Updates & FAQs

To keep cancer treatments and insurance premiums affordable in the longer term, CDL is introduced by the Ministry of Health of Singapore (MOH). The CDL comprises clinically proven and more cost-effective cancer drug treatments (i.e drugs paired with specified clinical indications, dosage form & strength, for which the drugs can be administered). 

 

A treatment is approved for clinical use if it has met the regulatory authority's [in the case of Singapore, the Health Sciences Authority's (HSA's)] required standards of safety, quality and efficacy.  A treatment is cost-effective if its clinical benefits commensurate with its costs. For more information, please refer to the FAQs on MOH's website at https://www.moh.gov.sg/home/our-healthcare-system/medishield-life/what-is-medishield-life/what-medishield-life-benefits/cancer-drug-list.

 

The CDL is published on MOH's website at https://go.gov.sg/moh-cancerdruglist. MOH updates the CDL every few months to keep up with medical advancements and the latest clinical evidence.

'Multiple Primary Cancers' refers to two or more cancers arising from different sites and/or are of different histology or morphology group. The claim limits for patients receiving treatment for multiple primary cancers are accorded on an application basis; doctors are to send the application form to the MOH and AIA for review of MediShield Life and Integrated Shield Plan claims respectively. 

 

The occurrence of the Diagnosis of Multiple Primary Cancers must be proven to our satisfaction at your own expense, and any such proof shall include the following: 

 

AIA HSG Max Standard plan provides higher coverage for multiple primary cancers, where under:  

 

 

Insured who is diagnosed with lung cancer and brain cancer and prescribed the following treatment regimen. The total benefit payable under the Cancer Drug Treatment on the CDL Benefit and Cancer Drug Services Benefit are as follow: 

 

Higher claim limits for patients receiving treatment for multiple primary cancers are accorded on an application basis. Patients can follow the steps below for AIA assessment.  

 

You are strongly advised to submit your application for multiple primary cancers at least 1 month before your treatment commences.

 

Failure to complete the above may lengthen the process for assessment and reimbursement. We will only provide higher coverage for multiple primary cancers after the treatment regimen has been assessed and approved by us. Otherwise, the coverage will be based on the limits for "one primary cancer". 

 

After paying the applicable deductible, policyholders will need to pay out-of-pocket of a minimum of 5% on their covered bills before the insurance pay-out can cover the expenses. This means that Integrated Shield Plan (IP) and rider will no longer cover 100% of medical bills.

 

Expenses that are not covered by AIA are not subject to the 5% co-payment as the full amount is already paid out-of-pocket by the policyholder.

 

 

The co-payment is capped at $3,000 (or $6,000 for VitalHealth Max A Value) per policy year, if the insured receives treatment from an AIA Quality Healthcare Partners (AQHP) specialist or a public hospital, or if the treatment is pre-authorised.

 

Note that for AIA Max VitalHealth & AIA Max VitalCare riders, the co-payment cap of S$3,000 is extended to include emergency confinement via A&E, even if the treating doctor is non-panel and/or without pre-authorisation.

 

The aim of the co-payment cap feature is to protect you against large bills by limiting the out-of-pocket amount you have to pay per policy year. The minimum co-payment cap insurers can apply is $3,000.

From 1 April 2024 onwards, you may find the estimated amount of total lifetime premium payable in the Product Summary of respective current selling AIA HealthShield Gold Max plans and riders. Also, you may refer to the Ministry of Health of Singapore's website (go.gov.sg/moh-compare-ip) for a comparison of the benefits and estimated lifetime gross premiums payable for the current selling Integrated Shield Plans (IPs) across all insurers. 

 

The total lifetime premiums are calculated by taking the sum of premiums, from Age Next Birthday (ANB) 1 to 100, based on insurers' premium tables as of 1 Apr 2024. It does not include the premiums of the MediShield Life component of Integrated Shield Plans (IPs). Figures shown are for education and general information only. They do not represent the actual amount that the policyholder will pay over their lifetime as premium rates are not guaranteed and may be revised from time to time.

There are five premium levels in the claim-based pricing for AIA Max VitalCare.

 

With claim-based pricing, all policyholders will start off at the Standard Level premium, the lowest premium level of your age band. During each policy renewal, the renewal premium level will be determined by the previous claim made during the premium evaluation period. As long as you stay healthy, with no claims made during the premium evaluation period while your AIA Max VitalCare is at Standard Level, you will continue to enjoy the No Claim Discount on your Standard Level premium at your next policy renewal.

 

Find out how the different premium levels will affect you.

Currently, only AIA Max VitalCare is subject to claim-based pricing. AIA Max VitalCare is a rider that is only attachable to the AIA HealthShield Gold Max A plan.

In implementing claim cost containment initiatives, we have always prioritised initiatives that will truly be effective without affecting the adequacy of the protection we provide. We will monitor and review the new claim-based pricing approach closely to ensure that we continue to strengthen our comprehensive healthcare proposition in a meaningful way.

 

As a leading insurer in the healthcare space, AIA Singapore is committed to journeying with our customers through their lives as well as continuously providing them with innovative solutions that truly meet their needs.

Your premium level may move up or down depending on the source of claim and the claim amount paid from your AIA Max VitalCare during each policy year. This is assessed and determined during the Premium Evaluation Period.

 

For the very first renewal of AIA Max VitalCare, the Premium Evaluation Period will cover the first 10 months from the issue date or renewal date of AIA Max VitalCare.

 

For subsequent renewals of AIA Max VitalCare, the Premium Evaluation Period will be a period of 12 months commencing from the date immediately following the previous Premium Evaluation Period.

 

For example, if the previous Premium Evaluation Period ended on 8 November 2020, the subsequent Premium Evaluation Period shall be from 9 November 2020 to 8 November 2021.

Your premium level may move up or down depending on the source of claim and the claim amount paid from your AIA Max VitalCare during each policy year. This is assessed and determined during the Premium Evaluation Period.

 

Please be assured that you will be notified of the premium level in your next renewal through the yearly Premium Notification Letter, and you can also access the information through our customer portal.

Yes. The Standard Level Premium rates are not guaranteed and are expected to be adjusted from time to time to allow for ongoing reviews of claims experience, medical inflation, and general cost of treatments, supplies or medical services in Singapore.

When there were claims made for both private hospital and restructured hospital treatment during the premium evaluation period, only private hospital claims made will be used to ascertain the next renewal premium level for AIA Max VitalCare.

With claim-based pricing, you will start off at the Standard Level premium, the lowest premium level of the relevant age band. During each policy renewal, the renewal premium level will be determined by the previous claims made during the premium evaluation period. Any changes to your premium level will be implemented on your next policy renewal.

 

The lock in date for AIA Max VitalCare's renewal premium level is T - 2 calendar months, where T is the next policy anniversary date.

 

In addition, the rider must have been in-force for at least 2 consecutive years and the premiums for the next policy year must have been duly paid and received by AIA. 

 

You may utilise your benefit in 4 simple steps:

 

Step 1: Retrieve your voucher

 

Upon receiving SMS / email notification from AIA, you may login to customer portal to retrieve your screening vouchers.

Step 2: Make an appointment

 

Schedule an appointment with your preferred clinic/imaging centre from our list of participating screening partners.

 

 

Step 3: Go for your screening

 

Present the following upon registration at the clinic / imaging centre on the day of your screening

 

Step 4: Collect your health report

 

Collect your health check report directly from the service provider.

The voucher is valid for 1 year from the policy anniversary date.

The voucher has a validity period of 1 year (from policy anniversary date) and no extension is allowed.

 

To ensure that you secure your preferred appointment date and time, we strongly encourage you to make an appointment with your preferred screening partners listed in advance. You may reach them via voice call, SMS, WhatsApp, and/or Email as indicated on the list.  

 

Please refer to Terms and Conditions stated on the Early Detection Screening voucher. 

Coverage of further investigations and treatments will depend on whether these fall within the benefits of your AIA HealthShield Gold Max A policy, as well as any other applicable terms and conditions in your policy. The admissibility of claims for any such expenses will be assessed under and in accordance with the terms of the policy. 

- AIA Max VitalHealth A

- AIA Max VitalHealth A Value

- AIA Max VitalCare

Please contact AIA HealthShield Hotline at 1800 248 8000 if you need further assistance.

Introducing AIA Preferred Providers is one of the measures that the Company has put in place to manage rising healthcare costs. Such was one of the recommendations of the Health Insurance Task Force to ensure that health insurance premiums remain sustainable in the long run.

By using medical services provided by AIA Preferred Providers, AIA HealthShield Gold Max customers will enjoy the following enhanced benefits with their policy:

 

AIA HealthShield Gold Max customers can submit an AIA HealthShield Pre-authorisation request for non-emergency hospital or surgical bill (including day surgery) before admission or surgery, and for outpatient cancer treatments. 

We will call you if your pre-authorisation request is declined or partially approved and provide the reasons for rejection. We will also offer alternative solutions and assist you on your care journey.

AIA HealthShield Pre-authorisation is not applicable for emergency cases admitted through the hospital's A&E department.

There is no need to apply for eLOG as the Certificate of Pre-authorisation also includes waiver of deposit at the point of admission. The hospital will only need to collect the deductible and co-insurance (if applicable) at the point of discharge and we will settle the rest of your medical directly with the hospital.

 

You can refer to this link for more information on eLOG.

 

Please refer to the link provided here for further details.

He needs to submit the original final hospital bill and a copy of our settlement letter to his company insurer to claim the balance of the hospital bill not covered under the integrated plan.

All medically necessary medications prescribed by the attending physician related to the hospitalisation is claimable, subject to the terms and conditions of the Policy. This does not include supplement, experimental drugs etc.

AIA HealthShield Gold Max covers the majority of your medical bill. Here is an example to illustrate*:

 

John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total bill was $100K.

 

 

 

* Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HealthShield Gold Max covers the majority of your medical bill while AIA Max VitalHealth A covers deductibles and co-insurance, subject to 5% co-payment.

 

Here is an example to illustrate*:

 

John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total eligible bill was $100K. As the policy has a Deductible Waiver Pass, John does not need to pay any deductible. With a certificate of pre-authorisation for his treatment, the co-payment payable by John will be capped at $3,000. Hence, John will pay $3,000 from his own pocket and the remaining bill is covered under his policies.

 

 

 

* Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HealthShield Gold Max covers the majority of your medical bill while AIA Max VitalHealth A covers deductibles and co-insurance, subject to 5% co-payment.

 

Here is an example to illustrate*:

 

John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total eligible bill was $100K. As the policy does not have a Deductible Waiver Pass, John needs to pay $2,000 deductible from his own pocket. With a certificate of pre-authorisation for his treatment, the co-payment payable by John will be capped at $3,000 per policy year. Hence, John will pay a total of $5,000 from his own pocket and the remaining bill is covered under his policies.

 

 

 

* Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HealthShield Gold Max covers the majority of your medical bill while AIA Max VitalHealth A covers deductibles and co-insurance, subject to 5% co-payment.

 

Here is an example to illustrate*:

 

John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total eligible bill was $100K. As the policy has a Deductible Waiver Pass, John does not need to pay any deductible. As treatment was not pre-authorised, the co-payment cap does not apply. Hence, John will pay a co-payment of $5,000 from his own pocket and the remaining bill is covered under his policies.

 

 

 

* Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HealthShield Gold Max covers the majority of your medical bill while AIA Max VitalHealth A covers deductibles and co-insurance, subject to 5% co-payment.

 

Here is an example to illustrate*:

 

John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total eligible bill was $100K. As the policy does not have a Deductible Waiver Pass, John would need to pay $2,000 deductible from his own pocket. As the treatment was not pre-authorised, the co-payment cap does not apply. Hence, John would need to pay a total of $6,900 from his own pocket. The remaining bill is covered under his policies.

 

 

 

* Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HealthShield Gold Max covers the majority of your medical bill while AIA Max VitalCare covers deductibles and co-insurance, subject to 5% co-payment.

 

Here is an example to illustrate*:

 

John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total eligible bill was $100K. With a certificate of pre-authorisation, the co-payment payable by John will be capped at $3,000. Hence, John only needs to pay $3,000 from his own pocket and the remaining bill is covered under his policies.

 

 

 

* Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HealthShield Gold Max covers the majority of your medical bill while AIA Max VitalCare covers deductibles and co-insurance, subject to 5% co-payment.

 

Here is an example to illustrate*:

 

John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total eligible bill was $100K. As the treatment was not pre-authorised, the co-payment cap does not apply. Hence, John would need to pay $5,000 from his own pocket. The remaining bill is covered under his policies.

 

 

 

* Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HealthShield Gold Max covers the majority of your medical bill while AIA Max VitalHealth A Value covers deductibles and co-insurance, subject to co-payment of up to 10%

 

Here is an example to illustrate*:

 

Example: John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total eligible bill was $100K. 

 

 

As the treatment is from a private hospital, John needs to pay $3,500 deductible from his own pocket. With a certificate of pre-authorisation for his treatment, the co-payment payable by John will be capped at $6,000. Hence, John will pay a total of $9,500 from his own pocket and the remaining bill is covered under his policies. 

 

However, should John be admitted to A Ward Class of a Restructured hospital, John does not need to pay any deductibles and there is a co-payment cap at $3,000 as shown below:

 

 

 

* Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HealthShield Gold Max will cover Ptosis (subject to terms and conditions of your policy contract) only when the condition affects your field of vision or gives rise to a functional problem.

 

If the severity of ptosis fails to fulfil the intervention criteria set out by MOH or if the said intervention is meant for aesthetic purpose, it will not be covered under your AIA HealthShield Gold Max policy.