Managed Healthcare System - Outpatient Plan

Please consider your needs carefully before you decide to convert to MHS-Outpatient plan. Once you have converted to MHS-Outpatient plan, you cannot convert back to your existing MHS plan.  Changing of plan type under the MHS-Outpatient plan, e.g. from MHS-Outpatient Plan A to MHS-Outpatient Plan B, is not allowed as well.
 

MHS-Outpatient is a plan that provides coverage for outpatient medical treatments (Primary Care, Specialist Care and Emergency Treatment benefits). It does not provide inpatient hospital care benefit. As such, the premium is lower compared to the existing MHS cover which provides both inpatient and outpatient benefits.

With the launch of MediShield Life by Ministry of Health/CPF Board by end of year 2015, all Singapore Citizens and Permanent Residents will be automatically insured under MediShield Life. To avoid possible overlap of inpatient cover under MediShield Life, we are offering our existing MHS policyholders the option to convert to a new MHS-Outpatient plan.

Please complete the enclosed MHS-Outpatient Plan Option form and send it back to us within the stated time. Upon receipt of the form, we will convert your existing MHS cover to the corresponding MHS-Outpatient plan type, e.g. MHS Plan A to MHS-Outpatient Plan A. If we do not receive the MHS-Outpatient Plan Option form within the stated time, your MHS policy will be renewed based on your existing cover.

The new MHS-Outpatient cover will take effect from the upcoming renewal date if we receive your completed MHS-Outpatient Plan Option form within the timeline indicated in your letter. You will receive a new set of policy document once we accepted your application to convert your plan.

Your outpatient claim utilisation amount under your existing MHS policy will be used to determine the balance lifetime limit of your MHS-Outpatient plan. We will less off the amount incurred for outpatient claims up to the renewal date to derive the balance lifetime limit you have under  MHS-Outpatient plan.

You will only enjoy the full policy year limit (as stated under point 4 above) for the new policy year if this limit is within your balance lifetime limit of your MHS-Outpatient plan. Otherwise, your policy year limit will be reduced to be the same as your balance lifetime limit. 

Example 1
MHS-Outpatient Cover : Plan A
Limit per policy year:  $60,000
Limit per lifetime: $180,000
Claims utilisation under existing MHS policy: $20,000 (Outpatient) + $10,000 (Inpatient)

After you convert to MHS-Outpatient plan on renewal, your lifetime limit will be $160,000
($180,000 - $20,000) and your policy year limit will be $60,000 for the new policy year.

Example 2
MHS-Outpatient Cover : Plan A
Limit per policy year:  $60,000
Limit per lifetime: $180,000
Claims utilisation under existing MHS policy: $140,000 (Outpatient) + $10,000 (Inpatient)

After you convert to MHS-Outpatient plan on renewal, your lifetime limit will be $40,000 ($180,000 - $140,000). As the balance of your lifetime limit is below the policy year limit of  MHS-Outpatient Plan A ($60,000), your policy year limit will be reduced to be the same as your lifetime limit, $40,000 for the new policy year.
 

The benefits of MHS-Outpatient plan are the same as those covered under the existing MHS policy under (A) Primary Care, (B) Specialist Care and (C) Emergency Treatment benefit. However, MHS-Outpatient plan does not provide (D) Hospital Care benefit.

The key features of the MHS-Outpatient plan are re-produced below for your easy reference. Please refer to the policy contract for the precise terms, conditions and exclusions of the plan.

The policy year limit and lifetime limit of MHS-Outpatient plan are as follows:

Based on past claim experiences of MHS, the average proportion of outpatient claims is 75% of the total claims. In view of this, the policy year limit and lifetime limit of the MHS-Outpatient plan have been revised accordingly.

You may consult your insurance adviser for further advice if you have one. Alternatively, you may call our Healthcare Hotline at 6788 1777.

No, underwriting is not required.

No, any type of operation, regardless whether an overnight stay is required in the hospital, is not covered under the MHS-Outpatient plan.

View FAQ for Change of Administrator (2016)