There was an article on the Straits Times forum yesterday written by a parent whose child was denied the Medishield plan by CPF.
It was unfortunate that CPF did not want to cover the child, and it seemed to go against the Health Minister Khaw Boon Wan’s announcement that every newborn baby will have basic medical insurance coverage at birth.
There was an earlier case of a newborn with congenital defects being excluded, but from the reply it seemed to imply that at least they would still be covered by Medishield with an exclusion for the congenital defect.
This does not seem to be the case here. Hopefully, MOH can shed some light on this issue.
When it comes to medical insurance for adults, the situation is much clearer. However, there are some things you should take note of. These points relate to the Medishield and private integrated shield plans.
- When you apply for a medical plan, pre-existing conditions are automatically excluded (whether you are aware of it or not). The acid test comes at the point of claim since the doctor will be able to report on when the condition first developed. For example, if a tumor started growing one year ago (unknown to you) but you only applied for the medical insurance six months ago, then it won’t be covered.
- Therefore, you should not wait until you develop a medical condition before you start looking for medical insurance. Switching plans should also be avoided unless really necessary.
- If you are aware of a medical condition but fail to disclose it in your application, it is a form of non-disclosure. Once discovered, the insurer can choose to amend your policy to exclude that condition or even worse void your policy altogether.
- There are certain medical conditions whereby an insurer will reject your application outright. This need not be serious conditions but can be (what might appear) a minor thing like being diagnosed with high cholesterol before the age of 35. The conditions that trigger this automatic decline will differ from insurer to insurer.
- For people that fall into the above category (4), they can apply with a certain insurer under the moratorium option with no medical underwriting. This offers guaranteed acceptance into the plan no matter what their underlying condition is. Of course, the underlying conditions will still be excluded. However, it is important that such people are aware of this option and do not go and apply with other insurers as one of the conditions to take up the moratorium option is that they have NOT been rejected by any insurer before.
