In our line of work, we have conducted countless insurance reviews, and one key area we have observed is that long-term care planning is often neglected or under-planned in the event of severe disability. This issue affects all Singaporeans and permanent residents due to the high financial risk involved.
This article aims to help you understand the risk, the financial impact, and how we can be better prepared to deal with it.
What is Long-Term Care (LTC)?
Long-term care refers to the personal and medical assistance needed when an individual is unable to perform daily “Activities of Daily Living (ADLs)” — such as washing, feeding, dressing, toileting, walking or moving around, and transferring. These are basic self-care tasks, and if a person is unable to perform at least three out of the six ADLs, they are considered severely disabled.
Circumstances That Could Cause Severe Disability
Severe disability may arise due to several factors, such as:
- Sudden Disabling Events (e.g., stroke, spinal cord injuries)
- Worsening of Chronic Conditions (e.g., diabetes)
- Progression of Illnesses with Age (e.g., dementia)
According to studies and research, one in two healthy Singaporeans aged 65 and above could develop severe disability in their lifetime and may require long-term care. In Singapore, one in 10 people over the age of 60 suffers from dementia, and half of those aged 80 and above have dementia. Therefore, it is estimated that more than 100,000 people in Singapore may have dementia by 2030.
Cost of Severely Disabled
Healthcare costs are often neglected because people may not fully appreciate the needs and financial implications. This oversight can stem from a few reasons: some might underestimate the cost of severe disability, while others may feel they have sufficient financial resources to manage it.
The cost of long-term care varies depending on the level of care required. Some individuals may prefer to remain in their own homes when severe disability occurs, while others might opt for a nursing home to avoid burdening family members. Here are the available caregiving options:
- Home-Based Care
- Assisted Home Care
- Nursing Home Care
1) Home-Based Care
Speaking of home-based care, Singlife has recently conducted a study indicating that an average individual with severe disability would require about $3,000 per month to meet their healthcare needs.
Source: Singlife: Are Young Families Prepared for Their Long-Term Care Needs?
To manage severe disability, individuals often need to make significant life adjustments, which can increase expenses. This situation can also impact family members, particularly if they are the primary caregivers. They may need to take more time off work, resulting in a loss of income. To minimise these changes, family members might hire trained domestic helpers or full-time caregivers to assist the severely disabled person during work hours or resting periods.
In addition to the costs associated with life adjustments, hiring domestic helpers or full-time caregivers adds further expenses for the family. Based on our research, here is a breakdown of these costs:
a) Engaging a Domestic Helper
- Monthly Salary ($450 – $700): This is the largest cost associated with hiring a domestic helper.
- Living Expenses ($270): This includes food, utilities, public transport for daily errands, and mobile credit, which are often overlooked in the monthly cost.
- Maid Levy: With a levy concession, this monthly expense can be reduced from $300 to $60.
- Insurance for a Domestic Helper: This mandatory insurance costs approximately $450 for 26 months.
There are also other one-time costs, including agency fees, work permit applications and issuance, the settling-in programme for new helpers, the security bond required by the Ministry of Manpower, and other one-off fees.
Source: Income: Cost of Hiring a Domestic Helper in Singapore (2024)
In some cases, an experienced and trained domestic helper may request a higher monthly salary, which could amount to around $1,500 per month on the conservative side.
b) Engaging a Trained Caregiver
- Based on the information on Active Global Caregiver, the cost of engaging a trained caregiver is similar to that of employing a domestic helper.
One may choose not to engage a trained domestic helper or full-time caregiver for various reasons. However, if there is a need for caregiving services on an ad-hoc basis, they can still be hired at an hourly rate, as detailed in this table below.
Source: Homage: Care Services & Rates
2) Assisted Home Care
Assisted home care is somewhat similar to a nursing home, but offers an alternative for elderly people who prefer living independently but also need assistance with daily activities and personal care services. Seniors can also benefit from continuous care and 24/7 monitoring, while participating in stimulating programs that help them develop and acquire new skills. There are two types of assisted home care services:
- Basic Assisted Living Facility at Housing Development Board (HDB), 2 Bedder Room – $2,900 to $4,600 per month
- Red Crowns concierge fee
- Shared monthly rental, home repair, and maintenance
- Shared monthly salary and other expenses due for the caregivers
- Meals, Utilities, Wi-Fi, CCTV
- Basic Assisted Living Facility at Condominium, 2 Bedder Room – $3,400 to $5,000 per month
- Red Crowns concierge fee
- Shared monthly rental, home repair, and maintenance
- Shared monthly salary and other expenses due for the caregivers
- Meals, Utilities, Wi-Fi, CCTV
While living in assisted home care, medical escort, personal consumables (medication, adult diapers, toiletries, etc.) are not covered and are an additional cost.
3) Nursing Home Care
There are different types of Nursing homes in Singapore such as Voluntary Welfare Organisation (VWO) nursing homes, Private nursing homes, and Premium (Luxury) nursing homes. Therefore, the cost of these nursing homes varies. Here is the typical cost of the nursing home
- VWO nursing home (non-subsidy rate): Monthly cost – $1,300 to $3,500
- Private nursing home (non-subsidy rate): Monthly cost – $1,200 to $9,000
- Premium (Luxury) nursing home (non-subsidy rate): Monthly cost – Above $10,000
The monthly fees of nursing homes usually include:
- 24/7 caregiving duties (such as personal care assistance with feeding, dressing, bathing, etc)
- Dementia/psychiatric facilities
- Nursing care
- Night respite
- Physical and social activities
- Daily meals
- Rooms
- 24-hour emergency care and monitoring
As we’ve explored in this first part, long-term care planning is crucial yet often overlooked. Understanding the costs and options available is the first step towards better preparation. But this is just the beginning.
In Part 2, we dive deeper into how you can navigate long-term care, understanding the key challenges and financial risk mitigation strategies you could apply to your situation.
This is an original article written by our Insurance Specialist at Havend.
At Havend, if we are found to have oversold you, we have put in place a Money Back Guarantee (MBG) scheme, so you can trust that we will always prioritise your interests first. Unprecedented in Singapore, learn more about our Money Back Guarantee scheme here.

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