Note: This post below has been updated on 12 May 2026.
Unanswered Questions from Making Sense of IP Claims: Your Top Questions Answered
1. If you are a relatively healthy individual, in your mid-sixties, which integrated shield plan should one person choose? Private, A ward or B1 ward should suffice? What are the factors to consider deciding the cost efficiency of the IP?
This is a fair question that we often receive. We have written 2 articles to explain our approach. Our first article talks about the considerations in your IP plan. The second article explains that affordability is not just about the ability to pay the premium but the trade-offs in your quality of retirement if the premium constitutes a large part of your retirement income. We hope you find these articles useful! Should you have additional questions, do not hesitate to reach out to us via our email: communications@havend.com.
2. When you make a claim, does it affect the premium of your IP in subsequent years?
Whether making a claim affects your future premiums depends on the specific Integrated Shield Plan (IP) rider you have.
Base IP plans’ premiums are not adjusted based on individual claims experience. However, some rider plans may include a claims-based pricing structure, where premiums or discounts can be affected by your claims history.
As the terms differ across insurers and rider types, it is best to refer to your policy terms and conditions or check with your adviser to understand whether claims-based premium adjustments apply to your plan.
3. In the market, there are claim-based premium policies. What is, from your experience, the charge-up in premiums (for the following years) once there is a big claim, for example, a $100K payout?
Claims-based pricing applies only to certain Integrated Shield Plan (IP) rider plans and does not apply to the IP base plans themselves.
The extent of any premium adjustment after a claim depends on the insurer’s rider pricing structure and factors such as:
- Your age
- The type of doctor or hospital used (for example, panel, extended panel, or non-panel providers)
- The size and frequency of claims made
As different insurers have different pricing frameworks, there is no standard market-wide increase even for a large claim such as a $100,000 payout. For the exact premium adjustment structure applicable to you, it is best to refer to your rider policy terms and conditions or speak with your adviser.
4. Having introduced mandatory sizeable copayment and deductible, do you think it is it fair for insurance company to increase premiums after a claim has been made?
The introduction of deductibles and higher co-payments for new IP riders was intended to encourage more responsible healthcare consumption and to help keep Integrated Shield Plan (IP) premiums sustainable over the long term. In fact, when these features were introduced, premiums for many newer rider plans were generally lower than the legacy riders that provided very high or near-full coverage.
Claims-based pricing is another mechanism insurers use to manage risk sharing within the insurance pool. The objective is to balance affordability, sustainability, and responsible usage, so that premiums remain fair not only for individuals who claim frequently, but also for the wider pool of policyholders.
5. What is the difference between a LOG and pre-authorisation?
A Letter of Guarantee (LOG) and pre-authorisation serve different purposes in the claims process.
A Letter of Guarantee (LOG) helps to partially or fully waive the hospital admission deposit that may otherwise need to be paid upfront. However, an LOG is not a confirmation or pre-approval that the claim will be covered. Each insurer has its own LOG limits, which can vary depending on the insurer, your plan, and whether treatment is at a private or public hospital. If the estimated bill exceeds the LOG limit, you may still need to pay the excess amount upfront upon admission.
Pre-authorisation, on the other hand, is a form of pre-approval from the insurer. It provides an indication of whether the planned treatment is claimable and how much is expected to be covered under your policy. This gives greater clarity and peace of mind before treatment, as you have a better understanding of your expected out-of-pocket costs.
6. Between Company and IP hospitalisation coverage, what criteria decides the LOG from which insurance, company insurance or personal IP?
Under policy conditions and MOH guidelines, your Integrated Shield Plan (IP) is considered the last payer after other available medical coverage has been utilised.
As such, if your company insurance is able to provide a Letter of Guarantee (LOG) or pre-authorisation, you should typically obtain it through the company insurance first.
During the claims process, the hospital will coordinate the claims submission to both the company insurer and the IP insurer if there are remaining eligible expenses not fully covered by the company insurance. The company insurer’s portion will be applied first, and the IP insurer will assess and settle the remaining eligible amount according to your policy coverage.
In most cases, this coordination between insurers and the hospital is handled directly and seamlessly for the patient.
7. Does HSBC life allows pre-authorisation? How do I get it?
Yes, HSBC Life does offer pre-authorisation for private hospital treatment, although they refer to it as a “Guaranteed LOG”.
To request for it, you can contact HSBC Life’s LOG hotline at least 3 working days before the planned admission or procedure. The insurer will assess the planned treatment and advise on the eligible coverage amount.
HSBC Life LOG Hotline: 6342 5292
You can also find more information here: HSBC Life Shield Panel & Letter of Guarantee – HSBC Life SG
8. My company insurance covers up to Ward A in government hospitals. However, my IP covers me up to private hospital. What would the process be like should I decide to go to a private hospital? For context, I am still holding the old rider.
You should first check with your HR or company insurer whether your company medical coverage:
- Does not cover private hospital treatment at all, or
- Provides partial/pro-rated coverage for private hospital treatment.
If your company insurance does not cover private hospitals, then you would claim directly under your Integrated Shield Plan (IP) and rider.
If your company insurance does provide some level of private hospital coverage, then the usual process is to first obtain a LOG or pre-authorisation from the company insurer where applicable. The hospital will then coordinate the claims with both your company insurer and your IP insurer for any remaining eligible amount not covered under the company plan.
As coverage terms can differ significantly between employers and insurers, it is best to confirm the exact arrangement with your HR department or adviser before admission.
9. Is the pre-authorisation/LOG process the same for government hospitals?
For government hospitals, the process can be slightly different. Most insurers do not provide pre-authorisation for government hospital treatment.
You can request for a Letter of Guarantee (LOG) during the admission process at the hospital. The hospital staff will assist in submitting the LOG request to the insurer on the spot.
If your policy was issued within the past year, or if your policy has specific exclusions, it is advisable to check with your insurer beforehand on whether a LOG can be issued for your admission.
10. For Income Insurance, would the extended panel be treated in the same way as panel doctors? For context, I have an old Assist Rider which if I am not wrong is equivalent to the Classic Care Rider.
Under Income IP with Assist Rider, treatment with an extended panel doctor is subject to an additional non-panel payment component, and the pre/post-hospitalisation coverage period is shorter compared to treatment with a panel specialist.
As rider terms may have changed over time and can differ depending on the policy version, it is advisable to refer to your latest policy terms and conditions or check with your adviser for the exact benefits applicable to your plan.
11. Are we able to see how much MediShield Life payout is being paid to the insurer?
Whether you can see the MediShield Life payout amount depends on the format of the claim settlement statement issued by your Integrated Shield Plan (IP) insurer.
Some insurers provide a detailed breakdown showing amount paid by MediShield Life and the IP plan. However, some insurers may only show the final payable amounts without separately stating the MediShield Life component.
If the breakdown is not reflected in the settlement letter, you may contact your insurer or the hospital billing department to request for more details.
12. If I was referred by my private GP to govt hospital, is the hospital bill considered public i.e. Ward A cover is sufficient? Can pre-hospitalisation at private GP be claimed?
If you are referred by a private GP to a government hospital, you are generally considered a non-subsidised patient unless the referral is made through specific subsidised pathways such as the CHAS referral system. Similarly, if you request to see a specific specialist, you would also typically be treated as a non-subsidised patient.
In such cases, treatment would generally fall under private/Class A billing rates in the government hospital, so a Class A Integrated Shield Plan (IP) would be appropriate for the coverage level.
The private GP bill can be claimed under pre-hospitalisation benefit but will be subject to the Class A to Private upgrade proration factor.
13. Is B1 ward considered as subsidised (lesser percentage)? How does the claim look like in the example highlighted in during the webinar (gallbladder)?
B1 ward in a government hospital is considered a non-subsidised ward class, similar to Class A. However, the overall bill size is usually lower than Class A because patients stay in shared rooms and ward charges are lower.
For the gallbladder surgery example (SF801G – Gallbladder Cholecystectomy), MOH-published figures show that the typical bill size range for a B1 ward stay is approximately $6,941 to $10,752.
You can refer to the MOH bill benchmark information here: SF801G – Gallbladder, Various Lesions, Cholecystectomy (Partial/Total) | Ministry of Health
14. What if you downgraded your rider after a day surgery, but still have follow up appointments? How will claiming pre/post hospitalisation work then?
From our understanding, pre- and post-hospitalisation claims are generally assessed based on the policy terms and conditions in force on the date the medical bill was incurred.
This means that if you downgrade your rider after a day surgery, any follow-up consultations, tests, or treatments incurred after the downgrade would typically be assessed based on the benefits and coverage terms of the new rider or plan in force at the time of those follow-up bills.
As insurer practices and policy wording may differ, it is still advisable to confirm the exact treatment of such claims with your insurer or adviser.
15. Hi, I am due to renew my IP in July and I am going for an endoscope in August. Does it mean that I will paying for the endoscope fully since it would fall below the deductibles? Currently, I have a rider that covers private hospital bills. Copayment is 5%.
The deductible for your Integrated Shield Plan (IP) resets at the start of each new policy year. So if your policy renews in July and your endoscopy is done in August, the claim would fall under the new policy year’s deductible.
However, since you have a rider, whether you need to pay the bill fully out-of-pocket depends on:
- The total bill amount for the procedure
- Whether your rider covers the deductible partially or fully
- The terms and structure of your specific rider plan
It would be best to refer to your policy terms and conditions or speak with your adviser to understand how your specific plan and rider will apply to the upcoming procedure.
16. How does the claim process work if you have an IP and another medical insurance from company?
Under policy conditions and MOH guidelines, your Integrated Shield Plan (IP) is considered the last payer after other available medical coverage has been utilised.
As such, if your company insurance is able to provide a Letter of Guarantee (LOG) or pre-authorisation, you should typically obtain it through the company insurance first.
During the claims process, the hospital will coordinate the claims submission to both the company insurer and the IP insurer if there are remaining eligible expenses not fully covered by the company insurance. The company insurer’s portion will be applied first, and the IP insurer will assess and settle the remaining eligible amount according to your policy coverage.
In most cases, this coordination between insurers and the hospital is handled directly and seamlessly for the patient.
17. For a person with IP for public hospital only, up to A class, can he choose a specialist from the private sector who does not work with public hospital he is admitted?
A private specialist who is not practising at the public hospital you are admitted to would generally not be able to treat you there.
If you wish to be treated by that private specialist, you would usually need to be transferred to the private hospital where the doctor practises. In such cases, your claims would then be assessed based on the private hospital benefits under your Integrated Shield Plan (IP), including any applicable pro-ration factors if your plan only covers up to public hospital Class A wards.
18. I have a Class A IP in public hospitals. But I heard that the wait time is long – not much difference with subsidised wards. And it will be worse still when more private hospital insured patients downgrade to Class A in public hospitals. Any comments?
In public hospitals, referrals are generally prioritised based on the urgency and clinical severity of the patient’s condition, regardless of whether the patient is subsidised or unsubsidised. Patients with more urgent medical needs will typically receive earlier appointments.
That said, there is still generally a difference in waiting times between subsidised and unsubsidised patients. Based on publicly available 2024 figures, the median waiting time for referrals from primary care providers to public hospital Specialist Outpatient Clinics was approximately:
- 35 days for subsidised patients
- 12 days for unsubsidised patients
As for whether waiting times may worsen if more private hospital policyholders downgrade to public hospitals, this is possible over time if demand continues to increase. However, the government is also continuously monitoring public healthcare demand and expanding capacity through longer-term healthcare infrastructure and manpower planning to help balance demand and supply.
That said, actual waiting times can still vary significantly depending on factors such as the medical specialty, hospital, doctor availability, and the urgency of the condition.
19. Why do private clinics always ask me whether I have insurance during my first visit? Sometimes, they even say that if I do not have health insurance, they will try to reduce their charges. Shouldn’t their charges be the same regardless of whether I have health insurance?
We are unable to comment on the charging policies or practices of individual clinics or doctors.
In general, medical fees and charges may vary depending on factors such as the complexity of the condition, treatment required, clinic practices, and administrative arrangements. Some clinics may also have different billing arrangements for insured and self-paying patients.
Patients who have concerns about fees should feel free to ask for a fee estimate or breakdown of charges before proceeding with treatment. MOH fee benchmarks are also publicly available as a general reference for common procedures and treatments.
20. Are all deductibles and co-insurance covered by Medisave?
Not necessarily. Medisave usage is subject to specific withdrawal limits for different types of inpatient bill items and treatments.
If the deductible and co-insurance amounts fall within the applicable Medisave withdrawal limits, they can generally be fully paid using Medisave. However, if the amounts exceed the allowable limits, the excess would need to be paid out-of-pocket
You can refer to the Medisave inpatient withdrawal limits here: Inpatient care | Ministry of Health
21. If the base IP is downgraded, can the old rider be maintained? Or do I have to take new rider?
From our understanding, many of the older-generation riders which don’t meet the new MOH IP rider requirements have already been discontinued and are no longer available for new sales. As such, if you downgrade your base Integrated Shield Plan (IP), you will also be required to switch to the currently available rider that corresponds to the downgraded plan.
However, practices can differ between insurers. It is therefore advisable to check directly with your insurer or adviser before making any downgrade decision so you can understand the impact on your rider benefits and future coverage.
22. Does Havend advise on a set of insurance companies or do you advise across all insurance companies?
Havend currently works with 8 insurer partners:
- Singlife
- Income Insurance
- HSBC Life
- Etiqa Insurance
- Tokio Marine Life Insurance Singapore
- Raffles Health Insurance
- FWD Singapore
- China Taiping Insurance
As an independent financial advisory firm, Havend’s approach is to advise across the insurers we are partnered with, based on the client’s needs and objectives.
We would ideally like to work with even more insurers where possible. However, some insurers such as AIA Singapore, Great Eastern, and Prudential primarily distribute their products through tied agents and bancassurance channels, and therefore generally do not partner with independent financial advisory firms.
23. How is pro-ration determined?
Pro-ration factors are determined by the insurer and are stated in your policy’s table of benefits.
The applicable pro-ration factor can differ depending on:
- The insurer
- The specific Integrated Shield Plan (IP) you hold
- Your entitled ward class under the policy
- The actual ward class or hospital type you choose for treatment
For example, the pro-ration applied may differ between:
- A B1 plan holder receiving treatment in a Class A ward
- A B1 plan holder receiving treatment in a private hospital
- A Class A plan holder receiving treatment in a private hospital
The insurer will apply the relevant pro-ration factor to determine the percentage of the bill that is claimable under the policy. As these factors vary across plans and insurers, it is best to refer to your policy documents or check with your adviser for the exact figures applicable to your coverage.
24. Is it true that for some insurers, some of the coverage is better with the new riders?
The current regulatory requirements for Integrated Shield Plan (IP) riders are applied across insurers. Newer riders are required to include:
- A deductible component that is not fully covered
- A minimum co-payment by the policyholder
- A co-payment cap, typically up to $6,000 per policy year under qualifying conditions
In comparison, many older-generation riders were more generous in certain areas, with some covering the deductible fully and having lower co-payment caps, such as $3,000. From this perspective, older riders may provide higher reimbursement levels for hospital bills.
However, when people refer to “better coverage” in newer riders, they may be referring to additional features or benefits introduced over time, such as:
- TCM benefits
- Ambulance coverage
- Outpatient therapy benefits
- Improved pre-/post-hospitalisation coverage terms
These additional benefits can differ significantly between insurers and rider versions. It is therefore important to compare the specific features, limits, and conditions of your own plan and rider rather than assuming newer or older riders are universally better.
25. To clarify, if company’s insurer can issue Pre-Authorisation, we do that first. Otherwise, we e-file our personal IP with the hospital before admission.
Yes, that is correct.
If your company insurer is able to issue a pre-authorisation or LOG, it is usually advisable to arrange that first. In such cases, the hospital will typically coordinate and submit the claims to both the company insurer and your Integrated Shield Plan (IP) insurer where necessary.
If the company insurer is unable to provide pre-authorisation, you can request for the hospital to e-file the hospitalisation claim to your IP insurer upon discharge. After the IP claim is completed ,you may submit a claim to your company insurer with the IP claim settlement letter. As IP has the last payer status, the company insurer and IP insurer will coordinate with each other to recover and allocate the claim amounts appropriately based on each policy’s coverage terms.
26. Find more related resources here!
Article – Unanswered Questions during Making Sense of IP Claims (Oct 2025)
Article – Learn about Our Transparent Practices
eBooks – Download our complimentary eBooks
Video – 1M65 Interview with CEO Eddy Cheong and Group CEO Christopher Tan
Article – The False Insurance Pitches We’re Tired of Hearing – The Woke Salaryman – Havend
Article – An Honest Look at My Own Insurance Planning
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