When MediShield came into effect in 1990, Terry Lee waited not a moment to make sure he and his entire family were covered under the scheme. As an insurance man, he knew all too well the importance of providing adequate cover for medical crises.

Two years ago, about 12 years after he went with the scheme, his father suffered kidney failure, needing prolonged hospitalisation, regular dialysis, medicines, vitamins and anti-biotics. Fortunately, MediShield was able to take the load off Terry in a significant way.

"I am so glad that MediShield has been able to cover about half of my father's medical bills. He fell ill last year in November and had to be hospitalised in Singapore General Hospital and the Ang Mo Kio Community Hospital. During that long period of treatment, medical bills for him went way above $10,000, most of which was paid by MediShield."

Even now for his twice-weekly kidney dialysis and medicine, the family forks out about $200-$300 a week, again falling back on MediShield for some relief.

The portion of the bills that he has to pay by cash, Terry has claimed under Medisave. This is a part of your monthly Central Provident Fund (CPF) contribution that is put aside for medical emergencies. In a sense, you are saving your own money to help tide you over during times of need. MedisShield, on the other hand, is an insurance scheme administered by the CPF board with premiums paid through Medisave. Children can pay premiums for their parents to be covered under the scheme. Beyond this, private schemes have also co-existed as Incomeshield, AIAshield etc, emulating MediShield and in many cases providing higher cover for higher premiums.

Sole Breadwinner

Terry, who is the General Secretary of the Singapore Insurance Employees Union (SIEU) is the sole breadwinner in his family. His wife is a homemaker. His son, 24, is doing accountancy studies while his daughter 17, is in junior college.

"Fortunately my brother and sisters did not shrug off their responsibility. A younger sister and a younger brother are helping me financially, while my elder sister and another sister helped out by looking after our parents who prefer to live on their own in their three-room flat in Toa Payoh."

Terry said it pains him to see his 77-year-old father sometimes cry when Terry or his siblings sign to pay for a bill or dialysis treatment. Terry personally drives his father twice a week (on Wednesdays and Saturdays) to the Kidney Dialysis Centre at Kim Keat.

The worry that he is causing the family financial distress by being sick is agitating his father, Terry knows. The once active man who used to be an upholstery maker has thrown tantrums many times. Once he even had to be tied with a belt to the dialysis machine to force him to complete the treatment.

"Father has said many times that he wishes to die to spare us the financial burden. But, we have only one father and we all want to do our best for him. We have arranged for a maid to look after him and my mother. The cost of the maid is also shared by my siblings and I."

Terry is sure that making his father's life as comfortable as possible 'with regular treatments and even full-time maid care' has been possible because MediShield has provided him support.

He adds: "Because of my own experience, I feel very strongly that everyone should come under MediShield."

Being without coverage is just too high a risk.

Know your 3Ms

Why the need to change MediShield?
The 14-year-old MediShield scheme is going through a major shake-up. While premiums have remained the same since it started, medical cost has not. What that means is that it was paying out far more than it was collecting. Also, since the scheme was not compulsory, many had chosen to opt-out of it in the past 14 years, thinking that they could save some money. Some of these people may have adequate cover through an insurance scheme of their own, but many others are actually depending on their employers to provide medical cover when they fall sick. When the economy went into a downturn, causing many to lose their jobs, many people suffered.

What are the key points of the new change?
The most significant change in MediShield is that premiums will now be raised from July this year. The deductible limit, which works like the excess clause for car insurance, has also been raised from $500 to $1,000 for Class C. So, MediShield will pay from $1,000 and above if you are covered. This is in line with what the scheme intends to do - take care of those with bigger bills better. With the new changes, MediShield is estimated to take care of about 60 per cent of the cost of each big bill.

What then is Medifund?
Medifund is a public assistance scheme for those who don't have Medisave or MediShield. It's like a social welfare scheme.
For details, please look up the MOH website www.moh.gov.sg

The Pain of the 50-somethings

Terry is 52 years old. He will continue to enjoy MediShield cover, but will pay a considerably higher premium from July - going from $60 to $160 per year. This $100 increase is the highest premium increase and Terry, being a unionist, is worried that there will be many like him who are hit hard on many fronts "CPF cuts, job loss,and now this", he says.

Commenting on this, NTUC Asst Sec General Halimah Yacob said for as long as the 50 plus and older are employed, they have little to worry about. Even when they are out of work, most would have enough in their Medisave to pay the increased premium.

"Although older workers have to pay more in premiums, if they are working it is still affordable. Those in the 50 to 60 age group, for example, will have to pay $160 annually in MediShield premiums from July 1. If they are working, they will be contributing 8% of their monthly income into their Medisave. Even a worker who earns $1000 will then have $960 a year in Medisave contributions, which will be sufficient for his increased premium."

"The average Medisave balance for most CPF contributors is around, $10,600. Most people would be able to pay their MediShield premiums even if they are out of jobs," she added.

Halimah also pointed out two aspects of the revamp which work to the benefit of older workers.

Better coverage of bigger bills: The whole idea behind the revamped MediShield is to help families that have big medical bills. That, she pointed out, has been vastly improved. Where Medisave used to pay for just 30% of the big bills, it now covers over 60%, or two thirds of the bill.

Discounts for the elderly: Those who have remained with MediShield paying yearly premiums will also be getting a 10% discount above the age of 70. This will be given for every 10 years after that.

Madam Halimah said there are trade-offs in MediShield. "For greater protection, we will have to pay more."