​Costs and financing

Singapore offers universal healthcare coverage to our citizens, with a financing system anchored on the twin philosophies of individual responsibility and affordable healthcare for all.

Healthcare Financing Philosophy

Singapore offers universal healthcare coverage to our citizens, with a financing system anchored on the twin philosophies of individual responsibility and affordable healthcare for all. Through a system with multiple layers of financing coverage, the use of market-based mechanisms to promote competition and transparency, and the adoption of value-based care to improve the quality and cost-effectiveness of healthcare services, we have secured good healthcare outcomes for our population. We have done so with a national healthcare expenditure of about 5% of our GDP (as of 2022), which is low among developed countries (although this is expected to grow with an ageing population).

These features of the Singapore system have been recognised in various international assessments.  We intend to continually evolve and improve our policies over time. 

Universal coverage, multiple layers of protection

We have a multi-payor financing system, with different layers of protection that work together to ensure that no Singaporean is denied access to appropriate healthcare due to an inability to pay.  
 

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The first tier of protection is provided by Government subsidies of up to 80% of the total bill in acute public hospital wards, which all Singaporeans can access.  

 The second tier of protection is provided by MediSave, a compulsory individual medical savings scheme which Singaporeans can tap on to pay for their share of the medical treatment costs. Working Singaporeans and their employers contribute a part of the monthly wages into the MediSave account to help them meet their current and future healthcare needs.  

The third level of protection is provided by MediShield Life. MediShield Life is a basic health insurance scheme which helps to pay for large hospital bills and selected costly outpatient treatments, such as dialysis and chemotherapy for cancer. As a basic insurance scheme, its coverage is sized for subsidised treatments in public hospitals. MediShield Life protects all Singapore Citizens and Permanent Residents for life, including for any serious pre-existing conditions. The Government has also committed to keep MediShield Life premiums affordable with a range of Government subsidies. 

Many Singaporeans also choose to supplement their MediShield Life coverage with Integrated Shield Plans (IPs). IPs are made up of two components – the MediShield Life component and additional private insurance component providing additional benefits and coverage (e.g. to cover the costs of private hospitals or Class A/B1 wards in the public hospitals). As they provide additional benefits and coverage, premiums for such plans are also higher than MediShield Life’s. 

CareShield Life is a long-term care insurance scheme that provides basic financial support to policyholders who are assessed to be severely disabled on account of them being unable to perform 3 or more of the 6 activities of daily living. These six activities are feeding, dressing, toileting, washing, walking or moving around, and transferring from bed to chair and vice versa. Its coverage is mandatory for Singaporeans born in 1980 or later, who are automatically covered by CareShield Life when they turn 30 years of age. For those before 1980, participation is optional. Policyholders may also choose to purchase privately offered Supplements for additional disability benefits and coverage beyond CareShield Life. 

ElderShield, a severe disability insurance, was previously offered to all 40 year old Singaporeans with Central Provident Fund Board accounts, to risk-pool against the financial risks associated with developing severe disability. Enrolment into ElderShield has ceased with the introduction of CareShield Life in 2020.  

​Finally, MediFund is a m​edical endowment fund set up by the Government as a safety net for needy Singaporean patients who face financial difficulties with their remaining medical bills even after Government subsidies and drawing on other means of payments including MediShield Life, Integrated Shield Plans (IPs), MediSave and cash.  

ElderFund is a discretionary assistance scheme targeted at severely disabled lower-income Singapore Citizens aged 30 and older, who are not able to benefit from CareShield Life, ElderShield, and have low MediSave balances, and inadequate personal savings to meet their long-term care needs. 

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