Friday, 8 May 2015

Insurance for my 63 Years Old Mum

I am a paranoid person.



Being paranoid, I always fear that my loves ones will be stricken with illness or meet with incidents. Now that my family only consist of my mother and me, it is only natural for me to be worried about my mother healthcare needs since mine is already taken care of (read HERE).

Yup, just realise I am probably quite selfish since I insured myself before insuring my mother first. Time for some self-reflection in a dark corner:(

Okay, I am done with the emo-ing..Now let us look at some of the questions bothering me with regards to my mother healthcare needs:

1) What is the average hospitalisation cost for an elderly stricken with a complicated illness?


Let us assume that an elderly had a heart attack, which is one of the more expensive illness to treat in Singapore. In this worst case scenario, we can expect a hefty hospitalisation bill of about S$13,523 before taking into account subsidies by the goverment.

This is assuming that the patient is warded in a public C-class ward at Tan Tock Seng Hospital, which is the nearest public hospital to where my mum is living. My personal experiences with the quality of healthcare provided at the C-class wards are pleasant and I believe that being warded in a C-class ward will be more than adequate if our finances does not allow us to upgrade to a higher-class ward

This figure of S$13,523 for treating heart attack was obtain from here. For more information on the hospital bill for other major illness as well as the different class of wards, you may wish to visit this webpage here.

2) How much of the cost is subsidised by the government?


Subsidies by the government for C-class wards in public hospital range from 65%-80%. For more information on the different level of subsidies for the different class of wards, you may like to refer to this page here.

Let us now assume that I am only looking to ward my mother in a C-class ward and that we can only obtain 65% subsidy, which is the minimum range due to our income level.

Hence, in this assumption, for a major hospital bill of about $13,523 for treating heart attack, the government will subsidize about $8789.95, leaving me to foot the remaining $4733.05.

3) How much cash would I have to fork out in such an event?


Of the $4733.05 that is not subsidized by the government, part of it will be paid via MediShield, with the balance paid via MediSave and/or Cash.

So what are MediShield and MediSave?

MediShield 

It is basically a nationwide insurance scheme by the government that works on a basis that the patient will share some of the responsibility of their medical bills by paying for the Deductible and Co-Insurance. MediShield will then be applied to help the patient cover the reminder of the bill.

In case anybody is wondering what are deductibles, co-insurance and the entire intricate workings of the MediShield scheme; I will be lazy and not rephrase what has already been explained succinctly by the Ministry of Health (MOH) over HERE:p

Go on, read it people. It wouldn't take you more than 10minutes to fully appreciate the wonder of the MediShield scheme; especially for low income group like me:(

If you are bored by the chunks of words and would prefer a visual explanation of MediShield, I have displayed two graphs from the MOH website :






MediSave

It is a nationwide saving account set up by the government in which a small portion of our monthly payroll will be transferred into. In other words, it is a forced saving 'banking account' set up to pay for our medical expenses. Click HERE if you like to find out more about the MediSave.

In summary:
MediShield - Nationwide healthcare insurance scheme
MediSave - Nationwide forced saving account for healthcare needs

I am going to run some numbers now to calculate what are the amount in cash that we have to fork out based on the scenario below:

Scenario:


An elderly, aged 63, is covered by MediShield and have a balance of $12,500 in her Medisave account. Unluckily for her, she had a heart attack and was warded in a C-class ward at Tan Tock Seng Hospital.

Thereafter, she made a full recovery :D but was saddled with a hospital bill of $13,523.

After subsidies of 65% by the government for being warded in a C-class ward, her bill is reduced to $4733.05.

With the coverage of MediShield, the elderly will only have to pay the Deductible of $1500, as well as the Co-Insurance of $559.56 [(20% of $1500 = $300) + (15% of $1733.05 = $259.96)]. Hence, the bill is further reduced to $2059.56 [$1500(Deductible) + $559.56(Co-Insurance)] as MediShield will cover the balance amount.

This payment of $2059.56 can be fully paid using MediSave, of which the elderly still has a balance of $12,500.

In summary, as long as the elder is warded in a C-Class ward in a public hospital, she should not have any problem making payment for her hospitalization due to the coverage of MediShield, as well as the subsidies from the government.


4) What if an elderly is afflicted with a long term illness and requires long term care?


In Singapore, there is the ElderShield, which provides monthly monetary disbursement for the long term care of a severely disabled(mentally or physically) elderly. This is another initiative by the government to provide affordable severe disability insurance for the elderly.

Under the basic ElderShield scheme, which is the ElderShield300, an elderly will be entitled to a monthly payout of $300 up to 60 months if the elderly is unable to perform any three of the following activities:
  • washing
  • dressing
  • feeding
  • toileting
  • mobility
  • transferring
Of course if you would like to receive more payout or a longer period of payout, you may choose to enhance your ElderShield via private insurers. For more information on enhancing your ElderShield, please see here.


Scenario:

Let us assume that an elderly covered by ElderShield400, is immobilized or suffers from mental incapacity such as dementia, and has only one child with no other dependent or spouse caring for her.

As the child is the sole breadwinner, he definitely have to work despite earning a meager salary of only $2600 per month (yes, that's me). Therefore, the per capita household monthly income is $1300.

With the child out at work, a caregiver such a maid have to be hired. Alternatively, the child can choose to place the elderly in a nursing home.

With the above considerations, the cost of caring for this elderly would come up to about $1500 per month. This cost estimation applies to both hiring a maid or a placement in the nursing home; as well as the miscellaneous medical cost of caring for the elderly.

I made this estimation based on information from the sources listed below:

To help relieve some of the $1500 incurred in caring for the elderly, the child can rely on the following:
  • $400 monthly payout from ElderShield
  • $500 monthly from renting out the common room

As we can see, there is still a deficit of $600 even after recovering some of the cost. Hence, the child should look into enhancing the existing ElderShield400 by purchasing supplement ElderShield insurance from private insurers. This will help to relieve a big part of the monthly cost of $1500, incurred for caring for the elderly.

For a comparison of all the supplement ElderShield insurance by the private insurers, please refer to here.

I will blog about which supplement ElderShield I might be getting for my mother on another day. This is a very long post already:/

I am tired; so are you I believe:p

Psstt.. I believe you guys can tell that my mum was used as an example for all the above scenario. However, I can't explicitly state that it's her as this would appear to be cursing her. Hur hur hur:(

Nonetheless, this blogpost was written with her health-care needs in mind and hence, I have to tailored the scenarios such that it would mirror my concerns.

I sincerely wish my mum the best of health and I just like to say 'I Love You Mum' <3.

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