Healthcare guide for expats moving to Singapore

Singapore has a high quality and efficient health system.  However, both medical care and treatment are extremely expensive if you do not have access to the Singaporean health system, which is why many expatriates decide to purchase an international private medical insurance.

This article looks at the Singaporean healthcare system, explains the different health insurance options for expats as well as offering an overview of the average cost of local healthcare.

Health statistics

  • Total Population: 5,412,000
  • Gross national income per capita (PPP international $, 2013): 76,860
  • Life expectancy at birth m/f (years, 2013): 81/85
  • Probability of dying between 15 and 60 years m/f (per 1 000 population, 2013): 69/38
  • Total expenditure on health per capita (Intl $, 2013): 3,578
  • Total expenditure on health as % of GDP (2013) 4.6
The quality of the health care system

Singapore’s health system is the shining star of the small Republic, which remains the envy of many other governments. Health spending in Singapore is moderate (4.6% of GDP against 9.3% in the UK), while health indicators are among the highest in the world: life expectancy is 82.5 years on average, against 80.5 in the UK.  Infant mortality is 3 per thousand births (it is 5 per thousand in the UK).

What is Singapore’s secret for such an efficient health system?  The healthcare system is funded in a way that increases awareness of the cost of healthcare among the population. While in many countries citizens are disconnected from the cost of their health, in Singapore each person saves a certain amount of their salary every month to participate in financing the medical expenses that they will encounter during their lifetime.  The unused savings in the account generate interest.  The aim of this system is to avoid overuse of medical care / treatment.

Meanwhile, due to the quality of their doctors, state of the art equipment, and quality of service offered, Singapore has become the centre of excellence for healthcare in Asia, whether in the private sector or the public sector. Treatment for cancer is very highly rated.  Singapore has 20 health facilities internationally accredited by the JCI (Joint Commission International), an American institution establishing a global quality standard for medical facilities, and the Gleneagles Hospital is one of the top ten best hospitals in the world.

How does the health care system work

The state of Singapore covers the majority of the healthcare costs of its citizens in the form of subsidies within public health institutions, often covering up to 80% of costs.  Subsequently, the Singaporean health system is organized around the ‘3M’:  Medisave, MediShield and Medifund. It also allows for flexibility in the choice between the private and the public sector.

Subscription to the Singaporean healthcare system is compulsory for Singapore citizens as well as foreigners with permanent residency.

Medisave

Medisave is the universal medical savings scheme, enabling every citizen to participate in their individual / family’s future health costs.  Employees and their employers save a percentage of their salary, around 7 to 9.5 % of the employee’s monthly salary, in an exclusive savings account.  The money is transferred to an organisation called the Central Provident Fund (CPF) and the funds are then used to contribute to the health care costs of the accountholder and his family (spouse, children, and parents).

People have the freedom to use their Medisave savings for treatment in the private sector but they do not benefit from subsidised rates.

Medishield

Medishield is an optional health insurance cover.  The contributions can be deducted from the Medisave savings account. Medishield aims to cover serious illness or more expensive forms of care (intensive care, surgery, transplants…) which Medisave is not sufficient for.

Medifund

Medifund caters for the poorest. This is a fund created by the state in 1993 with a capital sum of 200 million Singapore dollars.  The state uses the interest on the capital (S$3bn in 2012) to pay for health expenses of people who cannot afford Medisave savings or who have difficulty meeting medical expenses.

Private health insurance approved by Medisave

It is also possible to purchase private health insurance from a list of approved Medisave (Medisave -approved Integrated Shield Plan) insurance companies.  This coverage can be bought in addition to Medishield (it is not possible to subscribe without having Medishield).  This allows the policyholder an additional private insurance to seek treatment in private hospitals or to pay for more comfortable rooms in the public sector.

Choice of health insurance for expatriates

An international health insurance is the most suitable type of medical cover for an expatriate. It offers freedom in your choice of doctors or medical centre, not only within Singapore but in many other countries (within your zone of cover). Therefore, if you prefer to be treated in your home country or in another country, within your zone of cover, your medical costs will be reimbursed by your insurance company. Moreover, if you leave Singapore and move elsewhere your international insurance may be able to follow you.

If you are a permanent resident in Singapore, a private medical insurance will not replace your obligation to subscribe to the local system. The international cover will act in addition to the State provided cover.

If you do not have permanent resident status, you are not covered under the ‘3M’ system and you will have to pay your medical expenses directly. Therefore, subscribing to a private health insurance is strongly recommended.

Expats in Singapore tend to agree on the fact that health insurance is a necessary expense because the cost of care is very high if you are not covered by the local Singaporean healthcare system. If a serious medical event occurs, an unexpected bill can be very expensive. It is therefore advisable to have insurance which at least covers hospitalisation and cancer treatment.

If you would like to insure yourself and your family more fully, Expat Assure can also advise you on life insurance and income protection. To find out more, please, read our Protection page.

Which expat insurance should you choose?
We can help you decide which international health insurance or protection plan is best suited to your needs. Don’t hesitate to contact us to request your insurance comparison.

Overview of medical costs

Consultation with a GP: costs range from 40 – 100 SGD (£20 – £50*).

Consultation with a dentist: for an inspection, consultation is free in many dental centres. Otherwise, it varies from 20 – 30SGD (£10 – £15). For a crown, it costs approximately 650 – 760 SGD (£315 – £370 including consultation and investigation fees) in the public sector or 650 – 1,500SGD (£316 – £730 excluding consultations and investigation fees) in the private sector.

Example of costs for hospital care: an appendectomy costs between 1,200 and 9,600 SGD (£580 – £4600) in a public hospital, depending on the room type selected. In the private sector, the same operation varies from 17,600 to 20,500 SGD (£8,500 – £10,000).

When choosing between the public or private sector for treatment, most expatriates choose the private sector because there can be little difference in cost between the two them (it is not possible to benefit from the government subsidies in the public sector for people who are not affiliated to the Singaporean health system).Regarding out-patient costs, these can be reasonable, but you need to keep in mind that some examinations/diagnostic tests can be very expensive.

*Exchange rate from October 2014

Practical information

Vaccinations

Ensure your vaccinations are up-to-date, according to your country schedule. Depending on the type of stay, these vaccinations are recommended: Japanese encephalitis, hepatitis B, typhoid. A vaccination certificate against yellow fever is required only for travellers coming from a country where there is a risk of transmission of yellow fever.

Emergency Numbers

Police: 999
Fire / Ambulance: 995

Useful links

Singapore ministry of health
Central provident fund board

 

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