A surgery bill and changes to IP rider premiums made me relook my insurance. Here's what I learnt

A surgery bill and changes to IP rider premiums made me relook my insurance. Here's what I learnt When reviewing your health insurance, experts warned not to focus only on premiums, but also to consider that healthcare needs can change with age. Adulthood is not just one phase of life but comes in stages. Its many facets can be overwhelming, from managing finances and buying a home to achieving work-life balance and maintaining healthy relationships. In this series, CNA TODAY's journalists help readers deal with the many challenges of being an adult and learn something themselves in the process. I have to admit that insurance was, until recently, an afterthought for me. My mother has been a financial adviser for over 20 years and I had always left it in her capable hands to ensure I had sufficient coverage. I agreed to whatever she suggested to me with a nod and a signature. All I needed to do was ensure I paid my premiums to avoid her nagging. But earlier this year, I had to undergo day surgery that was not fully covered by my corporate health insurance, and also had to deal with large expenses looming in the form of a wedding and Housing and Development Board flat purchase. That prompted me to take a closer look at my finances, including my insurance policies. It was a timely review for me because the Ministry of Health (MOH) had on Apr 1 implemented new rules for Integrated Shield Plan (IP) riders to keep private health insurance sustainable amid rising medical costs. Under these new rules, new policies would generally have lower premiums, but require a larger part of hospital bills to be paid out of pocket. The idea was to discourage Singaporeans from purchasing IP riders unnecessarily and over-insuring themselves, a trend that has been driving up healthcare costs and premiums. And so I took some time out to consider some key questions: What kind of health insurance do I really need, and in what areas do I want to be covered? WHAT IS AN IP AND AN IP RIDER? As most people would know, health insurances helps cover the cost of dealing with injury, illness or disability, should they arise. The insurance market offers a wide variety of policies with coverage limits that differ for specific diseases or conditions, hospital wards and types of healthcare services, among other things. There are "layers" when it comes to getting coverage for the cost of a hospital stay in Singapore, said Ms Li Huijing, the head of partnerships and investment management at MoneyOwl. Singaporeans and permanent residents (PRs) can tap their MediShield Life, the mandatory lifelong health insurance coverage for all citizens and PRs, but the claim limits on this are sized to cover only the cost of subsidised treatment in public hospital wards, she said. This means there are limits on how much MediShield Life covers hospitalisation and treatment in Class A or B1 wards, which have fewer beds and are air-conditioned, as well as private hospitals. This is where IPs come in – they are optional private insurance plans that provide coverage on top of MediShield Life. "The coverage is meant to cover the larger bill size of a higher public ward, or private hospital ward," Ms Li said, adding that different IP plans cover different ward types. IPs also cover a percentage of medical costs, meaning that a portion still requires an out-of-pocket payment – and this is where IP riders come in. These riders help to reduce out-of-pocket expenses before MediShield Life or an IP kicks in. "In addition to reducing deductible and co-insurance payments, the IP rider also offers other benefits such as cancer treatment that falls outside the cancer drug list, which could be a valuable benefit to some," said Ms Li. BUYING HEALTH INSURANCE Experts told CNA TODAY that there are several key considerations for an individual when looking at health insurance policies, including the long-term affordability of such plans and an individual's potential medical needs. When it comes to long-term affordability, the Monetary Authority of Singapore's basic financial planning guide states that the total spent on life and health insurance should generally remain within 15 per cent of one's take-home income. Premiums for policies such as IP plans and riders tend to be lower when the insured person is still young. However, premiums do rise as the person grows older to match medical inflation, said Mr Chan Wai Kit, the executive director of Life Insurance Association Singapore (LIA Singapore). That being said, as one grows older, the likelihood of developing health conditions increases. Mr Chan said that this means that older people purchasing new IP plans and riders, or upgrading their policies, might see higher premiums or exclusions if their health has deteriorated. But he also cautioned younger people looking to purchase their first health insurance policy to balance their healthcare needs with affordability. "If you choose a plan that stretches your budget today, this may become difficult to sustain when you are older," he said. Mr Chan also said that young people should keep in mind that their current decisions can affect future coverage options. He advises anyone who is young and healthy to take advantage of these attributes to secure a policy with more comprehensive coverage. In the future, if they are still in good health but their financial situation changes, they can choose to reduce their coverage without additional underwriting, which refers to the process where the insurer assesses a person's risk profile. When it comes to hospitalisation coverage, it is also important to consider where you wish to seek treatment, said Ms Li. If a patient is comfortable with the most basic type of ward, having an IP may not be necessary. However, if a patient prefers receiving treatment at private hospitals, then an IP plan to cover these costs would be desirable. "Once you have determined your desired level of healthcare coverage, you can then decide whether a rider is appropriate for your needs. The rider should complement the base plan rather than drive the decision," Ms Li said. "While riders can help reduce out-of-pocket expenses, they also come with additional costs that need to be weighed against the benefits provided. In other words, choose the base plan first, then the rider." Besides hospitalisation policies, one could also consider income-replacement policies in case one falls ill and is unable to work. "An IP covers the medical bill, but not the salary you may not be able to earn as you recover from your illness," Ms Li explained. For this, there is disability income insurance as well as critical illness insurance. But even without such policies, there are other safety nets accessible to all working Singaporeans and PRs. MediSave, the national medical savings scheme, can help pay for the healthcare needs of you and your loved ones – though there are limits on how much can be used. To address long-term care needs, there is CareShield Life, a compulsory policy for Singaporeans or PRs born in 1980 or later. Those born in 1979 and earlier can join the programme if eligible; otherwise, they have ElderShield, into which they were automatically enrolled between 2002 and 2019, unless they opted out. REVIEWING YOUR COVERAGE As a rule of thumb, experts said that everyone should periodically review their health insurance coverage and consult their financial advisers, as there are different considerations based on each life stage. As mentioned earlier, younger people tend to have lower health insurance premiums, but these premiums may increase over time. Those in their 40s or older might have more cost concerns as they take on the responsibility of insuring not only themselves but their dependants. Nearing retirement, it is wise to review one's insurance portfolio to consider whether one can afford the premiums upon retirement. But an individual must also consider that there might be greater healthcare needs in old age. "It is important to re-evaluate your preferred hospital ward and choice based on your ongoing affordability," said Mr Chan of LIA Singapore. In reviewing all these factors, some individuals might want to consider downgrading their IP riders purchased before Nov 27 last year, which were based on older terms and would have higher premiums than IP riders purchased on or after Apr 1, when MOH's new rules kicked in. IP riders bought from Nov 27, 2025 till Mar 31, 2026 will transition to riders that meet the new requirements no later than their next policy renewal after Apr 1, 2028. An IP rider premium must be entirely paid in cash, while IP premiums can be paid using MediSave up to the withdrawal limit. Hence, downgrading the policy or switching to a new rider might be ideal, depending on one's current budget – though this might mean paying more out of pocket if one is hospitalised in certain wards or at private hospitals. However, Ms Li noted that the savings from downgrading an IP rider may not be apparent in one's annual health insurance bill, as some IP premiums have increased. Five of the seven insurers authorised by MOH to offer IPs raised their base IP premiums, with only AIA and Great Eastern leaving theirs unchanged in the latest round of premium reviews, she said. "For now, the savings are generally larger than the base increases, especially at younger ages, but that balance should not be assumed to hold forever," she said. "We would also be cautious about the large lifetime savings figures being quoted, since they are based on today's premiums and ignore future increases, so the real savings are likely smaller." Mr Chan added that if you choose to terminate their IP or switch to a lower-tier plan that covers lower ward classes with the same insurer, this does not require additional underwriting. This is crucial for policyholders who may have had policies purchased before they were diagnosed with long-term illnesses. However, if an individual chooses to purchase an IP or upgrade their coverage in the future, that individual will be subjected to underwriting – meaning the policy coverage and premiums will be based on their health and circumstances at that moment in time. Ultimately, after speaking to all the experts, I learnt that as I reviewed my portfolio I had to think through my current health status, the extent of medical coverage I want and the amount I want to set aside for insurance premiums. So for now, I'm leaving my policies untouched as the premiums are within my means and I do not want to reduce my coverage should I fall sick in the future. It seems that mothers do know best.