Monitoring Insurers who Raise Base Integrated Shield Plan Premiums that Negate New Rider Savings

7 Mr Yip Hon Weng asked the Coordinating Minister for Social Policies and Minister for Health (a) how does the Ministry address insurers which raise base Integrated Shield Plan premiums, effectively negating new rider savings; (b) what specific mechanisms ensure claims are not unreasonably rejected to mitigate rising costs; and (c) whether the Ministry will mandate greater transparency in premium calculation methods and publicly penalise insurers that engage in unjustifiable price hikes.

8 Dr Hamid Razak asked the Coordinating Minister for Social Policies and Minister for Health (a) whether the Ministry was aware of the intention by insurers to raise base Integrated Shield Plan (IP) premiums at the same time as the required changes to IP rider specifications from 1 April 2026; and (b) if so, whether any and what analysis was done on how base premium increases would interact with rider changes in affecting overall premiums for consumers.

The Minister of State for Health (Ms Rahayu Mahzam) (for the Coordinating Minister for Social Policies and Minister for Health): Mr Speaker, may I have your permission to address Question Nos 7 and 8 in today's Order Paper?

Mr Speaker: Please proceed.

Ms Rahayu Mahzam: Integrated Shield Plan (IP) insurers review the premiums of IPs and riders every year. Across a three-year period from December 2021 to December 2024, private hospital IP premiums have been rising every year at an average of 8.6% while private hospital rider premiums have been rising every year at an average of 17.2%.

In line with these trends, some private hospital IP and rider plans were recently repriced. However, with the launch of the new riders, policyholders can save on average 35% to 40% premiums by switching to the new riders. We have responded to previous similar Parliamentary Question Nos 1 to 4 asked by the Members at the 24 September 2025 Sitting, on increases in IP and rider premiums.

To recap, Government's role is to ensure affordable, accessible and quality subsidised healthcare for Singaporeans, with MediShield Life coming in to cover higher bills. IPs and riders are private, commercial products that supplement MediShield Life coverage for unsubsidised healthcare. While the Ministry of Health (MOH) regulates the key parameters of IPs, such as the co-payment and deductible, to ensure that the schemes are sustainable, MOH's general practice is not to intervene in insurers' commercial decisions, such as the setting of premiums.

To Mr Yip's question on claims management, the Monetary Authority of Singapore (MAS) and MOH require insurance companies to uphold their contractual obligations and process claims in a fair manner. Under MAS' insurance regulations, insurers must notify their policyholders of any change in policy terms and conditions at least 30 days before it takes effect. Should there be disputes over specific claims, policyholders can take it to the Financial Industry Disputes Resolution Centre (FIDReC), an independent and impartial institution that assists with insurance-related disputes. MAS will also take action against insurers if they do not pay claims in accordance with policy terms and conditions or have unfair claims handling practices.

Mr Speaker: Mr Yip.

Mr Yip Hon Weng (Yio Chu Kang): Thank you, Mr Speaker. I thank the Minister of State for her reply.

Many Singaporeans are already facing rising premiums year after year. As we have seen recently, even with cheaper riders, base premiums continue increasing. So, households may still have to pay more overall. So, will MOH consider imposing clearer limits or review triggers on premium increases?

My second supplementary question is for older Singaporeans. They face the steepest premium increases and have the least flexibility to change or switch plans. So, will MOH consider introducing additional safeguards, specifically for seniors, and how does the Ministry prevent them from being priced out of coverage that they have relied on for years?

Ms Rahayu Mahzam: I thank the Member for the question and I acknowledge that there are concerns among Singaporeans about this rising premium costs. But I would like to highlight that the premium increase actually reflects the underlying healthcare cost increases, the healthcare cost pressures and this increase include the increase in the cost because there is an ageing population, because of more expensive technological medical treatments, pharmaceuticals, manpower. So, there is a whole cluster of cost increases because of that.

There is also over-consumption and over-servicing, and that is just a result of over-generous products that we see in the market today. So, this causes increase in the cost of healthcare, which then results in increased claims, which results in increased premiums. Because for this to be sustainable, the providers will have to reprice. Because otherwise, if we artificially limit it, it will not be sustainable. They will not be able to, then, pay out in accordance to what they need to if they do not adjust and make sure that they can sustain in the long run. In the end, this will actually harm the policyholders because they may see reduction in the benefits or even market exits, which is going to be worse.

So, what we do at MOH, is that we do not just look at why these increases are happening. But we are looking at the root causes and trying to address the root causes.

As I mentioned earlier, there are the causes in relation to ageing population, technological advancements and we have measures and levers where we look at getting the most cost-effective products in the market. We are also looking at how we can address the issue of over-servicing, over-consumption by putting in the levers that we have in place, which we have discussed previously in questions the Member has raised before, which includes fee benchmarks, clinical guidance to ensure that appropriate care is given and we enforce against errant providers. We have rider reforms, which the Member has seen; and also, in the works, the development of not-for-profit private hospitals.

So, all these measures, in totality, will help to moderate the increases. But it is a reality that this will happen. We note, though, that there are concerns and we will continue to monitor this and respond accordingly to make sure that healthcare cost remains affordable.

This ties into the second point the Member is making, with regard to seniors. We note they are especially vulnerable, but I just want to assert the point that there are also practical pathways that can be taken because there are options now. Seniors can, at the appropriate juncture, review or right-size their coverage in accordance to their needs as well as to their affordability at that moment in time. There are other options, for example, cheaper riders, that they can look at and perhaps, they can convert to those options.

But in totality, I also want to give the assurance to members of the public and to the Member that no one will be left out or not have access to healthcare, because what is anchoring our healthcare system in Singapore is the fact that there will always be access to subsidised services in the public healthcare sector.

And so, that is an assurance that we give to all Singaporeans, and we will continue to monitor to ensure that there will be affordable healthcare services and it is accessible to all Singaporeans. So, that is not something they can worry about. There is already the S+3M framework that is already in place, so we know that MediShield Life is one, they have their MediSave and if all else fails, there is MediFund.

So, I hope that gives that assurance that we continue to monitor this, but at the same time, we need to appreciate that there are practical realities with regard to premium increases, but we also ensure that nobody will be left out or not to be able to have access to healthcare because of cost pressures.

Mr Speaker: Dr Hamid Razak.

Dr Hamid Razak (West Coast-Jurong West): Thank you, Mr Speaker, Sir. I thank the Minister of State for the reply.

I generally accept that the Ministry does not want to intervene in the arrangements within private insurance companies and in the private healthcare, but I am coming from an angle of not overburdening the public healthcare. Because we do not want a sudden surge of patients from private healthcare going to the public hospitals.

So, in that regard, I would like to ask if the Ministry has studied the components of bill sizes that have contributed to the recent increase in medical costs in the private healthcare. Because we have had measures to cool down, for example, the cost attributed to doctor's fee sizes with fee benchmarks as well as panel arrangements. So, has the Ministry studied whether other components – for example, facility costs, consumable costs and whether these have been riding steadily and whether there are plans to have similar benchmarks for these bill size components?

Following on to that, can I also ask the Ministry whether it has studied the effects of the panel arrangements on whether they have equitably kept doctors' fee sizes manageable compared to the fee benchmark that the Ministry already has? Because my worry is that with entrenching panel behaviours by insurers, that we are also limiting access to equitable healthcare in the private sector.

Ms Rahayu Mahzam: I thank the Member for the questions. On his first point about the components of healthcare costs in the private sector, we are indeed looking at the different dimensions. We already have some robust fee benchmarks on the professional fees front. We are reviewing to see if there is a need and if there are some ways for us to also put in benchmarks in the other components of the other costs.

On the panel arrangement, I believe we had a discussion also in a previous Sitting about why this came about. Really, it is going back to the whole big picture about insurers moderating the costs and how they can remain sustainable. Because claims are high and because there is over-consumption, over-servicing, they then need to make sure that they are moderating their costs. And this becomes an administrative effort in their effort to try and moderate the payouts by actually empanelling members so that they can limit their cost to those who fit their structures.

This remains something that will be an enduring feature because this is a market reaction to something that is causing a pressure on the insurer's part. So, while we will take a position where we must protect the consumers and there must be fairness in all interactions with the panel doctors. We do this in many different ways. As the Member know, we are quite robust in actually putting errant doctors to task, if, let us say, they have not done it properly. We are sending out clinical guidelines to make sure that people are following proper care protocols and not just treating based on what they have as insurance policies.

So, these are all multi-pronged approaches and efforts that we are putting in place to ensure that we are responding to some of the concerns in this space. It is just a symptom, so the underlying cost pressures still need to be addressed. The description that we had put earlier in the past is that it is a knot that we need to untangle; and that is something we are doing with a multi-pronged, with engagements with different parties and stakeholders.

Mr Speaker: Dr Hamid Razak, you have a short supplementary question to ask?

Dr Hamid Razak: I just want to mention for the record that I declare that I am an orthopaedic surgeon in private practice, and also a visiting consultant at public healthcare institutions.

Mr Speaker: Noted. Last supplementary question, Mr Andre Low.

Mr Low Wu Yang Andre (Non-Constituency Member): Thank you, Speaker. My supplementary question to the Minister of State is, I accept that a primary driver of premium increases is rising healthcare costs. But there is also other levers, such as reducing administrative costs at insurers themselves. So, the insurance industry as a whole has a big effort towards driving down administrative costs, third-party processor costs, claims processing costs, things like that.

Has the Ministry considered policy levers to incentivise insurers to have these cost savings pass on to consumers in the form of moderating premium increases, or even reducing premiums, as opposed to these cost savings directly going to insurers' profit margins?

Ms Rahayu Mahzam: We engage the insurance providers quite regularly, but we are very mindful about where we intervene, especially because they need to be competitive and there is a commercial dimension to it, which we feel that we should respect. So, how we intervene is via the conditions that are put in place vis-a-vis the consumers. We note how there should be adherence to deductibles as well as the co-payment.

So, these are things that we take a measured approach on. What the Member suggests is a dimension of the cost components. I will not preclude us from having just general conversations with insurers. But I just wanted to express the point that, while we do engage insurers quite robustly, we are very conscious about the fact that we also have to draw a line somewhere because it is a commercial product and we have to have them remain competitive.