MediShield
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-Insurance | Claimable 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 procedure | Claim Limits |
---|---|
Chemotherapy for Cancer/Certain Benign Neoplasms - Per 7-day treatment cycle - Per 21- or 28-day treatment cycle | $270 $124 |
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 |