How insurance protected me from financial ruin

So, my readers would know by now that I have cancer.  

This is an expensive disease to treat, with surgery, chemotherapy, and radiotherapy all costing a lot of money. All in all, my medical bills have been about $120,000. This is actually on the lower side, since I had some of the treatment in a public hospital.

Fortunately for me, this was mostly covered by insurance.  I wanted to share my real-life experience so that people know how important insurance is and how unexpectedly disasters can happen. There isn’t a lot of real first- hand information out there, and I had to stumble along myself. I hope this helps.

How it started

I was feeling fine. I was accepted and entering a Master’s programme at a top local university. My wife was about 8 months pregnant with our first child, and we were eagerly waiting to be parents.

The first sign was an ache in my left thigh, which I thought was a muscle tear from exercise. When it didn’t go away within a few days, I walked into my local private hospital to check it out. What followed was a series of scans, where a large tumour was accidentally discovered in my tailbone. I underwent surgery to remove the tumour, and then radiotherapy. Chemotherapy wasn’t effective for my particular cancer, so I didn’t get to do that. The biopsy post-surgery confirmed it was a stage 3 cancer.

A private shield plan is worth it

The benefits of a private shield plan are beyond just getting a nicer bed in a nicer hospital. It expands your options for treatment drastically. This means you can get treatment from all the best doctors in Singapore, not just those in the public hospitals. This is especially crucial if you get hit by a rare disease.

Treatment is also a lot faster. Because I had private health insurance, I was able to get a scan which discovered the tumour and a specialist in the space of a few hours. This would normally take up to 6 months in the public health ecosystem in Singapore. You have to wait the polyclinic to refer to you a specialist (1-4 months wait), wait for the scan (about 3 months), and 2-3 weeks for the results to come in.

In addition, I could walk across the road to my private hospital to get radiotherapy treatment which lasted for 6 weeks. Given the fatigue and damage that radiotherapy caused, this was much better than the 1.5 hour commute back and forth to the nearest public hospital.

I advise people to go for the new shield plans which allow for up to 12 months post-hospitalisation outpatient visits. As a cancer patient, I will have to do scans up to 4 times a year for the foreseeable future. Each of this is about $2,000. As it is no longer within three months from my hospitalisation date, I need to pay for this out of my own pocket.

A word of warning: you need to have large cash stash, even with a shield plan. A lot of my bills weren’t covered by a letter of guarantee and I had to pay first and be reimbursed later.  This is especially true for private hospital bills, which tend to be much larger than those from the public hospitals.

You should choose a shield plan that doesn’t cause you financial hardship. Any shield plan is preferable to none at all. However, the difference in costs between a private and “A” class ward shield plan is less than $300 a year if you are below 40 years old. It’s disheartening that most Singaporeans won’t blink at an expensive vacation or their daily coffee, but hesitate at spending another dollar a day for a better medical care.

Get the riders

Cancer is an especially expensive illness to have, given the long treatment period and years of follow-up.

When you buy a shield plan, get the rider which limits your deductible and co-payment. For me, I had a payment cap of 10% of my claimable amount, with a maximum co-payment of $3,000. Without the rider, my out-of-pocket including the deductible and co-payment, would have been about $15,000 ($3,500 deductible and 10% of remaining amount). Instead I paid $3,000, a much more affordable amount.

The daily cash rider was surprisingly helpful. A daily cash rider pays you a cash benefit for each day you were in hospital, typically $100 – $200 a day. The great advantage of this rider as compared with other policies such as critical illness or disability income claims is that the claim is fast and easy. You don’t need to fill out long forms or get a doctor’s statement (takes 4-6 weeks) to get the claim. This claim is automatic, easily verifiable with the discharge summary. Given that this can be used for both accidents and illnesses, and long hospital stays are not uncommon, this is something I would recommend most people to have. The daily cash rider shouldn’t be tied to your critical illness plans, as these plans end once you have contacted a critical illness.

Know what your shield plan covers

Read your policy terms and conditions carefully. Some people get upset or surprised when they learn that not all their medical bills are covered, but it is all there in black and white. Don’t rely on your agent to tell you, because if they are wrong, you are liable for the bills, not your agent.

For example, outpatient charges aren’t part of your shield plan, unless it is within a set period from your hospitalisation. Outpatient charges can be very expensive, usually ranging from $100 – $200 a visit if you have been in an “A” class ward and above. This also doesn’t include scans and medicine, may not subsidised. This is why many people opt to downgrade to a “B” ward and below, despite being qualified for a higher class, because they will continue to get subsided outpatient visits and medicine.

Some other treatments you won’t usually have under your shield plan are hospice, home nursing, and overseas treatments. This is also why your critical illness, disability income plans, and cash stash are all important to keeping you and your family protected.

Closing

In closing, I would like to tell a story that stuck with me. A nurse told me how a guy a few years younger than me was found to have stage 4 colorectal cancer. He had no symptoms before, and just found blood in his stools 2 weeks before. That young man didn’t have insurance, and was sobbing in the room, facing a mountain of bills and no good options.

I was fortunate enough to have been well – covered and gotten top treatment, but not all are as lucky as I am. I hope you can get yourself covered well too, for your sake and your family’s.