Case studies: Private health coverage as safety net

What started as an ordinary day at home took an unexpected turn for our insured. A slip on a wet floor caused a fall that left Mark* with a head injury, and what seemed minor at first soon developed into persistent headaches and giddiness.

Our insured was eventually admitted to Mount Alvernia Hospital for observation and treatment of a head injury.

How his Hospital Cash Plan Stepped In

During this difficult period, Mark was able to lean on the protection provided under MSIG’s Essential Hospital Income:

• Daily Hospitalisation Cash Benefit

  His hospital stay of 13 days qualified him for the policy’s $400 Daily Hospital Cash Benefit, capped at a maximum of 365 days per disability. Mark was able to claim $5,200 under this benefit.

• Get Well Cash Benefit

  Though his hospitalisation ended, recovery took much longer. As Mark was certified unfit for work for 61 days, he was eligible for the policy’s Get Well Cash Benefit, capped at 5 days per disability. This added another $1,000 to his claim payout.

In total, our insured received $6,200. The reimbursement has helped to reduce the immediate cost burden of his hospital stay, and offered additional relief during his extended recovery period.

Early planning can make all the difference when health issues arise. For 64-year-old Jennifer*, the foresight to secure layered medical coverage years earlier proved invaluable when lingering abdominal discomfort led to urgent investigations and unexpected medical bills.

A Diagnosis that Needed Immediate Attention

After reporting gastrointestinal symptoms, our insured was advised to undergo further investigations at Gleneagles Hospital where she underwent several procedures:

• An Oesophago gastro duodenoscopy (OGD)
• A colonoscopy
• Removal of stomach and colonic polyps

These procedures revealed multiple findings, including stomach polyps, colonic polyps and haemorrhoids, making early intervention essential. The total cost of the investigations and procedures came up to over $7,000, including pre and post procedure consultations.

• An Integrated Shield Plan (Private Hospital, Ward A and below)
• A rider from the same private insurer
• Medisave

She submitted her claims to the Shield insurer and utilised her Medisave as follows*:

• Shield Plan payout: $4,000
• Rider payout: $2,100
• Medisave deduction: $327

Even after these reimbursements, she still had a cash outlay of about $527.

Having been insured under the Prestige Healthcare’s Elite Plan since 2017, she filed a claim with MSIG to cover her remaining expenses.

Under standard coordination-of-benefits rules, the rider payout was excluded to avoid double insurance. However, MSIG went on to:

• Reimburse her full cash outlay of about $527
• Refund money back into her Medisave
• Reimburse the Shield insurer for the portion it had paid

In total, MSIG paid over $4,900, ensuring the insured did not bear unnecessary costs.

For the policyholder, this meant peace of mind, knowing her personal expenses were taken care of and her Medisave savings restored.

* Names used are for illustrative purposes only and do not represent real individuals. Any figures shown are rounded to the nearest dollar.