yong tabled the MediShield Life Scheme Bill in Parliament. It provides details on how the scheme is to be implemented and administered. Among other things, it gives wide-ranging powers to the administrator to access people's income and health status without explicit consent from them.

Here's a look at MediShield Life and some examples of how it will benefit patients.

What is MediShield Life?

- A compulsory healthcare insurance scheme which covers all Singapore citizens and permanent residents for life.

- MediShield Life will replace MediShield, the current basic healthcare scheme.

- All Singapore citizens and permanent residents will be automatically covered under MediShield Life when it kicks in end 2015.

What are the key differences between MediShield and MediShield Life?

- MediShield Life covers everyone, including those with pre-existing conditions who are not covered under MediShield today.

- MediShield Life has higher claim limits for hospital bills and outpatient cancer treatment.

- There is no more lifetime claim limit under MediShield Life; MediShield has a lifetime claim limit of S$300,000.

Here's a comparison between the MediShield and MediShield Life schemes:

What are the different MediShield Life premium subsidies and who are eligible for them?

- Premium subsidies for the lower- to middle-income-earners (covering up to two-thirds of households);

- Transitional subsidies for all Singapore Citizens;

- Special premium subsidies and Medisave top-ups for the pioneer generation for life.

Premium subsidies for lower- and middle-income households are applicable to Singapore citizens and permanent residents with monthly per capita household income (PCHI) of up to $2,600, and living in residences with an annual value of $21,000 or less. PCHI is the total household income divided by the number of family members living under same roof.

The government will provide additional financial assistance for those who cannot afford premiums even after subsidies. No Singaporean will drop out of MediShield Life due to inability to pay for premiums.

Do I need to apply for MediShield Life?

No. All Singapore Citizens and Permanent Residents will be automatically covered under MediShield Life when it is implemented in end 2015. CPF Board will inform you of the details nearer to the implementation date.

How much will MediShield Life premiums cost?

Go to www.medishieldlife.sg/calculator to calculate your estimated MediShield Life premiums after subsidies. The premiums can be full paid from Medisave. Those with serious pre-existing conditions will have to pay 30 per cent higher premiums for 10 years.