Insurance - Corporate (Company)
Insurance administrators may have more than one insurance company under them, e.g. an administrator may provide services for HSBC Life, NTUC Income, Great Eastern, Tokio Marine, and AXA.
Please do not hesitate to reach out to us with your insurance card or e-card to check if we are able to make claims directly with the administrator or insurance company. Very often the e-card is available on the insurer's or administrator's app. Your company's HR will be the to-go-to person regarding this.
Your policy may have specific requirements, exclusions, and co-payments. For instance, you may be required to visit an approved GP on their list of clinics for a referral letter to visit a specialist clinic, for the insurance coverage to be valid. Also, not all visits, diagnoses, procedures, and medications may be claimable - the coverage various from policy to policy.
In the event that we are not "on the panel" or not able to directly claim for you, you may submit the invoices to claim on your own. If you are also required to submit a memo, please let us know.
For global insurances, we are able to assist you where necessary in providing information to the insurer or administrator to make your claim a smoother process. Where a procedure is required, in some instances a pre-authorisation, letter of guarantee, or guarantee of payment can be arranged in advance to reduce or eliminate the upfront payment you are required to make at admission to the hospital or surgery centre.
Insurance - Personal Shield Plans
Personal shield insurances are often purchased to protect against large hospital bills, and to allow for private medical coverage for selected plans. Even for basic plans, there can be significant benefits when opting for private healthcare. For the most up-to-date and accurate information about your insurance plan, you should approach the insurer or your agent who will best be able to advise you.
More Shield Insurance Information
For the shield insurances that we are not on the panel (or on the extended panel), we may still be able to submit a pre-authorisation (also known as a Letter Of Guarantee - LOG) if you require a procedure or surgery to be done. Some insurance plans may require you to activate the pre-authorisation process, or to submit the necessary documents on your own.
Depending on the individual benefits and plans, the claimable amounts may be different between a doctor or clinic that is on the panel, on the extended panel, or not on the panel. This is due to the deductible, co-pay, and coverage period that may differ depending on the afore-mentioned. You may check with your insurer or insurance agent if this is a concern. Your claim amounts may also be different depending on whether you have any rider that is in force (an optional add-on to your main plan that gives greater coverage in certain circumstances).
Shield insurances typically do not cover consultations and clinic visits (e.g. for you to get a general eye check or health check-up) unless expressly stated.
Medisave Accreditation
The Ophthalmology Practice is a Medisave Accredited specialist clinic.
You can withdraw from your Medisave and/or claim from your Private Integrated Shield Plan for minor procedures done in our clinic (such as for an intravitreal injection).
E-filing is available, which ensures a seamless process for you.
Using your Medisave
Did you know that Medisave can be used for necessary surgeries and procedures?
There is a cap depending on the complexity of the surgery - you may have heard of the "Table"; this is a numbering system where Table 1 is the least complex while Table 7 is the most complex.
An example of a Table 1 surgery would be an intravitreal injection, where we inject medication into the eye ball. Cataracts surgery would be a Table 4 surgery as it would comparatively be more complex and take a longer time.
Here is the current cap for some common surgical procedures:
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Intravitreal injection - Table 1B - $420
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Cataract removal surgery - Table 4A - $2380
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Vitrectomy - Table 6B - $3610
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YAG laser capsulotomy - Table 1C - $490
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Peripheral laser iridotomy - Table 2C - $1120
Do note that the amounts may change, or the table code may vary depending on the exact procedure or complexity of the case.
FAQ on insurance coverage and Medisave/Medishield claims
Is my clinic visit covered?
Corporate insurance in many instances cover clinic visits as well as surgical procedures.
Integrated shield plans typically cover surgical procedures, and may cover clinic visits within a certain time frame of a procedure, depending on the policy.
Both of the above are subject to the actual plan benefits and may involve deductible and co-payments. Some diagnoses, tests, procedures, and medications may not be covered.
Should I do my surgery in a hospital or surgery centre?
Your insurer may have a list of preferred locations that will allow you to be able to maximise your claim amount. Your comfort and preference also matters - which is why we have written a Hospital VS Surgery Centre article to help you decide on this.
How do I know the specifics of my coverage? How do I know how much can I claim for a surgical procedure?
The best way to find out about your coverage is by contacting your insurer, insurance agent, or the administrator of your insurance policy.
For corporate direct claims for outpatient visits to our clinic, we will be able to check on some details and advise you accordingly - simply contact us via WhatsApp text and provide us your details including your insurance card / e-card.
The amount claimable or covered by your insurance plan may also be subjected to a yearly allowable claim limit, as well as taking into account any deductible and/or co-payment.
What is deductible? What is co-payment?
Deductible is an out-of-pocket amount that you will have to pay before the insurer starts paying out. This is typically calculated on a yearly basis.
For instance, if your hospital bill is $10,000, and your deductible is $2,000, then you would have to pay the $2,000 first before the insurer looks at the remaining $8,000. Should you then require a second surgery the same year at $10,000, then the insurer would directly look at the $10,000 since the deductible has already been paid.
Co-payment is typically a percentage of the remaining bill after the deductible. Using the example above, if the co-payment is 10% of the remaining bill of $8,000, then you would have to fork out $800. Hence, the total to be paid out-of-pocket would be $2,800 for the first surgery (and $1,000 for the second).
This co-payment can range from $5 for outpatient clinic visits on certain corporate plans, to a maximum cap of $3000 (eventually to be raised to $6000) for surgical procedures on integrated shield plans and is 'reset' on a yearly basis.
Your actual deductible and co-payment amounts depend both on the insurance plan, if you have additional rider coverage, as well as other factors like your age, and the ward class you choose should you be hospitalised. For plans covering restructured hospitals, seeking private medical care would also usually mean a higher co-payment or deductible amount.
We may opt for procedures to be done at a lower-cost facility, thus reducing the total bill amount, and therefore reducing the co-payment amount.
How can I reduce the amount I pay upfront when undergoing a surgical procedure?
Ideally, you should apply for a Letter Of Guarantee (LOG) or Guarantee Of Payment (GOP) before the surgical procedure is performed. This is also sometimes called Pre-Authorisation (or pre-auth in short). What this does is the pre-empt the insurer about the upcoming procedure, providing details such as your medical diagnosis and the planned procedure to manage the eye condition. The insurer would then agree to pay to the hospital or surgery centre an amount based on their evaluation of the situation.
In some instances, surgery is urgently required, or the patient may wish to carry out the surgical procedure sooner (e.g. needing to leave the country soon). In these circumstances where the LOG or GOP cannot be ready before the admission to the hospital or surgery centre, then the patient would have to pay for the procedure and/or hospitalisation costs upfront and do a claim with the insurer subsequently.
Are there limits on Medishield claims?
Yes, there are annual limits, please refer to the CPFB website for the most updated information.
I am going for cataracts-removal surgery. How much will this cost out-of-pocket?
When you intend to go for a surgical procedure, one of the various things we will advise you about is the cost, through a financial counselling form.
While there is no direct answer to this question, the total fee would typically include pre and post surgery visits (which also includes tests and medications), as well as the facility fee and consumables for the surgery itself, together with the surgeon and anaesthetist fees.
If a premium intra-ocular lens (IOL) in chosen, it would also incur an additional cost, as most insurance plans only cover for monofocal IOLs (i.e. only allowing you to see far or near). Premium IOLs include toric IOLs (helps to correct astigmatism), tri-focal lenses (allows for distance, intermediate, and near vision), and EDOF (extended range of focus) IOL lenses. This is because monofocal IOLs are deemed as a medical necessity while premium IOLs are more of a 'luxury' - though such premium IOL lenses are becoming increasingly commonplace.
Is there a difference between doing a surgery or procedure with a panel doctor or non-panel doctor?
In most instances, there is a difference. For instance, if you are on the AIA HealthShield GoldMax A insurance plan, a surgery performed with a pre-authorisation applied and approved, with a panel doctor and with a non-panel doctor, the deductible will be $2000 (or $0 with the Deductible Waiver Pass Benefit) with a 5% co-payment. However, if the surgery is with a panel doctor, the pre and post surgery extend to 13 months, while for a non-panel doctor it will be 100 days. Although the amount that you will pay for the surgery itself is the same, the duration of cover of the subsequent consultations with the doctor is different.
There may also be differences in the deductible and co-payments for some insurance plans - your insurer or insurance agent would be able to advise you on this as the terms of each individual's policy will vary. For example, for Income, there is a "Extended panel and non-panel payment (ENP)" of $2000 for policies with "Plus/Assist/Classic Care or Deluxe Care Rider", and there is a co-payment limit of $3000 each year for doctors under the panel and extended panel. This can make a significant difference for a large hospital bill, e.g. if you are using the Classic Care Rider and your bill after any ENP is $200000 at an extended-panel doctor, the co-payment limit caps your co-payment to $3000, but for a non-panel doctor, the co-payment would be $20000.
April 2026 MOH IP Changes
The recent changes by the Ministry of Health Singapore (MOH) mainly affect Integrated Shield Plan (IP) riders and the co-payment structure, starting 1 April 2026. The goal is to control rising healthcare costs and keep insurance premiums sustainable.
Here is a clear summary of the key changes:
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Riders can no longer cover the deductible
Previously, many IP riders could cover the entire deductible, meaning patients sometimes paid $0 out-of-pocket.
New rule (from 1 Apr 2026):
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Riders cannot cover the minimum deductible anymore.
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Patients must pay the deductible themselves (or via MediSave).
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Deductible ranges roughly $1,500 – $3,500 depending on ward class.
Impact: Patients now have to pay the first portion of the hospital bill before insurance payouts start.
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Co-payment still required (minimum 5%)
The minimum co-payment remains 5% of the bill after the deductible.
Example:
Hospital bill after deductible = $20,000
Patient pays 5% = $1,000
This rule was first introduced earlier to ensure patients share some cost and avoid over-utilisation.
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Co-payment cap increased
Previously: Annual co-payment cap: $3,000
Now: Annual co-payment cap: minimum $6,000
This cap excludes the deductible.
Effect: Patients may pay more out-of-pocket before insurance fully covers the rest.
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Rider premiums expected to drop
Because riders now cover less, premiums for new riders are expected to be ~30% cheaper on average.
Estimated savings:
~$600/year for private hospital riders
~$200/year for public hospital riders
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Who is affected?
New riders sold from 1 April 2026: must follow the new rules.
Existing riders bought before 27 Nov 2025: generally not immediately affected, though insurers may review them later.
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Why MOH introduced these changes
MOH observed that full riders (with almost zero out-of-pocket cost) led to:
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Higher healthcare utilisation
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Larger hospital bills
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Rapidly rising insurance premiums
The new framework aims to refocus insurance on protecting against large bills, while requiring patients to share some cost.
In summary:
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Deductible must be paid by the patient
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5% co-payment remains
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Co-payment cap increased to $6,000
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Rider premiums lower (~30%)
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Changes apply mainly to new riders from April 2026
Here’s a simple real-world example of how the new rules affect what you actually pay under the Integrated Shield Plan framework introduced by the Ministry of Health (MOH).
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Example: $30,000 hospital bill
Before the new changes (old riders), some riders covered almost everything.
Typical breakdown:
Deductible: $3,000 → rider covered it
Co-payment: 5% → rider covered most or all
Your payment: sometimes $0 to a few hundred dollars
Result:
Very low out-of-pocket cost.
Issue:
Because patients paid almost nothing, healthcare usage and bills increased, which drove insurance premiums up.
After the new MOH rules (from April 2026), the rider cannot cover the deductible.
Deductible (you must pay): $3,000
Remaining bill: $27,000
Co-payment (5%): $1,350
Total you that pay: $4,350
Insurance covers the rest.
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If the bill is very large (e.g. $150,000)
Deductible: $3,000
Remaining bill: $147,000
5% co-payment: $7,350
But the co-payment cap is $6,000, so:
Deductible: $3,000
Co-payment capped: $6,000
Total you pay
$9,000 maximum
Insurance covers the rest.
What this means for most people
Pros:
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Rider premiums cheaper (~30%)
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Insurance still protects against huge medical bills
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Helps slow rising healthcare costs
Cons:
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Patients must pay at least the deductible
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Out-of-pocket costs can be a few thousand dollars per hospitalisation
Why MOH did this
According to the Ministry of Health, insurance should mainly protect against catastrophic bills, not make healthcare completely free. When patients pay some portion, it encourages more careful use of healthcare resources.
Here are 3 common misunderstandings many people in Singapore have about the recent changes to the Integrated Shield Plan introduced by the Ministry of Health (MOH).
1) “All my existing riders will change immediately”
Many people think their current rider will automatically switch to the new rules.
If you bought your rider before the announcement date, most insurers allow you to keep the existing structure for now (subject to insurer terms).
The new framework mainly applies to:
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New riders sold from 1 April 2026
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New policies issued after the change
So many existing policyholders will not see an immediate change.
2) “Insurance won’t cover most hospital bills anymore”
Some people think the coverage has been drastically reduced.
The insurance still covers the majority of the bill.
Example: $50,000 hospital bill
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Patient might pay around $4k–$6k
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Insurance still covers $44k+
The system still protects against large medical expenses, which is the original purpose of the Integrated Shield Plan.
3) “Healthcare will become unaffordable”
People worry they will need to pay everything out of pocket.
Singapore’s system still has multiple layers of protection:
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MediShield Life
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Integrated Shield Plan
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MediSave for deductible payments
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Government subsidies in public hospitals
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MediFund as a safety net
These layers ensure serious illness does not lead to catastrophic financial burden for most citizens.
The main idea behind this change is to restore “appropriate cost-sharing", where the patients pay a small portion and the insurance covers large unexpected bills. This helps slow rising premiums for everyone.
