To put it at its simplest, think Medishield as an Insurance scheme which has deductible and co-insurance features.

Out of the total BILL, only a portion (up to a maximum specified for the specific procedure or hospitalization, subjected to max of $50,000 per policy year and max of $200,000 per lifetime) can be claimed.

Of this portion that can be claimed, your must first pay a “deductible” component (varies from $1,000 to $3,000 depending on patient’s age and class of ward), see table below.

Age (next birthday)'C' Class ward'B2" and above or Day surgery
Members aged 80 years old and below$1,000$1,500
Members aged between 81 – 85 years old$2,000$3,000

The remainder of the BILL after subtracting the deductible becomes what is “CLAIMABLE”.

Of this “CLAIMABLE” amount, MediShield will pay for _most_ of if, the rest will be paid by the patient (or his family) in either case or mediSAVE funds. This is the principle of co-insurance. It works in a tiered system. You will need to pay a LARGER portion of this claims for the first few thousands and a SMALLER portion of the later tiers according to the table below. Thus, the larger the bill size, the greater the proportion paid for the insurance scheme of MediShield.

'C' class'B2" class and above or Day surgery
Co-InsuranceClaimable Amount
$1001 - $3000 : 20%
$3001 - $5000 : 15%
Above $5000 : 10%
Claimable Amount
$1501 - $3000 : 20%
$3001 - $5000 : 15%
Above $5000 : 10%

In addition, MediShield can also be used to pay for outpatient procedures.

Outpatient procedureClaim Limits
Chemotherapy for Cancer/Certain Benign
- Per 7-day treatment cycle
- Per 21- or 28-day treatment cycle

Radiotherapy for Cancer
- External or Superficial
- Brachytherapy with or without external RT
$80 per treatment day
$160 per treatment day
Stereotactic Radiotherapy for Cancer$1,800 per treatment
Radiosurgery includes Novalis radiosurgery and Gamma Knife treatment$4,800 per procedure