Professional Documents
Culture Documents
GREAT SUPREMEHEALTH
& GREAT TOTALCARE
Benefit Schedule & Premium Rates
GREAT SupremeHealth Benefits Table
Restructured Hospitals, Restructured Hospitals, Restructured Hospitals, Restructured Hospitals, Private &
Hospital/Ward Class Entitlement
Class B2 Wards & lower Class B1 Wards Class B1 Wards & lower Class A Wards & lower Restructured Hospitals
Expense Item Benefit Limit Benefit Limit Benefit Limit Benefit Limit Benefit Limit
1. INPATIENT BENEFITS
“As Charged” means all Expenses incurred by the Life Assured in the Hospital and ward class of the Life Assured’s entitlement under 4
Claimable only upon referral from a Medical Doctor from a Hospital for further medical treatment after an inpatient admission.
the Plan Type insured. 5
Claimable only upon referral from a Medical Doctor from a Hospital after an inpatient admission or from a Hospital’s accident and
1
Includes meal charges, prescriptions, professional charges, investigations and other miscellaneous charges. emergency department for further medical treatment.
2
Additional S$200 per day for the first 2 days of hospitalisation in Normal Ward and Intensive Care Unit ward.
6
Classified according to their level of complexity and listed according to the “Table of Surgical Procedures” as published by Ministry of
Health.
3
Claimable only upon referral from a hospital after an inpatient admission or from a restructured hospital’s accident and emergency
department for further medical treatment.
GREAT SupremeHealth Benefits Table (Continued)
Restructured Hospitals, Restructured Hospitals, Restructured Hospitals, Restructured Hospitals, Private &
Hospital/Ward Class Entitlement
Class B2 Wards & lower Class B1 Wards Class B1 Wards & lower Class A Wards & lower Restructured Hospitals
Expense Item Benefit Limit Benefit Limit Benefit Limit Benefit Limit Benefit Limit
• Table 7A S$2,600 per procedure S$16,720 per procedure
• Table 7B S$2,600 per procedure S$16,720 per procedure
• Table 7C (more complex procedures) S$2,600 per procedure S$16,720 per procedure As Charged As Charged As Charged
Surgical Implants7 S$7,000 per admission S$9,800 per admission
Radiosurgery S$10,000 per procedure S$9,600 per procedure
B. ADDITIONAL INPATIENT BENEFITS
Daily In-Hospital Medical Doctor’s Visit
Covered under inpatient
Short-stay Ward8 As Charged As Charged As Charged
hospital treatment
Examination and Laboratory Tests
Pregnancy and Childbirth Complications N.A. As Charged9 As Charged9 As Charged9
Breast Reconstruction after Mastectomy As Charged10 As Charged10 As Charged10
Covered under inpatient
Accidental Dental Treatment hospital treatment
Stem Cell Transplant
Covered under inpatient
Organ Transplant11 hospital treatment As Charged As Charged As Charged
Human Immunodeficiency Virus (“HIV”)
Due to Blood Transfusion and Occupationally
Acquired HIV
“As Charged” means all Expenses incurred by the Life Assured in the Hospital and ward class of the Life Assured’s entitlement under infection of amniotic sac and membranes, still birth, maternal death, miscarriage, obstetric cholestasis, obstetric injury or damage
the Plan Type insured. to pelvic organs, placenta previa, placental abruption, postpartum haemorrhage, postpartum inversion of uterus, pre-eclampsia or
eclampsia, retained placenta and membranes, twin-to-twin transfusion syndrome and uterine rupture. A waiting period of 300 days
7
Includes: Intravascular electrodes used for electrophysiological procedures; Percutaneous Transluminal Coronary Angioplasty (PTCA)
from the Last Policy Effective Date applies during which no benefits are payable.
Balloons; Intra-aortic balloons (or Balloon Catheters).
10
Breast reconstruction surgery must be performed by a Medical Doctor within 365 days from the date of the first mastectomy.
8
Refer to Short-stay Wards in a Restructured Hospital.
11
Expenses incurred when Life Assured is the recipient of the following human organ(s) transplant – lung(s), kidney(s), heart, liver,
9
Pregnancy and Childbirth Complications covered are abscess of breast, accreta placenta, acute fatty liver pregnancy, amniotic
cornea(s), skin, pancreas and musculoskeletal tissue.
fluid embolism, antepartum and intrapartum haemorrhage, breech delivery, choriocarcinoma and hydatidiform mole, complications
resulting in a caesarean hysterectomy, disseminated intravascular coagulation, ectopic pregnancy, fourth degree perineal laceration,
12
Post-Hospitalisation Treatment provided after 180 days must be provided in a Restructured Hospital or prescribed by a Specialist
Doctor who is a Panel Provider.
GREAT SupremeHealth Benefits Table (Continued)
Restructured Hospitals, Restructured Hospitals, Restructured Hospitals, Restructured Hospitals, Private &
Hospital/Ward Class Entitlement
Class B2 Wards & lower Class B1 Wards Class B1 Wards & lower Class A Wards & lower Restructured Hospitals
Expense Item Benefit Limit Benefit Limit Benefit Limit Benefit Limit Benefit Limit
2. OUTPATIENT BENEFITS
Chemotherapy for Cancer S$3,000 per month S$5,200 per month
Stereotactic Radiotherapy for cancer S$1,800 per treatment session S$1,800 per treatment session As Charged As Charged As Charged
Immunotherapy for cancer N.A. N.A.
Radiotherapy for cancer
•External or Superficial
S$300 per treatment session S$550 per treatment session
(Except for Hemi-Body Radiotherapy) As Charged As Charged As Charged
• Brachytherapy with or without external S$500 per treatment session S$1,100 per treatment session
• Hemi-Body Radiotherapy S$900 per treatment session N.A.
Kidney Dialysis S$1,100 per month S$2,750 per month
Immunosuppressant for Organ Transplant S$550 per month S$1,200 per month
As Charged As Charged As Charged
Erythropoietin S$200 per month 13
S$450 per month13
Long-term Parenteral Nutrition S$1,700 per month N.A.
3. ADDITIONAL BENEFITS
Outpatient Bone Marrow Transplant S$6,000 per treatment S$20,000 per Period of Insurance14 S$25,000 per Period of Insurance14 S$30,000 per Period of Insurance14
Proton Beam Therapy N.A. S$30,000 per Period of Insurance S$40,000 per Period of Insurance S$50,000 per Period of Insurance
N.A.
Cell, Tissue and Gene Therapy S$100,000 per Period of Insurance S$150,000 per Period of Insurance S$200,000 per Period of Insurance
Psychiatric Treatment S$500 per day S$20,000 S$22,000 S$25,000
S$160 per day (up to 60 days)15
(including Pre & Post Hospitalisation Benefits) (up to 35 days per Period of Insurance) per Period of Insurance per Period of Insurance per Period of Insurance
“As Charged” means all Expenses incurred by the Life Assured in the Hospital and ward class of the Life Assured’s entitlement under 15
For daily ward and treatment only. Claimable up to 60 days per policy year.
the Plan Type insured. 16
The recipient must be a family member (parents, siblings, children or spouse) of the Life Assured. A waiting period of 730 days from
13
Prescribed for chronic renal failure only. the Last Policy Effective Date applies during which no benefits are payable.
14
Only for outpatient autologous bone marrow transplant treatment due to Multiple Myeloma.
17
MediShield Life will exclude any surgical interventions for the following rare congenital conditions which are severe and fatal
by nature: Trisomy 13, Trisomy 18, Bilateral Renal Agenesis, Bart’s Hydrops, Alobar Holoprosencephaly, Anecephaly.
GREAT SupremeHealth Benefits Table (Continued)
Restructured Hospitals, Restructured Hospitals, Restructured Hospitals, Restructured Hospitals, Private &
Hospital/Ward Class Entitlement
Class B2 Wards & lower Class B1 Wards Class B1 Wards & lower Class A Wards & lower Restructured Hospitals
Expense Item Benefit Limit Benefit Limit Benefit Limit Benefit Limit Benefit Limit
Congenital
Within (and including)
Abnormalities of S$12,000 per Lifetime19 S$16,000 per Lifetime19 S$20,000 per Lifetime19
730 Days from Date of Birth N.A. N.A.
the Life Assured’s (limited to S$3,000 per child) (limited to S$4,000 per child) (limited to S$5,000 per child)
of the Child
Biological Child18
5. PRO-RATION FACTORS22
Citizenship Status SC PR SC PR FR23 SC PR FR23 SC /PR/ FR23 SC/ PR/ FR
Day Surgery
• Private Hospitals/ Private Medical Clinics 25% 25% 65% 65% 65% 50% 50% 50% 70% 100%
• Restructured Hospitals – Subsidised 100% 58% 100% 100% 100% 100% 90% 80% 100% 100%
• Restructured Hospitals – Non-subsidised 35% 35% 100% 100% 100% 80% 80% 80% 100% 100%
Inpatient
• Private Hospitals/ Private Medical Clinics 25% 25% 50% 50% 50% 50% 50% 50% 70% 100%
• Restructured Hospitals – Class A 35% 35% 80% 80% 80% 80% 80% 80% 100% 100%
• Restructured Hospitals – Class B1 43% 38% 100% 90% 80% 100% 90% 80% 100% 100%
• Restructured Hospitals – Class B2+ 70% 47% 100% 100% 100% 100% 90% 80% 100% 100%
• Restructured Hospitals – Class B2 100% 58% 100% 100% 100% 100% 90% 80% 100% 100%
• Restructured Hospitals – Class C 100% 44% 100% 100% 100% 100% 90% 80% 100% 100%
• Private Community Hospitals/
50% 50% 50% 50% 50% 50% 50% 50% 70% 100%
Private Inpatient Palliative Care Institutions
“As Charged” means all Expenses incurred by the Life Assured in the Hospital and ward class of the Life Assured’s entitlement under 21
If the Life Assured dies during Hospitalisation or after discharge from Hospital, the Deductible and Co-insurance will be waived up to
the Plan Type insured. the limit stated.
“SC” means Singapore Citizen; “PR” means Singapore Permanent Resident; “FR” means Foreigner. 22
Pro-ration Factors are applied to reduce higher class wards/ Private Hospital/ private medical institution/ medical treatment bills to
equivalent ward/ medical treatment entitlement under each Plan Type in the claims computation.
18
A waiting period of 300 days from the Last Policy Effective Date applies during which no benefits are payable. 23
GREAT SupremeHealth A PLUS, B PLUS and STANDARD are available for Singaporeans and Singapore Permanent Residents only. If
19
The benefit limit refers to per lifetime of the Life Assured. there is a change of Life Assured’s Citizenship Status from Singaporean or Singapore Permanent Resident to Foreigner, Pro-ration
20
Covers all Expenses incurred if the Life Assured requires treatments, medical services and/or supplies as a result of an Emergency Factors for Foreigners will be applicable.
while outside Singapore up to limits stated above.
GREAT SupremeHealth Benefits Table (Continued)
Restructured Hospitals, Restructured Hospitals, Restructured Hospitals, Restructured Hospitals, Private &
Hospital/Ward Class Entitlement
Class B2 Wards & lower Class B1 Wards Class B1 Wards & lower Class A Wards & lower Restructured Hospitals
Expense Item Benefit Limit Benefit Limit Benefit Limit Benefit Limit Benefit Limit
Short-stay Ward
• Private Hospitals 25% 25% 50% 50% 50% 80% 80% 80% 100% 100%
• Restructured Hospitals – Subsidised 100% 58% 100% 100% 100% 100% 90% 80% 100% 100%
• Restructured Hospitals – Non-subsidised 35% 35% 100% 100% 100% 80% 80% 80% 100% 100%
Outpatient Treatment
• Private Hospitals/ Private Medical Clinics 50% 50% 65% 65% 65% 50% 50% 50% 70% 100%
• Restructured Hospitals – Subsidised 24
100% 67% 100% 100% 100% 100% 90% 25
80% 25
100% 100%
• Restructured Hospitals – Non-subsidised26 50% 50% 100% 100% 100% 80%25 80%25 80%25 100% 100%
Specially-approved Medical Treatments,
100% 100% 100% 100% 100% 50% 50% 50% 50% 50%
Services and/or Supplies27
24
MediShield Life Pro-ration Factors will be applicable for Outpatient Bone Marrow Transplant. 27
Refers to unregistered treatments, medical services and/or supplies with special authorisation by HSA and/or the Government solely
25
GREAT SupremeHealth Pro-ration Factors do not apply to Expenses incurred by the Life Assured in a Restructured Hospital on an for the purpose to treat the illness, disease or Injury (as the case may be) of the Life Assured, provided that the Life Assured has
outpatient basis: Kidney Dialysis Treatment, Cancer Treatment, Erythropoietin, Immunosuppressant drugs prescribed for treatment exhausted all conventional registered treatments, medical services and/or supplies.
of organ transplants and Long-term Parenteral Nutrition. 28
Deductible applies on a policy year basis and therefore payable only once in the year. Does not apply to Expenses incurred by the Life
26
MediShield Life Pro-ration Factors will be applicable for non-subsidised outpatient cancer treatments and Long-term Parenteral Assured on an outpatient basis: Kidney Dialysis Treatment, Cancer Treatment, Erythropoietin, Immunosuppressant drugs prescribed
Nutrition. Non-subsidised dialysis-related treatment and immunosuppressants will not be pro-rated. for treatment of organ transplants and Long-term Parenteral Nutrition.
GREAT SupremeHealth Benefits Table (Continued)
Restructured Hospitals, Restructured Hospitals, Restructured Hospitals, Restructured Hospitals, Private &
Hospital/Ward Class Entitlement
Class B2 Wards & lower Class B1 Wards Class B1 Wards & lower Class A Wards & lower Restructured Hospitals
Expense Item Benefit Limit Benefit Limit Benefit Limit Benefit Limit Benefit Limit
7. CO-INSURANCE
All Ward Classes & Day Surgery Claimable Amount29
S$0 - S$5,000 10%30
S$5,001 - S$10,000 5%
10%
> S$10,000 3%
Outpatient Treatments 10%
29
Total claimable amount is computed as the sum of all claimable amounts under each claim limit. The claimable amount under each 30
The first $5,000 Claimable Amount used to determine the Co-insurance under MediShield Life is inclusive of the Deductible.
claim limit is based on the lower of the maximum claim limit or actual amount (with Pro-ration Factor applied where applicable)
incurred under the claim limit. There will be Pro-ration Factor applied to bills that receive lower than the maximum subsidy level in
Class B2/C wards, such as bills incurred by patients in Class A wards.
GREAT TotalCare Benefits Table
SPECIAL BENEFITS Benefit Limit Benefit Limit Benefit Limit Benefit Limit Benefit Limit Benefit Limit
Other Outpatient Cancer Treatment S$10,000 S$10,000 S$10,000 S$10,000 S$10,000 S$10,000
(per Period of Insurance) Subject to Co-payment to be borne by the Policyholder
Emergency Accidental Outpatient Treatment S$1,000 S$1,500 S$2,000 S$1,000 S$1,500 S$2,000
(per Course of Treatment) Subject to Co-payment to be borne by the Policyholder
Ambulance Services
S$100 S$150 S$250 S$100 S$150 S$250
(per Course of Treatment)
Medical Aids
S$1,500 S$2,000 S$3,000 S$1,500 S$2,000 S$3,000
(per Period of Insurance)
1
Eligible Expenses incurred by the Life Assured for treatments and/or medical services provided within 180 days from the day the Life
Assured is discharged from the Hospital, Community Hospital or Inpatient Palliative Care Institution.
2
For Post-Hospital Follow-up Traditional Chinese Medicine Treatment provided by a registered TCM Practitioner in an approved TCM
clinic outside of a Singapore Hospital or a Community Hospital, the expenses incurred will be subject to a limit of $60 per visit, up to
1 visit a day. Refer to policy contract for the list of medical institutions.
3
A companion refers to the Life Assured’s parent, legal guardian, legal spouse, sibling, biological child or legally adopted child who is
above 18 years next birthday during the Hospitalisation of the Life Assured. The Expenses incurred will be subject to the daily Benefit
Limit up to 10 days per Hospitalisation.
GREAT TotalCare Benefits Table (Continued)
Community Hospital / Inpatient Palliative Care 5% of total Eligible Bills5 or the Deductible
Institution incurred under the Main Plan (where 5% of total Eligible Bills5
applicable), whichever is higher
5% of total Eligible
For Eligible Bills5 incurred under Private Hospital Bills5 or the Deductible N.A.
/ private Community Hospital / private medical incurred under the Main
clinic without Certificate of Pre-Authorisation Plan (where applicable)
whichever is higher
4
If the Eligible Bills in excess of the Benefit Limits or Bill Limits (if any) of this Policy and the GREAT SupremeHealth plan, respectively
are equal to or higher than the Co-payment, the Co-payment shall not be payable. For the avoidance of doubt, Policyholder shall bear
the Eligible Bills in excess of the Benefit Limits or Bill Limits (if any) of this Policy and the GREAT SupremeHealth plan, respectively.
5
Eligible Bills refers to the Expenses incurred, subject to Pro-ration Factor (where applicable), which are similar to those applied to the
GREAT SupremeHealth plan.
GREAT TotalCare Plus Benefits Schedule
For ASEAN2 countries 1. For a Life Assured who is not covered under GREAT SupremeHealth (As Charged)4
Expenses incurred are limited to the Reasonable and Customary Charges Benefits payable under this Rider for (B) shall be payable according to GREAT TotalCare plan insured for the Life Assured, with
in the country where the treatment was provided. the following Additional Annual Benefit Limits added to GREAT TotalCare plan:
Expenses incurred are limited to the Reasonable and Customary Benefits under this Rider for (B) shall be payable according to GREAT TotalCare plan and GREAT SupremeHealth (As Charged)4
Charges in the country where the treatment was provided. plan insured for the Life Assured, with the following Additional Annual Benefit Limits added to GREAT TotalCare plan:
• More than 90 days3 Additional Annual Benefit Limit S$50,000
Expenses incurred are limited to the Reasonable and Customary
Charges in the Country of Issue. Lifetime Benefit Limit
Benefits payable under this Rider for (B) shall be payable up to the following Lifetime Benefit Limits, in accordance with the plan
Expenses incurred are limited to the lower of the following:
(B) Overseas Non- type of GREAT TotalCare plan insured for the Life Assured:
• Reasonable and Customary Charges in Country of Issue, or
Emergency medical or
• Reasonable and Customary Charges in the country where the treatment
surgical treatment1 GREAT TOTALCARE (ELITE-P) GREAT TOTALCARE (ELITE-A) GREAT TOTALCARE (ELITE-B)
was provided.
GREAT TOTALCARE (CLASSIC-P) GREAT TOTALCARE (CLASSIC-A) GREAT TOTALCARE (CLASSIC-B)
1
All Expenses payable for (A) and (B) are subject to the Deductibles (where applicable), Co-insurance, Benefit Limits and Co-payment
as set out in GREAT TotalCare plan and/or GREAT SupremeHealth (As Charged) plan.
2
Brunei, Cambodia, Indonesia, Laos, Malaysia, Myanmar, Philippines, Singapore, Thailand and Vietnam.
3
Life Assured has resided outside the Country of Issue for more than 90 days, whether continuously or otherwise during the Period of
Insurance.
4
GREAT SupremeHealth (As Charged) plan refers to GREAT SupremeHealth P PLUS, A PLUS or B PLUS plans.
Premium Rates (Annual) – GREAT SupremeHealth STANDARD Premium Rates (Annual) – GREAT SupremeHealth STANDARD (Continued)
3. We will give a 15% child discount on the first policy year’s additional private insurance coverage premiums (before GST) for a child 37 475 390 85 300 0
up to and including 18 ANB as long as one parent, who is the policyholder, is insured under GREAT SupremeHealth P PLUS, A PLUS,
B PLUS or STANDARD.
Premium Rates (Annual) – GREAT SupremeHealth B PLUS (Continued) Premium Rates (Annual) – GREAT SupremeHealth B PLUS (Continued)
2. Annual premium rates are for standard lives and exclusive of any discounts or subsidies given by MediShield Life. 36 712 390 322 300 22
3. We will give a 15% child discount on the first policy year’s additional private insurance coverage premiums (before GST) for a child 37 712 390 322 300 22
up to and including 18 ANB as long as one parent, who is the policyholder, is insured under GREAT SupremeHealth P PLUS, A PLUS,
B PLUS or STANDARD.
Premium Rates (Annual) – GREAT SupremeHealth P PLUS (Continued) Premium Rates (Annual) – GREAT SupremeHealth P PLUS (Continued)
Plan GREAT TOTALCARE CLASSIC GREAT TOTALCARE ELITE GREAT TOTALCARE PLUS Plan GREAT TOTALCARE CLASSIC GREAT TOTALCARE ELITE GREAT TOTALCARE PLUS
Class Premiums (S$) Premiums (S$) Premiums (S$) Class Premiums (S$) Premiums (S$) Premiums (S$)
Plan GREAT TOTALCARE CLASSIC GREAT TOTALCARE ELITE GREAT TOTALCARE PLUS
Class Premiums (S$) Premiums (S$) Premiums (S$)
Age B A P B A P Essential
75 556 674 2,374 1,217 1,766 5,874 967
76* 579 701 2,485 1,267 1,838 6,118 1,015
77* 602 729 2,599 1,318 1,913 6,357 1,063
78* 626 758 2,717 1,370 1,989 6,593 1,115
79* 650 787 2,834 1,422 2,064 6,829 1,171
80* 673 815 2,950 1,473 2,138 7,051 1,227
81* 696 843 3,065 1,524 2,212 7,274 1,287
82* 721 874 3,190 1,579 2,292 7,495 1,350
83* 744 902 3,304 1,629 2,365 7,556 1,415
84* 766 929 3,418 1,678 2,436 7,618 1,485
85* 788 955 3,525 1,725 2,504 7,901 1,557
86* 808 979 3,627 1,768 2,567 8,185
87* 828 1,003 3,728 1,813 2,631 8,468
88* 847 1,027 3,826 1,853 2,693 8,675
89* 866 1,049 3,919 1,896 2,752 8,882
90* 882 1,069 4,003 1,932 2,804 8,953
91* 897 1,087 4,077 1,965 2,852 9,022
92* 911 1,104 4,146 1,994 2,895 9,091
93* 923 1,119 4,208 2,022 2,935 9,229
94* 935 1,133 4,265 2,047 2,972 9,365
95* 945 1,145 4,312 2,067 3,003 9,459
96* 953 1,155 4,350 2,087 3,029 9,553
97* 960 1,163 4,382 2,101 3,051 9,647
98* 965 1,169 4,403 2,113 3,066 9,789
99* 968 1,173 4,416 2,120 3,077 9,928
100* 968 1,173 4,411 2,120 3,077 10,069
>100* 968 1,173 4,411 2,120 3,077 10,069