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一文读懂新加坡医疗险：主险（IP）与附加险（Rider）2025

🇸🇬一文读懂新加坡医疗险：主险（IP）与附加险（Rider）

🏥 主险 (Integrated Shield Plan, IP)

新加坡的医疗险主险通常指的是综合健保双全计划 (Integrated Shield Plan, IP)。它是对政府强制性的终身健保 (MediShield Life) 的补充。

主险的核心功能：

  1. 提升住院病房级别保障：

    • 终身健保 (MediShield Life) 仅提供在政府医院 B2/C 级病房的基本保障。

    • IP 主险允许您选择更高的病房级别保障，例如：

      • 政府医院的 A/B1 级病房

      • 私人医院的病房

  2. 增加赔付额度和项目：

    • 它提供比终身健保更高的年度索赔限额。

    • 它通常涵盖住院前后的特定门诊治疗费用（例如出院后 90-365 天）。

  3. 两个组成部分：

    • 终身健保部分 (MediShield Life component): 由公积金局 (CPF Board) 运营，是强制性的，保费可用保健储蓄 (MediSave) 支付。

    • 额外私人保险部分 (Additional private insurance component): 由私人保险公司运营（如 AIA、大东方、保诚等），提供更高的保障，保费可用保健储蓄支付，但有提款顶限。

🛡️ 附加险 (Rider)

附加险是您在购买 IP 主险时，可选购的额外福利。其主要目的是大幅减少您在住院时必须自掏腰包的费用。

附加险的核心功能：

  • 减少自付费用 (Out-of-Pocket Expenses)： 这是附加险最重要的价值。住院账单通常包含两个主要自付部分：

    1. 免赔额 (Deductible)： 保险开始赔付前，您每年需要支付的固定金额。

    2. 共同保险 (Co-insurance)： 免赔额支付后，您需要支付的剩余账单的百分比（通常是 10%）。

  • 过往的“全额附加险”： 以前的附加险可以完全覆盖免赔额和共同保险，意味着您几乎无需支付任何费用。

  • 目前的共同支付制度 (Co-Payment)：

    • 自 2019 年 4 月 1 日起，所有新的附加险都必须包含至少 5% 的“共同支付 (Co-payment)”。这意味着即使您购买了附加险，您仍然需要支付至少 5% 的合格医疗费用。

    • 大多数附加险会将您全年需要支付的最高共同支付金额设定一个上限（例如 S$3,000 或 S$6,000，具体取决于保单和购买时间），这让您的医疗费用更加可预测。

  • 其他额外保障（取决于具体计划）：

    • 提供中医治疗、购买医疗辅助器具的费用等。

    • 如果使用保险公司指定的医生/专家网络 (Panel Specialist)，通常可以享受更高的保障或更低的共同支付。

附加险的重要考量点：

特点 详细说明
保费支付 附加险保费只能用现金支付，不能使用保健储蓄 (MediSave)。
保障变化 随着年龄增长，附加险保费会显著增加。政府也正在推动改革，以控制医疗成本。
价值权衡

购买附加险： 带来安心，住院时自付费用低且可预测（有最高限额）。


不购买附加险： 保费较低，但住院时需支付全额的免赔额和 10% 的共同保险，大额账单的风险高。

💡 总结对比

特性 主险 (Integrated Shield Plan, IP) 附加险 (Rider)
性质 核心保障，对终身健保的升级。 额外附加福利，依附于主险。
主要目的 提升病房级别、增加年度赔付限额。 大幅降低住院时的自付费用 (免赔额 /自付额+ 共同保险)。
保费支付 部分或全部可使用保健储蓄 (MediSave)。 必须使用现金。
自付费用 需支付免赔额和共同保险（通常 10%），无自付上限。 需支付最低 5% 共同支付，但设有年度最高自付上限。

2025年11月26日，卫生部又对附加险出台了新的规定：

核心变化要求旨在加强私人医疗保险的可持续性，并遏制不断上涨的医疗成本。

1. 附加险 (Rider) 不再允许全额覆盖最低自付额（Deductible）

  • 旧规定： 以前的附加险（Rider）可以涵盖主险中的最低自付额 (Deductible)。这意味着患者住院时无需支付这部分费用。

  • 新规定（自2026年4月1日起销售的新附加险）： 新的附加险将不再允许覆盖最低自付额。

    • 这意味着，即使购买了附加险，患者在保险公司开始赔付前，仍需自己支付主险规定的最低自付额。

    • 主险的最低自付额金额取决于您所选择的病房级别，例如私人医院住院可能在 S$3,500 到 S$5,000 不等（请注意：这部分费用可以使用保健储蓄 MediSave 支付，但需符合提款顶限）。

2. 共同承担额（Co-payment）的最高自付上限提升

  • 共同承担额 (Co-payment) 的本质： 这是指在支付完自付额（Deductible）后，患者仍需承担的剩余账单的百分比（通常为 5% 或 10%）。

  • 旧规定： 之前的附加险通常将每年的共同承担额自付上限（Co-payment Cap）设定在最低 S$3,000。

  • 新规定： 针对新的附加险，共同承担额的年度最低自付上限将提升至 S$6,000。

    • 这意味着，即使您购买了附加险，您每年需要自掏腰包支付的共同承担额（在支付完自付额之后），最高可能达到 S$6,000。

    • 请注意： 这个 S$6,000 的上限不包括您需要先支付的最低自付额 (Deductible)。

核心影响总结

费用项目 变化前 (旧附加险，通常 S$3,000 上限) 变化后 (新附加险，最低 S$6,000 上限)
最低自付额 (Deductible) 附加险通常全额覆盖，患者无需自付。 附加险不再覆盖，患者必须自己支付。
共同承担额 (Co-payment) 年度自付上限通常为 S$3,000。 年度最低自付上限提高到 S$6,000。
整体影响 极端情况下，患者几乎无需支付（“零现金”）。 患者在每次住院时，需支付最低自付额，外加共同承担额（最高 S$6,000）。
附加险保费 较高。 预计平均降低约 30%。

🤝 欢迎联系我，获取专属咨询

面对政策的重大调整，您的现有保单（尤其是附加险 Rider）是否需要升级或调整，以确保未来的医疗保障无缝衔接，至关重要。

我们深知医疗险的条款复杂且涉及您家庭的财务安全。

如果您对以下任何方面有疑问：

  • 您的现有保单将如何受新规影响（特别是 2028 年前的过渡期）。

  • 如何规划最低**自付额（Deductible）和共同承担额（Co-payment Cap）**的现金储备。

  • 比较市场上各大保险公司（如 AIA、大东方、保诚等）最新推出的 IP 与附加险。

欢迎随时联系我！ 将为您提供专业的分析和个性化的建议，确保您的医疗保障始终有效且最符合您的财务需求。

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:

Wang Hongna Anna

您好，我是洪娜（Hongna），现任新加坡理财顾问公司 Financial Alliance 鑫盟理财的资深理财顾问，拥有8年从业经验，持有国际金融理财师CFP®认证及AEPP高级认证，并荣获新加坡银行与金融学院（IBF）高级认证。

专注为职场人士、家庭及企业提供全方位的财务保障和理财规划服务，从单一保险公司起步，现已全面转型为理财顾问，始终秉持“客户优先”的原则，为客户提供中立、客观、专业的财务建议。无论是医疗保险索赔、教育与养老规划，还是企业员工福利保险，我都能为您量身定制解决方案。

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欢迎添加我成为您的理财伙伴，为您的家庭与企业保驾护航。

Hello, I’m Hongna, a Senior Financial Advisor at Financial Alliance – the largest Independent Financial Advisory (IFA) firm in Singapore – with 8 years of experience in the industry. I hold the CFP® (Certified Financial Planner), AEPP certification, and the IBF Advanced Level accreditation from the Institute of Banking and Finance Singapore.

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  • 在与鑫盟理财进行讨论或签订合约时，您应确保您已完全遵守并将继续遵守您所在原居住国的所有适用法律及条规。

In compliance with the Personal Data Protection Act, Financial Alliance Pte Ltd (“FAPL”) seek your consent to collect and use your personal data (e.g. name, NRIC, contact numbers, mailing addresses, email addresses and photograph) for the purposes of and in accordance with FAPL’s Data Protection Policy, which can be found on FAPL’s website at https://fa.com.sg/data-protection-policy/.

根据《个人数据保护法》，鑫盟理财私人有限公司征求您的同意向您收集并使用您的个人信息。鑫盟理财将根据公司的个人数据保护政策所阐述的用途使用您的个人资料（例如姓名，证件号码，联系电话，邮寄地址，电邮地址和照片）。 该政策可在本公司网站上查寻，网址为 https://fa.com.sg/data-protection-policy/.

By submitting this form, you are deemed to have read and understood FAPL’s Personal Data Policy.

提交此表格，即表示您已阅读并理解鑫盟理财私人有限公司的个人数据政策