Deductibles and Co-Payments in Integrated Shield Plans: What Do They Mean?

Understanding the world of health insurance can sometimes feel like navigating a labyrinth. With various terms and jargon, it’s easy to get lost. At G&L Surgical Clinic, we believe in empowering our patients with knowledge, ensuring they make informed decisions about their healthcare. In this article, we’ll demystify two critical terms in Integrated Shield Plans (IPs): Deductibles and Co-payments.

What Are Deductibles in Insurance?

Deductibles refer to the initial amount that a policyholder must pay before their insurance coverage kicks in. Think of it as a threshold. Until you’ve paid this amount, the insurance company won’t cover any expenses. For instance, if your deductible is $3,500 and your medical bill is $30,000, you’ll pay the first $3,500, and the insurance will cover a significant percentage of the remaining amount. Deductibles are needed to filter out small claims as Integrated Shield Plans are specifically created to cover large hospital expenses. 

However, depending on the insurance plan and riders you have purchased, some patients may not need to pay deductibles at all. Co-payments, on the other hand, are compulsory no matter the type of coverage.

Understanding Co-payments

Co-payments, or co-insurance as it’s sometimes termed, operate on a slightly different principle. Once you’ve met your deductible, co-payments represent a percentage of the subsequent medical costs that you’re responsible for. It’s a shared cost model. 

The example above is of an Integrated Shield plan without a rider. Insured patients will have to pay their deductibles and co-payment out-of-pocket. In this scenario, the patient will pay a total of $6,150.

This ensures that even after the deductible is met, policyholders remain conscious of their medical expenses, promoting judicious use of medical services.

However, your co-payment percentage may vary depending on the insurance plan you have purchased and whether they come with riders. The minimum co-payment amount is 5% if your plan comes with a full rider. This is an MOH guideline that requires patients to pay a minimum of 5% of their total medical bill. 

How To Reduce Your Out-of-pocket Fees

Rider

In the insurance landscape, a rider is akin to an add-on or an upgrade. It’s an additional benefit that you can opt for, enhancing the coverage of your base Integrated Shield Plan (IP).

The primary allure of riders is their ability to significantly reduce the out-of-pocket expenses like deductibles and co-payments. Imagine undergoing a medical procedure and not having to worry about the hefty bills, all because your rider covers the majority of the costs. It provides an added layer of financial security, ensuring that unforeseen medical emergencies don’t translate into financial burdens. A full rider can reduce your out-of-pocket fees to just 5% of your total bill, completely covering your deductibles as well. 

Choose Panel Doctors

Insurance companies, in their bid to ensure quality care for their policyholders, often collaborate with a select group of healthcare providers. These are termed ‘panel doctors’ or ‘preferred providers’.

Beyond the assurance of quality care, choosing a doctor or clinic from this panel often translates to financial benefits. This could be in the form of reduced co-payments, special rates, or even additional medical benefits. Essentially, you’re rewarded for choosing a healthcare provider that your insurance company trusts.

G&L Surgical: Integrated Shield Panel Doctor

At G&L Surgical Clinic, we’re proud to collaborate with major insurance partners like Prudential, HSBC Life, Singlife, NTUC Income. Our affiliation ensures that our patients can enjoy the benefits of their IPs to the fullest, with streamlined processes and maximised coverage.

We’re always here to help. Whether you have questions about your IP or need assistance with claims, our dedicated team is just a call away. Remember, knowledge is power, and in the realm of healthcare, it’s the key to both physical and financial well-being.