We are always working to make your insurance and Medisave/Medishield claims as seamless as possible.

Here are all the insurance information which you will surely find useful. If in doubt, please feel free to contact us to verify acceptance of your insurance.

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Shield Insurance

Medisave

FAQ

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.

Parkway Shenton

Parkway is part of IHH Healthcare. We are on the panel for Parkway Shenton.

iXchange

We are able to process your visit directly with programs administered by iXchange.

CIGNA

CIGNA Singapore plans can be processed directly while global plans may allow for surgical procedures to be claimed - please check your benefits for more information.

ADEPT Health (DA)

DA Vantage administers programs from DA Pay and DA Care, AXA Insurance, Great Eastern Life, NTUC Income Insurance, and Tokio Marine Insurance.

Alliance

Alliance administers various programs including HSBC Life, Great Eastern Life, Liberty Insurance, Tokio Marine Insurance, Singapore Life, Alliance Healthcare, Income Insurance, AIA Singapore, Cigna Europe, and EQ Insurance.

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Integrated Health Plans

InovaCare

InovaCare partners with insurance companies like MSIG to provide seamless care for patients in the network.

Insurance -Personal Shield

Personal shield insurances are often purchased to protect against large bills, and while not all plans provide private medical coverage, some plans do allow for a co-pay portion if you decide to seek private medical care, thus still providing a significant amount of benefits. 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.

Great Eastern

For Great Eastern Shield Plans, procedures would typically be conducted at Novaptus Surgery Centre.

We are on the panel for Great Eastern.

Prudential

For Prudential Shield Plans, procedures would typically be conducted at Novaptus Surgery Centre.

We are on the panel for Prudential.

AIA

We are able to submit a request for pre-authorisation (LOG) for procedures on your behalf.

We are currently not on the panel for AIA. However, AIA Healthshield Gold Max subscribers are entitled to benefits for outpatient clinic visits.

Singlife

For SInglife Shield plans, it is typically administered by iXchange.

We are on the panel for Singlife.

NTUC IncomeShield

For NTUC IncomeShield plans, it is typically administered by iXchange.

We are currently not on the panel for NTUC.

HSBC Life

For HSBC Life insurance, we are not on the panel of the administrator of the shield plan. For HSBC Life corporate plans, it will be under Alliance as above in the Corporate category.

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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:

Intravitreal injection - Table 1B - $420
Cataract removal surgery - Table 4A - $2380
Vitrectomy - Table 6B - $3610
YAG laser capsulotomy - Table 1C - $490
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.

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.