Health Insurance That Offers You More Options? Of Course. · Living Donor Organ Transplant...

Health Insurance That Offers You More Options?

RAFFLES SHIELD

A MEMBER OF RAFFLES MEDICAL GROUP

Of Course.

2

Upgrade your plan within 5

years, without underwriting.

In the unfortunate case of death or total or

permanent disability of a parent paying for a child’s

policy, RHI will waive the additional private

insurance premiums of the IP and ensure that

the child’s coverage continues.

Choose a High Deductible Option1 which comes with lower premiums.

Health Insurance

That Fits Your Healthcare

AND Financial Needs?

Health Insurance

That Protects Children Too?

Health Insurance That Complements

Your Company’s Benefits?

Of Course.

Of Course.

Of Course.

2

3

Choose the Raffles Hospital Option that lets you enjoy private

hospital facilities while paying lower private

premiums. Together with medical doctors, we will partner with individuals with chronic conditions2

(ie. diabetes, hypertension and high cholesterol) to

manage their health.

Policyholders will have access to a

panel of specialists across a wide range of

specialties.

Health Insurance That Offers Access

To A Private Hospital At A

Lower Price Tag?

Health Insurance That Partners

With You To Manage

Your Chronic Conditions?

Health Insurance With A Specialist

Network ?

Of Course.

Of Course.

Of Course.

3

4

Raf es Ho

spital O

ption

Basic Coverage – MediShield Life

Private Insurance Co

verage – Raf es Shield

Key Rider High D

eductible Option

Prem

ier Rid

er

Rafes Shield complements MediShield Life

High Deductible Option

complements your company’s benefits,

resulting in no coverage overlaps and thus, even more savings

Rafes Hospital Option allows you to enjoy Raffles Hospital Treatment

without paying the full Private Premiums

Key Rider replaces your Raffles Shield deductible and

co-insurance with a 5% co-payment

Premier Rider provides you with greater benefits such as

Immediate Family Accommodation and Post-Hospitalisation Traditional Chinese Medicine

Of Course.

A Plan That Adapts To Your Needs?

MediShield Life provides basic coverage for all Singapore Citizens

and Singapore Permanent Residents and is administered by the CPF Board

5

Of Course.

Always There For You?

Need An Appointment With Specialists? We will assist you with specialist appointment bookings and healthcare advice.

Need Pre-Authorisation Of Treatment? We will help you in getting the treatment authorized prior to your hospital admission to ensure a smooth claim procedure.

Need To Enroll In The Rafes Care Management Programme? We will coordinate with the Raffles Medical Primary Care Network (PCN) to help you register in the programme and arrange your doctor’s appointments.

Need Personal Assistance? Should you have any questions with respect to your coverage, claims or appointments, we are ready to assist you.

Need More Information Regarding Healthcare? We have access to a wealth of healthcare information which we can share with you.

6

Rafes Shield A

Rafes Shield Private

Inpatient Treatm

ent

Daily Room & Board and Medical-related Services5

As Charged

As Charged

As Charged (Up To 45 days Per

Hospitalisation)


Hospitalisation)

$8,000 / Year (Incl. Post-Hospitalisation

Psychiatric Treatment)



As Charged

As Charged

Intensive Care Unit (ICU) and Medical-related Services

Surgical Benefits6

Surgical Implants and Approved Medical Consumables7

Gamma Knife and Novalis Radiosurgery

Community Hospital8

Inpatient Psychiatric Treatment

Accidental Inpatient Dental Treatment

Benefit Schedule(Payout Includes MediShield Life Payout)

Citizenship Status3 (Based on Pro-Ration Factors4) SC/PR/FR SC/PR

7

Rafes Shield A


Ad

ditio

nal Benefi

ts

As Charged

As Charged(Up To 180 Days For

Treatment By Panel10

Or Government Restructured Hospital (GRH), Up To 90 Days

In Other Private Hospitals)

As Charged(Up To 365 Days For Treatment By Panel

Or GRH11, Up To 180 Days In Other Private

Hospitals)

Covered Under Inpatient Psychiatric Treatment (Up To 90

Days After Discharge)

As Charged(Limited To Panel

Charges & Subject To Pro-Ration Factor12)

In The Event Of Death / Total And

Permanent Disability (TPD) Of The Parent

(payor), Premium Will Be Waived For

The Insured Until He / She Reaches Age 21





As Charged(Limited To Singapore GRH Ward A Charges)




Or GRH, Up To 90 Days In Other Private

Hospitals)


Or GRH, Up To 180 Days In Other Private

Hospitals)

As Charged

Pre-Hospitalisation Treatment9

Post-Hospitalisation Treatment9

Post-Hospitalisation Psychiatric Treatment

Emergency Overseas Medical Treatment

Waiver Of Premium For Insured13

Major Organ Transplant

Stem Cell Transplant

Breast Reconstruction After Mastectomy14

Human Immunodeficiency Virus (HIV) Due To Blood Transfusion And Occupationally Acquired HIV

Outp

atient Treatment As Charged As Charged

(i) External or Superficial Radiotherapy (ii) Brachytherapy With Or Without External Radiotherapy

Chemotherapy

Immunotherapy

Stereotactic Radiotherapy

Immunosuppressants for Organ Transplant

Erythropoietin

8

Rafes Shield A


$60,000 / Transplant(24 Months Waiting

Period15 For Recipient)


Period For Recipient)

Living Donor Organ Transplant (Insured As The Living Donor Donating An Organ

As Charged(10 Months

Waiting Period)


Waiting Period)


Waiting Period)


Waiting Period)

$60,000 / Transplant $40,000 / TransplantLiving Donor Organ Transplant (Non-Insured Donating An Organ To Insured)

Pregnancy Complications Benefit16

Congenital Abnormalities Benefit For Insured

Pub

lic H

osp

italsR

afes

Hospitals

Com

munity

Hospitals

Other

Private

Hospitals

100%

100%

100%

100%

70%18

60%

100%

100%

60%

Class A

Private

1-2 Bedded Ward / 4-10 Bedded Ward / Short Stay Ward


Day Surgery / Outpatient Treatment


Class B1

Class A

Class B2+ / B2 / C

Class B1

Day Surgery, Short Stay Ward / Outpatient Treatment (Subsidised / Non-Subsidised)

Class B2+ / B / C

10%

Panel – $1,500,000 Non-Panel – $600,000

10%

$600,000

Unlimited

$4,000

Unlimited

$5,000

Policy Year Limit

Lifetime Limit

Co-Insurance17

Final Expense Benefit

9

Rafes Shield A


Pub

lic H

osp

italsP

rivate H

osp

italsC

om

munity

Ho

spitals

Ded

uctibles Fo

r Each P

olicy Year

(For insured

Ag

e 81 Years and ab

ove

at next birthd

ay) ($)

5,250 5,250

5,250 5,250

4,500 4,500

3,000 3,000

5,250 5,250

3,750 3,750

2,250 2,250

3,750 3,750

3,000 3,000

3,000 3,000

4,500 4,500

2,250 2,250

Class A

Private / Class A

1-2 Bedded Ward / 4-10 Bedded Ward

Day Surgery / Short Stay Ward

Class B1

Class B1

Class B2+ / B2

Class C

Class B2+ / B

Day Surgery (Subsidised) / Short Stay Ward (Subsidised)

Day Surgery (Non-Subsidised) / Short Stay Ward (Non-Subsidised)

Class C

Pub

lic H

osp

italsP

rivate H

osp

italsC

om

munity

Ho

spitals

Ded

uctibles (A

ge 80 Years and

belo

w

at next birthd

ay) ($)19

3,500

3,500 3,500

3,000 3,000

3,500 3,500

2,500 2,500

2,000 2,000

1,500 1,500

3,500

2,500 2,500

2,000 2,000

2,000 2,000

3,000 3,000

1,500 1,500

Class A

Private



Class B1

Class A

Class B2+ / B2

Class C

Class B1



Class B2+ / B

Class C

10

Rafes Shield Standard

Rafes Shield B

Inpatient Treatm

entO

utpatient Treatm

ent

Daily Room & Board and Medical-related Services5

Intensive Care Unit (ICU) and Medical-related Services

Surgical Benefits6

Surgical Implants and Approved Medical Consumables7

Gamma Knife and Novalis Radiosurgery

Community Hospital8

Inpatient Psychiatric Treatment

Accidental Inpatient Dental Treatment

Kidney Dialysis

(i) External or Superficial Radiotherapy (ii) Brachytherapy With Or Without External Radiotherapy

Chemotherapy

Immunotherapy

Stereotactic Radiotherapy

Immunosuppressants for Organ Transplant

Erythropoietin

Benefit Schedule(Payout Includes MediShield Life Payout)

Citizenship Status3 (Based on Pro-Ration Factors4)


Hospitalisation)



As Charged

As Charged

As Charged

$1,700 / Day

$2,900 / Day

(i) $550 / Session(ii) $1,100 / Session

$650 / Day

$1,200 / Month

$500 / Day (Up to 35 Days)

$450 / Month

Covered Under Inpatient Hospital Treatment

$9,800 / Admission

Not Covered

$9,600 / Procedure

$1,800 / Treatment

$2,750 / Month

Table 1: $590Table 2: $1,670 Table 3: $3,290Table 4: $4,990 Table 5: $8,760

Table 6: $11,670Table 7: $16,720

$5,200 / Month

PRPR SCSC

11


Rafes Shield B

Ad

ditio

nal Benefi

ts

Pre-Hospitalisation Treatment9

Post-Hospitalisation Treatment9

Post-Hospitalisation Psychiatric Treatment

Emergency Overseas Medical Treatment

Waiver Of Premium For Insured13

Major Organ Transplant

Stem Cell Transplant

Breast Reconstruction After Mastectomy14

Human Immunodeficiency Virus (HIV) Due To Blood Transfusion And Occupationally Acquired HIV





As Charged(Limited To Singapore GRH Ward B1 Charges)



As Charged(Up To 90 Days)

As Charged(Up To 90 Days)

Not Covered

As ChargedCovered Under

Inpatient Hospital Treatment

12


Rafes Shield B


Period For Recipient)


Waiting Period)


Waiting Period)

$20,000 / Transplant

Covered Up To MediShield Life

Benefits

Living Donor Organ Transplant (Insured As The Living Donor Donating An Organ

Living Donor Organ Transplant (Non-Insured Donating An Organ To Insured)

Pregnancy Complications Benefit16

Congenital Abnormalities Benefit For Insured

Pub

lic H

osp

italsR

afes

Hospitals

Com

munity

Hospitals

Other

Private

Hospitals

Class A

Private





Class B1

Class A

Class B2+ / B2 / C

Class B1

Day Surgery, Short Stay Ward / Outpatient Treatment (Subsidised / Non-Subsidised)

Class B2+ / B / C

Policy Year Limit

Lifetime Limit

Co-Insurance17

Final Expense Benefit

60%

50%

65%

65%

50%

50%

80%

50%

80% 80%

100%

100%

100%

100%

100%

100%

100%

90%

90%

90%

90%

90%

100%

90%

100%

80%

50%

100%

100%

Unlimited

$3,000

Unlimited

N.A.

$300,000 $150,000

10% 10%

Covered Under Inpatient Hospital

Treatment

13


Rafes Shield B

Pub

lic H

osp

italsP

rivate H

osp

italsC

om

munity

Ho

spitals

Ded

uctibles (A

ge 80 Years and

belo

w

at next birthd

ay) ($)19

Class A

Private



Class B1

Class A

Class B2+ / B2

Class C

Class B1



Class B2+ / B

Class C

3,500 2,500

3,000 2,000

3,5002,500

2,500

2,000 2,000

1,500 1,500

3,500 2,500

2,500 2,500

2,000 2,000

2,000 1,500

3,000 2,000

1,500 1,500

Pub

lic H

osp

italsP

rivate H

osp

italsC

om

munity

Ho

spitals

Ded

uctibles Fo

r Each P

olicy Year

(For insured

Ag

e 81 Years and ab

ove

at next birthd

ay) ($)

Class A

Private / Class A



Class B1

Class B1

Class B2+ / B2

Class C

Class B2+ / B



Class C

5,250

5,250

4,5003,000

3,000

3,000

5,250

3,750

2,250 2,000

3,0003,750

3,000

3,000

4,5003,000

2,250 2,000

14

Overview Of Special Options

Overview Of Riders

Special Options are variations to the Raffles Shield plans, and Premiums are payable by Medisave, subject to the Additional Withdrawal Limits (AWLs).

With the Raffles Key Rider, you can replace the deductible and co-insurance of your Raffles Shield policy with a co-payment of 5%20 for every claim.

#Key Rider is not available for Raffles Shield Plans with High Deductible Option.

Key Rider#

Increases the pro-ration factor (how much we pay) for medical expenses incurred at Raffles Hospital to 100% for all wards if added to the Raffles

Shield A plan.

Increases the Deductible applicable to $10,000 for all wards and ages

Only available for the Raffles Shield A plan.

Replaces Deductible and Co-Insurance under Your Policy with a co-payment of 5%21 for every claim.

Co-payment capped at $3,000 / policy year for treatment by Panel or GRH Specialists, or pre-authorised treatments, no cap on co-payment for

treatment by non-panel or non-GRH specialists.

Available with all plans except Raffles Shield

Standard Plan and plans with the Key Rider added.

Option

Benefits

Description


Restrictions

Rafes Shield A Rafes Shield B

Rafes Hospital (RH)

Reduced Co-Payment

High Deductible

15

Enjoy the following benefits when you choose Premier Rider.Premier Rider

Standard charges for an additional bed (Up to 30 days at RH

& GRH, 10 days in other hospitals)

$100 / Day, Up to $3,000 / Year

$200 Per Hospitalisation



$100 / Day, Up to $2,000 / Year

$100 / Day, Up to $1,500 / Year

$6,000 / Year (Within 180 days, TCM clinics at RH

or GRH only)

$2,500 / Year $1,500 / Year $1,000 / Year


or GRH only)


or GRH only)

RH or GRH – Standard charges for an additional bed (up to 30 days)

Other Private Hospitals – capped at $70/day (up to 10 days)

Benefits Rafes Shield Private Rafes Shield A Rafes Shield B

Immediate Family Accommodation22

Post-Hospitalisation Home Care24

Ambulance Services

Post-Hospitalisation Follow Up Traditional Chinese Medicine (“TCM”) Treatment23

Emergency Outpatient Due To Accident25

15

16

Premium of Rafes Shield Plans – For Singaporean / Singapore PRPremiums displayed do not include options and/or riders. All premiums are inclusive of GST.

Age Next Birthday Medishield Life Premiums (Fully Payable By Medisave26)

Additional Withdrawl Limits ($)27

1 - 18

19 - 20

21 - 25

26 - 30

31 - 35

36 - 40

41 - 45

46 - 50

51 - 55

56 - 60

61 - 65

66 - 70

71 - 73

74 - 7528

76 - 78

79 - 80

81 - 83

84 - 85

86 - 88

89 - 90

91 - 93

94 - 95

96 - 98

99 - 100

>100

130

130

195

195

310

310

435

435

630

630

755

815

885

975

1,130

1,175

1,250

1,430

1,500

1,500

1,530

1,530

1,530

1,530

1,530

300

300

300

300

300

300

600

600

600

600

600

600

900

900

900

900

900

900

900

900

900

900

900

900

900

17

Additional Private Insurance Coverage


Premiums ($)

Premiums ($)

Premiums ($)

Premiums ($)

Cash Outlay ($)

Cash Outlay ($)

Cash Outlay ($)

Cash Outlay ($)

Rafes Shield A

Rafes Shield B


194

194

218

221

339

342

537

632

948

1,057

1,537

2,233

2,844

3,344

3,980

4,752

5,285

6,508

7,066

7,529

7,612

8,230

8,561

9,518

9,518

0

0

0

0

39

42

0

32

348

457

937

1,633

1,944

2,444

3,080

3,852

4,385

5,608

6,166

6,629

6,712

7,330

7,661

8,618

8,618

73

78

89

89

112

126

217

221

349

375

605

946

1,389

1,665

1,926

2,352

2,567

2,850

3,238

3,451

3,720

3,874

4,246

4,621

4,621

0

0

0

0

0

0

0

0

0

0

5

346

489

765

1,026

1,452

1,667

1,950

2,338

2,551

2,820

2,974

3,346

3,721

3,721

56

56

59

59

83

83

126

126

224

233

378

612

910

1,063

1,223

1,407

1,442

1,808

2,026

2,336

2,678

2,704

2,722

3,099

3,099

0

0

0

0

0

0

0

0

0

0

0

12

10

163

323

507

542

908

1,126

1,436

1,778

1,804

1,822

2,199

2,199

39

39

48

48

62

62

108

125

141

163

275

395

620

743

951

1,013

1,173

1,198

1,507

1,646

1,800

1,960

2,146

2,368

2,368

0

0

0

0

0

0

0

0

0

0

0

0

0

0

51

113

273

298

607

746

900

1.060

1,246

1,468

1,468

18

Illustrative Case Study

With Raffles Shield A Plan

With Raffles Shield A Plan and Key Rider

Mr Tan, a 46-year old was diagnosed with Coronary Artery Disease. Doctor recommended him to undergo Coronary Angioplasty (PTCA) procedure. Mr Tan was admitted at A class ward in public hospital and his bill was $36,500.

Of Course.

Lower out-of-pocket expenses?

Total B

ill: $36,500

5%

95%

Deductible: $3,500 Co-Insurance: $3,300

Rafes Shield Pays:

$29,700

Rafes Shield Pays:

$34,675

Mr Tan Pays: $6,800

Mr Tan Pays: $1,825

19

1 However, do note that employee benefit schemes may not be portable if you change your employer.

2 Subject to underwriting.

3 SC: Singapore Citizen; PR: Singapore Permanent Resident; FR: Foreigner. A Citizenship Factor is applicable if the Insured is a Permanent Resident.

4 Pro-Ration Factor is calculated based on the discharge ward.

5 Including prescriptions, medical consultations, Miscellaneous Medical Charges, Specialist consultations, diagnostic test and examinations and laboratory tests. Also includes admission to high-dependency wards and Short Stay Wards.

6 Only applies to surgical procedures listed in Table 1A to Table 7C of the “Table of Surgical Procedures” published by MOH, i.e. excluding Minor Surgical Procedures.

7 Includes charges for intravascular electrodes for electrophysiological procedures; percutaneous transluminal coronary angioplasty (PTCA) balloons; intra-aortic balloons (or balloon catheters).

8 Must follow treatment in a Government Restructured Hospital (GRH) or private Hospital, for which inpatient treatment is payable.

9 Only payable if the inpatient charges are payable.

10 Specialist on the Raffles Shield Panel of specialists. Panel Specialist must be the Attending Physician for the Inpatient Episode.

11 Excluding Post-Hospitalisation Psychiatric Treatment. For post-hospitalisation visits to non-Panel or non-GRH Specialists, you may seek pre-authorisation from Us for such visits to qualify for benefits tied to Panel / GRH treatment, in accordance with the approval process at http://www.RafflesShield.com.sg

12 The percentage of the Reasonable and Customary Expenses we will pay, as set out in Your Benefit Schedule. We will apply the Pro-ration Factor if the Insured is admitted to a ward or Hospital that is higher than his or her ward entitlement.

13 The parent does not need to be enrolled on a Raffles Shield Policy. Waiver of premium is applicable to plans without Extra Premium; and waiver will be applied to Raffles Shield Base Premium only.

14 Mastectomy must be due to breast cancer, and breast reconstruction must be done within 12 months from original mastectomy.

15 Period from Policy Start Date within which claims under this benefit are not payable.

16 Includes charges incurred for inpatient treatment due to ectopic pregnancy, pre-eclampsia or eclampsia, disseminated intravascular coagulation, miscarriage, choriocarcinoma and hydatidiform mole, or postpartum haemorrhage requiring hysterectomy.

17 Co-insurance refers to the amount you have to co-pay after the Deductible has been applied to the Reasonable and Customary Expenses.

18 Increased to 100% if plan is purchased with Raffles Hospital Option.

19 The Deductible is the amount which You have to pay before we pay any claim under Your Policy. This is deducted before the co-insurance is applied. Deductibles are not applied to outpatient treatments. For the High Deductible Option, the Deductible for each policy year will be raised to $10,000 for all ward types and ages.

20 Applied onto eligible expenses, after pro-ration and within claim limits where applicable.

21 Applied onto Reasonable and Customary Expenses, after Pro-Ration and within applicable limits.

22 Accommodation expenses for an Immediate Family Member who shares the hospital room of the Insured during an Inpatient Episode.

23 Recommended in writing by the Attending Physician, and administered by a TCM Practitioner at Raffles Chinese Medicine Clinics or at a GRH.

24 Including home medical, home nursing and home therapy.

25 This Benefit is subject to Pro-Ration Factor (rates as stated in the Benefit Schedule). It is also subject to a co-payment of 5%.

26 Your MediShield Life premiums may differ depending on your premium subsidies, premium rebates and whether you need to pay for the Additional Premiums. The Net MediShield Life Premium Payable after accounting for these is fully payable by Medisave.

27 Refers to the cap on the Medisave deduction that Singapore Residents can make to pay for the premiums of the additional private insurance coverage component.

28 The last entry age is 75 years, based on the Insured’s age next birthday. This does not apply to the Raffles Shield Standard Plan.

General Notes

Important NotesThese insurance plans are underwritten by Raffles Health Insurance Private Limited (Reg. No. 200413569G). All insurance applications are subjected to our underwriting and acceptance.

This brochure is for reference only and is not a contract of insurance. You may refer to the exact terms and conditions, premiums, specific details and exclusions found at www.RafflesShield.com.sg or from our Raffles Health Advisors. Premium rates are not guaranteed.

Buying health insurance products that are not suitable for you may impact your ability to finance your future healthcare needs. You are strongly recommended to speak with a qualified Raffles Health Advisor. You may arrange for an appointment with our Raffles Health Advisors simply by contacting us at our hotline or email. You can also leave your contact details on our website for us to call you back.

Protected up to specific limits by SDIC.

Information is correct as of 01 January 2020.

Visit Us at www.RafflesShield.com.sg or Email Us at [email protected] or Call Us at +65 6286 9988

About Rafes Health InsuranceRaffles Health Insurance (“RHI”) was incorporated in 2004, commenced operations on 2 January 2005 as a general insurer and converted into a life insurer in March 2006 under the purview of the Monetary of Authority of Singapore. RHI is a wholly-owned subsidiary of Raffles Medical Group (“RMG”) - a leading integrated healthcare service provider in Singapore.

Prior to its inauguration in October 2012, Raffles Health Insurance was known as International Medical Insurers Pte. Ltd. (“IMI”).

We are a leading healthcare insurance specialist in Singapore, supported by RMG’s wide network of family medicine clinics and tertiary care private hospital, Raffles Hospital, to provide fully integrated and coordinated healthcare for our policy owners and members. We strive to be the preferred healthcare partner and service provider, specialising in providing you a healthcare financing solution to cater to your healthcare needs.

Health Insurance That Offers You More Options? Of Course. · Living Donor Organ Transplant...

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Transcript of Health Insurance That Offers You More Options? Of Course. · Living Donor Organ Transplant...