Reviewing Individual Requests to Exceed MediSave Withdrawal Limits

7 Ms Elysa Chen asked the Coordinating Minister for Social Policies and Minister for Health (a) what is the process for reviewing and approving individual requests to exceed MediSave withdrawal limits; and (b) what criteria, documentation and exceptional circumstances are considered in such case-by-case applications for urgent medical needs.

The Minister of State for Health (Ms Rahayu Mahzam) (for the Coordinating Minister for Social Policies and Minister for Health): Mr Speaker, all appeals for exceptional MediSave use beyond established withdrawal limits are reviewed on a case-by-case basis to consider each individual's unique circumstances. When assessing such appeals, we consider the patient's ability to afford their medical expenses, their available MediSave balances as well as the individual's eligibility for other financing options, such as MediFund.

Mr Speaker: Ms Chen.

Ms Elysa Chen (Bishan-Toa Payoh): I thank the Minister of State for her response. Several of my residents have shared that the current limit of $300 is too low for their healthcare needs. I have three supplementary questions.

The first is to ask the Minister of State whether patients and families are adequately informed of the option to apply for exemptions from MediSave withdrawal limits and what avenues exist for assistance in submitting these applications?

My second question: how long on average does it take for individual applications that exceed MediSave withdrawal limits to be processed and whether interim relief is available for patients with urgent medical needs?

And my last question: whether there are sufficient safeguards to ensure that lower-income patients are not discouraged from applying for MediSave limit exemptions due to the administrative burden or complexity?

Ms Rahayu Mahzam: Mr Speaker, I thank the Member for the questions. I can appreciate concerns from her residents, but I would like to highlight that in respect of her first point, within the public healthcare institutions, there are medical social workers who are embedded in the system and are ready and available to give guidance to the patients when they face difficulties in paying their bills.

I would also like to highlight that beyond just the usage of MediSave, having exceptional circumstances where they can withdraw within the limits, there are also other sources of support, including access to MediFund, discretionary support in the hospitals, in the public healthcare institutions. So, that is a key point to note. I would encourage the patients to go and seek support from the medical social worker, because they may be able to then look at the slew of support that is available for the patients.

On the second question, I would like to stress that in our healthcare institutions, the priority is given to providing treatment as necessary. So, no patient would be in a situation where they would not be able to get the treatment they need if it is medically indicated because of their financial circumstances. That would be prioritised and that would be something that the healthcare workers and the doctors and the nurses will ensure happen.

In the other part of the question, the Member asked about the timing needed. It really depends on the cases, because we do need to look at each case and the nuances and the reasons behind the application. And the complexity of the case may matter, in terms of the timing as to how we come up with the outcomes. But I would just want to stress that there has been no situation where if they cannot afford the treatment, they do not get the treatment, because that is usually prioritised.

The last bit, the Member had asked about how do we ensure that those from low-income families are not prevented or discouraged from applying for exceptional withdrawal limits. I would say that no one is prevented or discouraged from applying for the exceptional limits. Each application will be looked at on its own merits to account for, among other things, their ability to afford it, how much their MediSave balances are, and whether there are other supports that are available. For example, as I said earlier, MediFund. So, they should not hesitate to ask for help if they need to.

On a broader point, I just want to highlight that the first point is that MediSave is just one of the options for those who need support. There are other financial avenues available and I hope that patients are aware of that and would seek help from the medical social workers for that.

The second point is, it is always tricky about MediSave. The intention, the whole objective of MediSave is to ensure that you have enough for the big catastrophic events that happens. And this typically happens later part in life. So, we need to find that balance of making sure that there is accessibility to its usage, but to also preserve it for healthcare needs in the future. To that point, we do review it periodically to make sure that there are sufficient enhancements and support given. As you know, recently we made the announcements about the extension of usage of MediSave for outpatient treatments, as well as, for outpatient scans – Flexi-MediSave and Outpatient scan. So, these are things that reflect that we do review this periodically and will enhance it where appropriate.

Mr Speaker: Mr Pritam Singh.

Mr Pritam Singh (Aljunied): Just a follow-up question to the Senior Minister of State, with regard to the MediSave limits. I think some years ago, it was suggested by myself, whether the MediSave criteria for certain individuals could be loosened on the basis of how much they have in their MediSave accounts, particularly for seniors who, I am sure Member would appreciate, would visit at the meet-the-people sessions and say, "Look, we have got $40,000, $50,000 in our MediSave accounts and we just need a little bit more assistance", particularly, since these seniors have retired. I am wondering whether the Ministry is prepared to exercise some flexibility in a more purposive way to ensure that some of these seniors can be allowed to use more of their MediSave monies.

Ms Rahayu Mahzam: On the question from the Leader of Opposition, I appreciate the sentiments, because I also do get those appeals from time to time.

I would suggest that the Member can surface it to the Ministry. In fact, we do take a case-by-case approach to the situation, depending on the age. There have also been compassionate considerations, especially if the person is approaching end-of-life; there have been circumstances where there has been a bit more discretion exercised and leniency given. But we really have to look at the circumstances, the treatment, the costs as well as the balances in the MediSave.

Mr Speaker: Ms Cassandra Lee.

Ms Cassandra Lee (West Coast-Jurong West): I thank the Minister of State. I recognise that last September, MOH mentioned to a Parliamentary Question that you are looking to review these limits. Many Singaporeans, including my residents in Ayer Rajah, have told me that they do not qualify for the subsidies because they are retired and they are seniors, but they are also unable to fork out the top-up to pay for their medical fees in cash because that would affect their daily living. With rising costs of living, it is difficult for them. I am asking the Minister of State whether we have a timeline as to when the next review might be.

Ms Rahayu Mahzam: We do the review periodically, as and when we are looking into it, and when we have reviewed something, we will make the announcements. Recently, as the Member has highlighted, we announced the Flexi MediSave increase from $300 to $400, and we also increased the amount that you can tap on for outpatient scans, because we know those are big-ticket items, from 300 to 600 items.

So, we will continue to review this. Members who wish to give feedback can also let us know.

But as I said earlier, it is really about the balance. There is a need for us to make sure that there is sufficiency for a long run.

We also need to understand that there are many different levers. There are many different avenues of support. There is the Community Health Assist Scheme (CHAS), there is the MediFund in situations where they need it. And we may need to look at what are the different ways in which you can help support the particular individual.

But I am open to see if there are any further areas for which Members feel that there is a need of this. We do do this review fairly regularly.