Subsidies on Maternity Fees and Other Medical Bills for Foreigners who are Mothers or Relatives of Singapore Citizens

1 Mr Gan Thiam Poh asked the Minister for Health (a) whether the Ministry has received appeals from Singaporeans for help and subsidies to pay medical fees for their non-Singaporean relatives or foreign spouses in the past five years and if so, how many such cases there have been; and (b) whether the Ministry can work with ICA to consider implementing a policy requiring such foreign relatives or spouses visiting Singapore on long term visit pass to purchase medical insurance during their visit.

2 Ms Sylvia Lim asked the Minister for Health (a) whether the citizen-level subsidies for maternity fees accorded to foreign mothers giving birth to Singapore Citizens apply to all items incurred during a typical maternity hospitalisation or only to specified items; (b) if only for specified items, what are the specific items; and (c) whether a review will be done to equalise or reduce the disparity in the total bill size for all foreign mothers giving birth to Singapore Citizens.

The Minister of State for Health (Ms Rahayu Mahzam) (for the Minister for Health): Mr Speaker, may I seek your permission to answer Question Nos 1 and 2 together, please?

Mr Speaker: Please proceed.

Ms Rahayu Mahzam: Ms Sylvia Lim asked about maternity hospitalisation subsidies accorded to foreign mothers giving birth to Singapore Citizens. The majority of foreign spouses with Singapore Citizen children are Permanent Residents (PRs) or holders of Long-Term Visit Pass-Plus (LTVP+). Therefore, they are eligible for healthcare subsidies in public healthcare institutions. In particular, mothers with permanent residency or LTVP+ who are married to Singapore Citizens receive the same level of subsidies as Singapore Citizens for all items and treatments incurred for the entire delivery episode, from admission for childbirth to discharge after delivery.

On Mr Gan’s question about help and subsidies for non-Singaporean relatives and spouses, the Ministry and our public healthcare institutions do receive appeals regarding financing for healthcare costs incurred by foreign spouses or relatives of Singapore Citizens. We assess them on a case-by-case basis based on individual circumstances and do not specifically track the number of appeals.

Ultimately, as healthcare subsidies are borne by all Singaporeans, any extension of these benefits to foreigners must be assessed carefully. Foreigners facing financial difficulties with their healthcare bills may approach our medical social workers for assistance.

Healthcare insurance is another way to help protect families with foreigner members on LTVP or Dependant’s Pass from large hospital bills. Today, such individuals may buy plans offered by Integrated Shield Plan insurers and pay premiums in cash or using their Singapore Citizen/PR family members’ MediSave. They may also be covered by employer medical benefits.

However, making healthcare insurance mandatory for all long-staying foreigners will have to be carefully considered, as this may in turn pose a financial burden on their Singapore Citizen family members. We will continue to study the feasibility of this.

Mr Speaker: Ms Sylvia Lim.

Ms Sylvia Lim (Aljunied): Thank you, Speaker. I have three supplementary questions for the Minister of State.

First, I have asked for the figures from the Ministry of Home Affairs (MHA) for the answer to this, so I do not know, but does the Ministry of Health (MOH) also acknowledge that there is a significant number of Singaporean children being born to foreign mothers who are not holders of PR or LTVP+ but LTVP itself or less. So, does MOH acknowledge that fact?

Secondly, it is a national priority for us to increase our total fertility rate (TFR). So, if we look at the cost differential for foreign mothers giving birth to Singapore Citizens who are not holders of PR or LTVP+, does MOH not find that the total bill size is significantly higher than that for LTVP+ or PR mothers, in the sense that it works against our aim to increase our TFR, because the cost is just too high?

And finally, if we were to consider extending further support to this group of foreign mothers who are not PRs or LTVP+ holders, I think we are looking at probably a limited number of people and these delivery episodes are once in a lifetime, maybe twice. So, are we not able to afford to look into this?

Ms Rahayu Mahzam: I thank the Member for her interest. Firstly, on the numbers, I will leave MHA to respond to her queries. But based on the indications that we have in respect of delivery episodes in 2024, actually, in terms of the other Pass types – LTVP and others – the numbers are really a smaller percentage; I would say less than 10%. So, the majority of those who are foreign spouses, they are PRs or LTVP+ holders.

I would just highlight a couple of things to address the other questions that the Member has raised. I understand. The concern is really the Singapore child and you are helping a Singaporean with this situation. As I have mentioned earlier, firstly, the majority of the foreign spouses that we see are PRs or LTVP+ holders, which means that they are entitled to Singapore Citizen rates for the whole delivery episode. It means that from the time they are admitted for delivery to the discharge of the mother after birth, it is fully covered at Singaporean rates. In that sense, the issue of the Singaporean child not being supported, does not exist because for any mother who is delivering a Singaporean child and if they are a PR or LTVP+ holder, the whole episode of delivery is covered.

Also, it can be applied retrospectively. So, if the mother is in the process of applying for her LTVP+ and it has not yet been approved, and she then got admitted but there is a process or an application pending, she can actually apply for the rates to be applicable to her as well. This is also something that addresses those concerns.

There are two other points I wanted to make. If it is outside the episode of delivery, LTVP+ foreign spouses of Singapore Citizens are also eligible for healthcare benefits, such as subsidies for in-patient services at the restructured hospitals and this is at the same level as PRs. So, in that sense, they are also covered for some of their other expenses. In any case, if there are any difficulties, the foreign spouses may also seek help from medical social workers.

So, actually, a large part of the concerns that the Member has are already addressed with the existing policies. But we will continue to look at all gaps. We always review our financing policies regularly to see if there are emerging trends or needs that we need to address.

Mr Speaker: Ms Lim.

Ms Sylvia Lim: Thank you, Sir. One more supplementary question for the Minister of State. She mentioned in her answer that the number of foreign mothers giving birth to Singaporean children who are not already PRs or LTVP+ holders is small, less than 10%. I think as she correctly acknowledged, we are all in this together. Every Singaporean child born is precious to us. So, given that the numbers are not large, according to what the Ministry has just said, then I think there is scope for us to review, to see how we can better support, financially at least, the delivery episodes of these mothers who are holders of LTVP or less Passes.

Ms Rahayu Mahzam: As I mentioned, we will continue to assess this situation. But the Member may want to consider for those situations where the mother comes in, what they can do is to apply for LTVP+ and if she satisfies that requirement, she will then be entitled to Singapore Citizen rates.

In the meantime, we will continue to assess and to see where we can continue supporting the mothers who have difficulties with the delivery costs.