5 Surprising Things Your Integrated Shield Plan Doesn’t Cover

With 3 in 4 Singaporeans covered not only by MediShield Life but also by supplemental insurance, it may be hard to imagine that there are still lapses in your medical coverage. However, there are a few major exclusions in your Integrated Shield Plan that, if you are not careful, may lead to you paying thousands of dollars out of pocket.

Below, we discuss the top 5 most surprising things your Integrated Shield Plan (ISP) doesn’t cover.

Related: How Much Insurance Coverage Do You Really Need And What Insurance Plans Should You Get?

Dental Treatment or Surgery

While dental treatment is covered if it is due to an accident, it is highly unlikely that your root canal or wisdom tooth removal will be covered under your Integrated Shield plan. The average cost for a root canal in Singapore is S$606 per tooth, which can get quite pricey for those who need multiple root canals. Braces and crown implants are even more expensive, both costing an average of just under S$4,500.

If you are eligible for a government subsidy called the Community Health Assist Scheme (CHAS), you might be able to get dental services as a highly subsided rate. Individuals of low to middle income groups can get subsidies of up to S$256.50 on their dental procedures. If you are a senior citizen, the Pioneer CHAS card can give you a subsidy of up to S$266.50. These subsidies can be used anything from X-rays to root canals and fillings, giving some financial respite to those who can’t afford dental care.

_{***Information accurate as of February 2024}

Related: Average Cost of Dental Procedures in Singapore 2024

Maternity and Pregnancy-Related Events

As if starting a family wasn’t expensive enough, you’ll be responsible for most out of pocket costs relating to your pregnancy.

Aside from accidental miscarriages or pregnancy complications leading to ectopic pregnancy, eclampsia, coagulation or miscarriage, most Integrated Shield Plans do not cover maternity and pregnancy-related costs. This means that childbirth (Caesarian or natural), abortions, pre and post-natal care and other pregnancy-related costs will either be paid out of pocket or through your Medisave Maternity package.

The Medisave Maternity package can cover S$3,150 for a normal delivery and S$4,950 for a Caesarean birth, which can reduce your out of pocket costs by up to 35%. Alternatively, international health insurance plans do tend to provide more comprehensive maternity coverage, even in Singapore, with riders covering pre and post-natal examinations and childbirth. However, along with a 12 month waiting period, these riders can get very expensive with costs up to S$4,000 extra in addition to your premium. Nonetheless, the riders may be well worth the cost considering that a traditional birth can cost up to S$16,000 at a private hospital.

Related: The Importance of Maternity Insurance for Expecting Mums

Injuries and Illness Related to Drug/Alcohol Abuse

If you get into a car accident because you were drink-driving, chances are not only will your car insurance policy be violated, but your health insurance will refuse to cover you for any inpatient treatment as well.

Heavy drinkers might also not be covered for any diseases that are caused by heavy drinking, including but not limited to, alcohol-induced pancreatitis, liver disease, alcoholic gastritis (stomach inflammation), alcoholic heart disease and alcoholic myopathy (muscle tissue disease). These conditions are not only serious and costly, but can end up being chronic leading to thousands of dollars in continual inpatient and outpatient care. Lastly, you will also not be covered for rehabilitation for drug or alcohol abuse. 

HIV/AIDS Not Due to Blood Transfusion

HIV affects over 9,000 Singaporeans and can be expensive to treat because Integrated Shield Plans and Medishield Life do not cover HIV acquired through sexual intercourse. With 97% of recently analysed HIV cases acquired through this method, it means most Singaporeans who have HIV will not be able to claim for HIV and AIDS related medication and treatment. In fact, the only time AIDS/HIV will be covered by your insurance is if you contracted it through a blood transfusion or through your occupation (i.e. you are a doctor).

Unsubsidised anti-retroviral drugs can cost between S$1,000 and S$2,000 per month, with medication like Truvada costing around S$30 per pill. However, though your insurance will not cover costs associated with HIV, you may be able to get subsidies through Medifund and you can also use up to S$550 of your Medisave funds to cover approved HIV/AIDs medication.

Treatment Due to Self-Inflicted Injuries

Unfortunately, those who hurt themselves on purpose or attempt to commit suicide and survive will be responsible for paying their own hospital bills. While health insurance covers inpatient psychiatric treatment, it does not cover treatment for self-inflicted injuries or, attempted suicides and suicide.

The associated costs can reach up to S$688 per night at a private hospital or S$461 per night for a public hospital if your injuries were severe enough to land you in inpatient care. Furthermore, you will also be responsible for paying for any reports such as a specialist Psychiatrist Report (around S$400) or Investigation Results report (around S$5 per service). If you find yourself having troubling thoughts or you believe you suffer from unmedicated mood disorders, it is advisable that you take the time to seek professional help. There are several centers in Singapore dedicated to helping people through difficult times.

Hotlines for suicide prevention:

• Samaritans of Singapore (24-hour hotline): 1800-221-4444
• Care Corner Counselling Centre (Mandarin): 1800-353-5800
• For Emergencies: 995

Now that we have identified these gaps in your Integrated Shield Plan coverage, you may want to consider getting supplemental coverage so that you will never be faced with the impossible task of sourcing hundreds or even thousands of dollars to foot an unexpected expense. Read out to us to find out more about what plans would work best to bridge the gap in your your existing coverage.

Read More:

• Elevate Your Coverage Game with Hospital Cash Insurance Plans
• How To Get the Most Out of Your Integrated Shield Plan
• Average Cost and Benefits of Health Insurance 2024
• VC Compares: Critical Illness Plans VS Cancer Insurance
• Single-Pay vs Multi-Pay Critical Illness Plans

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