Guide to Health Insurance Claim
In the recent year, the awareness of the need for health insurance has increased, no thanks to rising medical inflation locally. However, as advisers, we often receive enquires from clients who are unsure about the claiming process of such plans. Hence, here we are, giving pointers and shedding light to this sometimes, confusing process.
Singaporean and Permanent Residences are offered a compulsory basic health insurance in the form of Medishield Life(MSL) by our government. Many have upgraded their MSL with integrated Shield Plans (ISPs) and their relevant riders to reduce out pocket expense when emergencies arise. At the same time, the gainfully employed among them are usually also covered under their employee insurance benefits.
Many foreigners, however, largely only have their employee benefits to rely on in the event of a hospitalisation. We often advise a top up of personal medical plans above the employee benefit for added protection, in the event of a job change.
Should an admission happen in Singapore, we hope the following list of FAQs can help you navigate the claim process smoothly.
1. How should I submit my claim?
For Singaporean & Permanent Residence, you are advised to do it via electronic filing, commonly known as E-File. You may request the admission office of the hospital you’re admitted in to do the electronic filing. This process only facilitates a direct billing to your insurer. It must not be mistaken as an approval of the admission claims.
For Foreigner, unless your health insurer provides a direct billing facility, you’re required to pay the bill on your own and, subsequently submit the claim for reimbursement.
2. How may I request for a Letter of Guarantee if the hospital requires one?
Most Insurers provides electronic Letter of Guarantee, kindly speak with the hospital admission officer and they shall check and advise you on this. Most insurer works directly with hospitals for eLOG issuance. Please be aware that LOG is by no means a claim submission or approval. It is simply a letter to reduce the upfront cash deposit by patients prior to admission and/or surgeries.
3. Who should I submit my claim first?
Despite employee benefit holds the first payor status before your personal health insurances (ISP or other type of health insurances), based on our experience, we would advise that you should submit your claim to your personal health insurance before going after your employee benefit. This shall gives you the benefit of faster processing time & reimbursement, higher claim ceiling and benefit of longer pre and post hospitalisation.
4. When should I submit my claim?
Upon discharge from the hospital/surgery, but preferably not more than 3 months after the procedure.
5. Where should I submit my claim?
For Singaporean/Permanent Residences, you could only submit your Integrated Shield Plan insurance claim via electronic filing by the hospital/clinic.
For Foreigner with Integrated Shield Plan and other type of health insurance, you could submit directly to your insurer portal online. Do contact your adviser for the relevant links.
For all the working adults covered by their employer, you could submit your claim through your employee benefit portal (broker/insurer portal).
6. What documents do I need to submit?
Minimally, you should submit the following documents:
- Discharge Summary Letter
- Duly signed Claim Form
- Duly signed Doctor Report Form
- Hospital/Clinic’s Invoices
Lastly, if you hold multiple health insurance policies, do note that:
- You may claim from multiple policies, one after another, as long as the total amount of reimbursement across all insurers shall not exceed total bill paid.
- Each Insurer shall review the claim as a whole against your entitlement and/or sublimit independently from other insurers’ settlement.
- In the event there is any overlapping claim reimbursement across insurer, the insurer with first payor status shall reimburse the insurer with last payor status.
- Medishield Life and Integrated Shield Plan reserve the last payor status, while company health insurance under your employee benefit has the first payor status.
If you’re unsure about your entitlement/insurance benefit, do reach out to me for a review!
Important: The information and opinions in this article are for general information purposes only. They should not be relied on as professional financial advice. Readers should seek unbiased financial advice that is customised to their specific financial objectives, situations & needs. This advertisement or publication has not been reviewed by the Monetary Authority of Singapore.
Published By:
Fendy Susanto
Fendy hails from a family who value entrepreneurship, where he understands that ones’ finance is ones’ responsibility. He follow suit after leaving his decade-long career in construction industry, becoming a Financial Advisor, an Entrepreneur and a Content Creator.
Prior to joining this career, Fendy had lost his Mom and Dad to Cancer and Heart Attack, respectively. Having a first hand experience on how devastating that was financially and emotionally, his main goal is to “Leave no Life Unprotected”
With his creative traits and his warm personality, rest assured that your needs always comes first at the best possible way. No doubts on the level of advices and services delivered as testified by his clienteles.
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