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Health Insurance Enhanced IncomeShield
Plans & Coverages
Enhanced IncomeShield Plan - Benefits & Coverages
Schedule of Benefits
| BENEFITS : | Limits of Compensation | ||
| In-patient Hospital Treatment: |
Preferred (Private Hospital/Private Medical Insitutions) |
Advantage (Government/ Restructured Hospital for A ward & below) |
Basic (Government/ Restructured Hospital for B1 ward & below) |
| Room, Board & Medical Related Services | As Charged | As Charged | As Charged |
| Intensive Care Unit (ICU) & Medical Related Services | As Charged | As Charged | As Charged |
| Surgical Limits (including Day Surgery) | As Charged | As Charged | As Charged |
| Pre-Hospital Specialist's Consultation (leads to hospitalisation within 90 days) | As Charged | As Charged | As Charged |
| Pre-Hospital Diagnostic & Laboratory Services (leads to hospitalisation within 90 days) | As Charged | As Charged | As Charged |
| Post-Hospitalisation Treatment (max. 90 days after discharge) | As Charged | As Charged | As Charged |
| Surgical Implants/Approved Medical Consumables | As Charged | As Charged | As Charged |
| Gamma Knife/ Novalis Radiosurgery1 | As Charged | As Charged | As Charged |
| Emergency Hospitalisation Outside Singapore | As charged, pegged to costs of S'pore Private Hospitals |
As charged, pegged to costs of S'pore Restructured Hospitals |
As charged, pegged to costs of S'pore B1 Restructured Ward |
| Accident In-patient Dental Treatment | As Charged | As Charged | As Charged |
| Ward Entitlement | Standard Room In Private Hospital | Class A1 and Below | Class B1 and Below |
| Confinement in Community Hospital (max 45 days) | As Charged | As Charged | As Charged |
| In-patient Psychiatric Treatment | $5,000 | $5,000 | $3,000 |
| Pregnancy Complications Benefit2 | As Charged | As Charged | As Charged |
| Congenital Abnormalities Benefit3 | As Charged | As Charged | As Charged |
| Outpatient Hospital Treatment: | |||
| Stereotactic Radiotherapy for Cancer | As Charged | As Charged | As Charged |
| Radiotherapy for cancer |
As Charged | As Charged | As Charged |
| Chemotherapy for cancer |
As Charged | As Charged | As Charged |
| Immunotherapy for cancer | As Charged | As Charged | As Charged |
| Renal Dialysis |
As Charged | As Charged | As Charged |
| Erythropoietin drug for chronic renal failure | As Charged | As Charged | As Charged |
| Cyclosporin/Tacrolimus drug for organ transplant |
As Charged | As Charged | As Charged |
| Pro-Ration Factor | |||
| Private Hospital/ Private Medical Institutions | N.A | 65% | 50% |
| Restructured Hospitals - Class A4 |
N.A | N.A | 85% if above B1 ward |
| Restructured Hospitals - Class B and below4 |
N.A | N.A | N.A |
| Deductible Per Policy Year for Insured Persons 80 years and below at next birthday | |||
| In-patient | |||
| C Class Ward | $1,000 | $1,000 | $1,000 |
| B2 Class Ward | $1,500 | $1,500 | $1,500 |
| B1 Class Ward | $2,000 | $2,000 | $2,000 |
| A1 Class Ward/Private Hospital | $3,000 | $3,000 | $2,000 |
| Day Surgery | $3,000 | $3,000 | $2,000 |
| Deductible Per Policy Year for Insured Persons above 80 years at next birthday | |||
| In-patient | |||
| C Class Ward | $2,000 | $2,000 | $2,000 |
| B2 Class Ward | $3,000 | $3,000 | $3,000 |
| B1 Class Ward | $3,000 | $3,000 | $3,000 |
| A1 Class Ward/ Private Hospital | $4,500 | $4,500 | $3,000 |
| Day Surgery | $4,500 | $4,500 | $3,000 |
| Co-insurance | 10% | 10% | 10% |
| Limit per Policy Year | $500,000 | $250,000 | $150,000 |
| Limit per Lifetime | Unlimited | Unlimited | Unlimited |
| Final Expenses Benefit | $5,000 | $5,000 | $3,000 |
| Last Entry Age (Age next birthday) |
75 | 75 | 75 |
| Maximum Coverage Age | Lifetime | Lifetime | Lifetime |
The above schedule of benefits is applicable to policies effected or renewed from 1 January 2009 onwards.
1. Gamma Knife/ Novalis Radiosurgery can be performed as an In-patient or day surgery procedure.The applicable Deductible and Pro-Ration Factor for Gamma Knife/ Novalis Radiosurgery procedure will depend on its classification as an In-patient or day surgery procedure.
2. Subject to a waiting period of 10 months from (i) 1 September 2008 or (ii) the Commencement Date or (iii) the last reinstatement date of the Policy, whichever is latest.
3. Subject to a waiting period of 24 months from (i) 1 September 2008 or (ii) the Commencement Date or (iii) the last reinstatement date of the Policy, whichever is latest.
4. No Pro-Ration Factor will be applied to Out-patient Hospital Treatment received from a Restructured Hospital.
Example to illustrate the Enhanced IncomeShield benefits
A 18 year old boy who is covered under Enhanced IncomeShield Preferred plan was admitted to a private hospital with a total bill of $8,000.
| Benefits | Expenses Amount | Claimable |
| Room & Board (5 days) | $4,500 | $4,500 |
| Surgical Benefits | $2,500 | $2,500 |
| Implant | $1,000 | $1,000 |
| Total | $8,000 | $8,000 |
Without Assist Rider
| Claimable | $8,000 |
| Less : Deductible | $3,000 |
| Less : Co-insurance | $500 |
| IncomeShield pays: | $4,500 |
| Insured pays (deductible and co-insurance) | $3,500 |
With Assist Rider
| Claimable | $8,000 |
| IncomeShield pays: | $7,200 |
| Insured pays (10% of $8,000 or Cap of $3,000, whichever is lower) | $ 800 |
And with Daily Cash Rider
| IncomeShield pays: | $1,050^ |
| Insured pays | $0 |
| In return, Insured receives net amount | $250 |
^ Insured receives an amount of $1,050 (Daily Cash Benefit of $150 x 5 days plus Get Well Benefit of $300).
 |
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