SINGAPORE: The severely disabled who join an enhanced ElderShield scheme from 2020 will receive lifetime payouts as long as their condition continues, following recommendations by the scheme’s review committee.
This is an improvement over the six-year limit to payouts under the ElderShield scheme, which will continue in its present form for existing policyholders.
Under the enhanced scheme, to be called CareShield Life, the severely disabled will also receive higher cash payouts of at least S$600 per month. The monthly payouts that people will be eligible for when they become disabled will increase over time.
This is above the S$300 or S$400 monthly flat amount provided under the ElderShield scheme.
The higher monthly payouts that people are eligible for are expected to increase by 2 per cent per year for the period that premiums are being paid, subject to regular review by an independent council. It will be supported by regular premium adjustments to account for inflation.
The increases in potential payouts will, however, end once premium payments stop at the age of 67, or when someone makes a successful claim and starts receiving payments, whichever is earlier.
Announcing that the Government has accepted the recommendations made by the committee, the Ministry of Health (MOH) said on Friday (May 25) that it plans to implement CareShield Life in 2020. Those aged 30 to 40 in 2020 will be the first to join the scheme, which will be compulsory.
Speaking to reporters on Saturday, Health Minister Gan Kim Yong said that the review of ElderShield is an important step in preparing Singapore for an ageing population.
"They (the committee) have worked very hard and consulted widely and put up a balanced set of recommendations that will significantly enhance ElderShield," he said.
CareShield Life and ElderShield help policyholders who cannot independently perform at least three of six activities of daily living - washing, dressing, feeding, using the toilet, moving around and movements such as transferring oneself from a bed to a chair.
A person under CareShield Life who has paid full premiums and becomes severely disabled at age 67 and remains so for 10 years, would receive a total of S$144,000 in monthly payouts of S$1,200, about 12 times the premiums paid. This is based on payout and premium increase of 2 per cent per year, and would be better than the S$28,000 that would have been paid under ElderShield.
During a media briefing on the committee’s recommendations on Friday, chairman Chaly Mah said that lifetime payouts would give the severely disabled assurance and certainty that they will be taken care of.
“When we look at how we take care of those who are severely disabled, there’s a sense that we need to do more for that category,” he said. He also pointed to figures that one in two healthy Singaporeans aged 65 could become severely disabled in their lifetime.
In deriving the initial payout of S$600, he said the committee looked at whether Singaporeans have enough in their Medisave account, and considered basic long-term care costs in a nursing home and for home and community care, factoring in co-payment.
For example he said, fees at nursing homes run by voluntary welfare organisations come up to S$2,400 per month. After Government subsidies and payouts from the enhanced scheme, the claimant or family member would have to pay S$400.
His committee’s recommendations, which centre around inclusivity, better protection, affordable premiums and improving administration, came after a review that lasted about 18 months.
Currently, all Singaporeans and PRs with Medisave accounts are automatically enrolled in ElderShield at the age of 40, unless they opt out of the scheme. MOH said that existing ElderShield policy holders can choose to join CareShield Life from 2021, and that the Government is looking into measures to encourage and support them in doing so.
A MORE INCLUSIVE SCHEME THAT IS ADMINISTERED BY THE GOVERNMENT
Mr Mah had in January this year given an interim update on recommendations. Following the final recommendations that were accepted by the Government, CareShield Life will, in the future, be universal for Singapore residents, starting from the age of 30.
This means that CareShield Life will cover everyone in future cohorts, including those with pre-existing severe disabilities. Under the current scheme, those with severe disabilities are not included.
The Government will also administer the enhanced scheme on a not-for-profit basis, instead of the three private insurers who administer ElderShield. In addition, the claims and disability assessment processes will be simplified.
Instead of navigating the claims process on their own, policyholders can seek advice from staff at hospitals or long-term care providers, the committee said. Disability assessment done by qualified professionals can also be used for the enhanced scheme, and this pool of professionals will be expanded through the inclusion of occupational therapists, physiotherapists and nurses, the committee added.
The first-time disability assessment fee will also be waived, regardless of outcome, with fees for subsequent assessment that result in successful claims reimbursed.
Dr Loh Yik Hin, chairperson of the claim assessment sub-committee, said that the whole intention of trying to improve the care assessment process was to reduce pain points.
“Many of the policyholders didn’t know whether they were covered by ElderShield, and who their insurer was, and they couldn’t find out easily,” he said.
The new framework will also give assessors explicit guidance on how to assess the lack of functional ability due to cognitive impairments such as dementia.
“The committee’s recommendations will offer better protection and greater assurance for Singapore residents. They will provide future cohorts, regardless of financial ability and health, with universal coverage and protection,” MOH said.