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HealthShield Support FAQs

Deductibles & co-insurance/co-payment

A deductible is the amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.
 
After you pay the deductible, you usually will need to pay the co-insurance / co-payment for covered services before your insurance starts to pay. The amount covered by the insurance plan, is subject to the co-insurance / co-payment percentage.
 
Both deductibles and co-insurance / co-payment features help keep premiums affordable.

On co-payment
 
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 IP plan 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.
 
On co-payment cap
 
The co-payment is capped at $3,000 per policy year, if the insured receives treatment from an AIA Quality Healthcare Partners 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.

5Existing 'AIA Max Essential A Saver' plans will be known as 'AIA Max VitalHealth A'.
6Subject to 5% co-payment.

Customers can enjoy zero deductibles on the first claim, be it a claim for treatments at either private or public hospital. The deductible waiver will reset if there are no private hospital claims in the last 3 consecutive policy years. Customers and insurance representatives may refer to My AIA SG and AgIA respectively to find out the Deductible Waiver Pass status at any time.

Premiums

1. How are premiums under AIA HealthShield Gold Max and its rider adjusted?
Premiums under AIA HealthShield Gold Max and its rider are expected to be adjusted from time to time to allow for our claims experience, medical inflation and general cost of treatments, supplies or medical service in Singapore.

Your premiums are used to pay for commissions, claims and other expenses involved in administering your policy*.
 
  2019 2022
Claims^ 81% 77%
Commissions and distribution 14% 11%
Management expenses 7% 7%
 
The cost of claims would change depending on the claim size and number of claims submitted by policyholders. In the past 3 years, the average bill size had remained unchanged in the public healthcare institutions but had increased by 15% in the private healthcare institutions. The number of claims submitted per policyholder had also increased by 8%.
 
*Based on all long-term accident and health plans, including IPs and riders. Premiums and claims are gross of reinsurance.
 
^ In 2022, there were some deferments of elective procedures in hospitals as a result of covid waves. There has been an increase in claims since the second half of 2022, and this trend appears to continue in 2023.

On claim-based pricing

Claim-based pricing is a fairer pricing approach to empower our policyholders with more control over their future renewal premiums by managing their claim experience. Customers who make less claims will be rewarded with lower premiums.
 
It is applicable for AIA Max VitalCare only.

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.
 

Claim-based pricing rewards customers who actively manage their health and are judicious in their use of medical services.

When no claims are made during the premium evaluation period, and if the AIA Max VitalCare is at Standard Level Premium, policyholders will get to enjoy a specified discount rate. The No Claim Discount applies only to the AIA Max VitalCare premium, and will increase based on the number of years without claim as shown in the table below.
 
AIA Max Essential A policyholders who have not made any claims in the policy year prior to conversion to AIA Max VitalCare will immediately enjoy a 10% discount at the point of conversion.

AIA Max VitalCare is the only AIA IP rider which is subject to claim-based pricing.
 
Customers who do not want to be subject to claim-based pricing may consider switching to AIA Max VitalHealth A or AIA Max VitalHealth A Value riders. 
 
When contemplating switching, customers should consider factors like age, pre-existing conditions, appropriate healthcare for your needs and affordability of future premiums. It is important to understand the risk of switching plans, as this could lead to an exclusion of pre-existing conditions or an increase in premiums (loading). 
 
Customers are encouraged to speak with your AIA Financial Services Consultant / Insurance Representative and he/she will be able to advise further based on your existing portfolio and health insurance needs.

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 My AIA SG.

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.

Switching of riders

You may request to switch to other riders by making a request for change. Please note that your request may be subject to underwriting.
 
AIA Max VitalCare policyholders may switch to:
 
  • AIA Max VitalHealth A - No underwriting is required if the request was submitted between 01 April 2021 to 31 March 2024. Thereafter, the request will be subject to underwriting.
  • AIA Max VitalHealth A Value, AIA Max VitalHealth B or AIA Max VitalHealth B Lite – No underwriting is required.
AIA Max VitalHealth A policyholders may switch to:
 
  • AIA Max VitalCare - No underwriting is required if the request was submitted between 01 April 2021 to 31 March 2024. Thereafter, the request will be subject to underwriting.
  • AIA Max VitalHealth A Value, AIA Max VitalHealth B or AIA Max VitalHealth B Lite – No underwriting is required.
AIA Max VitalHealth A Value policyholders may switch to:
 
  • AIA Max VitalCare or AIA Max VitalHealth A - Underwriting is required.
  • AIA Max VitalHealth B or AIA Max VitalHealth B Lite – No underwriting is required.
AIA Max VitalHealth B policyholders may switch to:
 
  • AIA Max VitalCare, AIA Max VitalHealth A or AIA Max VitalHealth A Value - Underwriting is required.
  • AIA Max VitalHealth B Lite – No underwriting is required.
AIA Max VitalHealth B Lite policyholders may switch to:
 
  • AIA Max VitalCare, AIA Max VitalHealth A, AIA Max VitalHealth A Value or AIA Max VitalHealth B - Underwriting is required.
AIA Max Essential C policyholders may switch to:
 
  • AIA Max VitalCare, AIA Max VitalHealth A, AIA Max VitalHealth A Value, AIA Max VitalHealth B or AIA Max VitalHealth B Lite - Underwriting is required.
Note: Upon switching of riders, the basic plan will be switched accordingly
 
When contemplating switching, please do consider factors like age, pre-existing conditions, appropriate healthcare for your needs and affordability of future premiums. It is important to understand the risk of switching plans, as this could lead to an exclusion of pre-existing conditions or an increase in premiums (loading). Speak with your AIA Financial Services Consultant / Insurance Representative and he / she will be able to advise further based on your existing portfolio and health insurance needs.

No, you can't as AIA Max Essential will no longer be available from 1 April 2021.

AIA Quality Healthcare Partners (AQHP)

AIA Quality Healthcare Partners or AQHP, is our panel of private specialist doctors exclusively curated for AIA HealthShield Gold Max customers. Each of them has at least 5 years of specialist experience and a clean professional track record.

Forming AQHP is one of the measures that the Company has put in place to manage rising healthcare costs. The formation of such preferred provider panels was one of the recommendations of the Health Insurance Task Force to ensure that health insurance premiums remain sustainable in the long run.

We have negotiated fee agreements with AQHP, which was set with reference to MOH published fee benchmarks, to help ensure treatment and charges are in line with what is reasonable and customary. This will ultimately benefit consumers as it will help moderate the rate of premium increases in the long run.

AQHP fees take reference from MOH's Fee Benchmarks. They are generally set at the midpoint between the upper and lower bounds, but there may be some deviations from this based on our negotiations with our panel. We set a fixed fee instead of a range so that there is more clarity for doctors and policyholders as to the expected charges.

With AQHP, we have made it easy for you to gain access to more than 500 specialists. It is also convenient for you to request for an appointment with your preferred AQHP specialist using the following methods:
  • On My AIA SG
  • Submit your request via our website 
  • Call our medical concierge at 1800 248 8000
Upon submission of your request, we will contact you via SMS/call on the status of your appointment within 1 working day*. You will also get to enjoy pre-negotiated outpatient consultation fees with our AQHP specialist as an AIA HealthShield customer.
 
(*For requests submitted on Mondays to Fridays, between 8.45am to 5.30pm. Excludes Public Holidays)
 
Notes:
  • We will try our best to arrange an appointment with your preferred specialist within 3 working days. However, there may be times when this is only possible with an alternative specialist in the same field.
  • Consultation or treatment with any AQHP specialists does not mean that the bills will be claimable. Claims eligibility will be subjected to the terms and conditions of the AIA HealthShield Gold Max policy.
  • Pre-negotiated AIA Quality Healthcare Partners outpatient consultation fee is not applicable at public hospitals and selected AQHPs.

All existing and new AIA HealthShield Gold Max customers will enjoy exclusive access to services provided by AQHP.

Our AQHP specialists are carefully selected based on their professional track record and a minimum 5 years of specialist experience. We also ensure that we have a healthy mix of medical fields when selecting our AQHP specialists to cater to your medical needs.

You can access our AQHP specialists' profiles here.
 
For easy access on the go, you can also access the list on the MY AIA SG app, which is available for download from the App Store and Google Play Store.

Appointment requests

You can request for an appointment with your preferred AQHP specialist using the following methods:
 
  • Via My AIA SG
  • Submit your request via our website
  • Call our medical concierge at 1800 248 8000
Alternatively, you may also contact your AIA Financial Services Consultant or Insurance Representative for assistance.

Yes, you may request for an appointment on behalf of another insured. Please submit your request here.

Upon submission of your request, we will contact you via SMS/call on the status of your appointment within 1 working day*.
 
(*For requests submitted on Mondays – Fridays, 8.45am to 5.30pm, excluding Public Holidays.)

If your appointment request is submitted:
 
  • Before 1 pm, the earliest appointment date you may request for is on the next working day.
  • After 1 pm, the earliest appointment date that may be requested for will be the day after the next working day.
Please note that the confirmed appointment date will be subject to the specialist's availability.

Example:
 
Appointment request submitted
Earliest possible appointment
Monday, before 1:00pm
Next working day, Tuesday
Monday, after 1:00pm
Day after next working day, Wednesday
Friday, before 1:00pm
Next working day, Monday
Friday, after 1:00pm
Day after next working day, Tuesday
 
Working days exclude Saturdays, Sundays, Public Holidays and eve of selected Public Holidays.

Most of the specialist clinics have short consultation hours on Saturdays, hence their appointment timeslots are usually full. They also do not operate on Sundays and Public Holidays.

You may call our medical concierge at 1800 248 8000 to make changes to your appointment or contact the clinic directly to make the changes.

Please bring along the following items:
 
  • Your NRIC, Birth Certificate, Work Permit or Passport (where applicable)
  • Any medication you are currently taking or the names of the medication
  • Relevant medical reports, x-rays or scans
The availability of the items will help the specialist to better understand your current medical condition.

You can arrange for follow-up appointments directly at the clinic after your consultation. You do not need to go through us again to make the follow-up appointment.

We do encourage you to let us help connect you with an AQHP specialist to make an appointment as we strive to provide you with the best experience possible.

In the event of an emergency, please proceed directly to the Accident & Emergency department of a hospital nearest to you.

AIA HealthShield Pre-authorisation

It is a service where AIA approves coverage for a hospital admission and/or day surgery based on your policy coverage, benefit entitlement and medical information provided by your doctor prior to the actual event. This provides customers with peace of mind knowing that their planned procedure or admission will be reimbursed.

All 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.

AIA HealthShield Pre-authorisation is applicable for non-emergency hospital admissions and day surgeries in all private hospitals and ambulatory centres.

You will have to send in your request for pre-authorisation and ensure that your doctor completes and submits the e-form at least 3 working days prior to the planned surgeries or hospital admissions.

Once the AIA HealthShield Pre-authorisation request has been approved, we will issue you a Certificate of Pre-authorisation stating the approved amount for the specified medical diagnosis, treatment date and procedures. A copy of the Certificate of Pre-authorisation will also be provided to the admitting hospital.

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.
 
Note: Subject to acceptance of the Certificate of Pre-authorisation by the hospital.

AIA HealthShield claims

Claims are to be submitted to us by the Medical Institutions through the system set up by the Ministry of Health of Singapore in accordance with the terms and conditions under the CPF Act and the MediShield Life Scheme Act 2015 (where applicable), as amended from time to time. Once you have given the medical institution the authorisation to submit your claim for you, the medical institution will submit a claim to the insurer on your behalf.
 
This will not be applicable to claims under Pre-Hospitalisation Benefit, Post-Hospitalisation Benefits, Congenital Abnormalities of Insured's Biological Child from Birth (for female Insured), Non-insured Donating an Organ to Insured, Emergency Overseas (outside Singapore) Medical Treatment Benefit and Post-Hositalisation Psychiatric Treatment under the Benefits Provisions of this Policy. Claims must be notified through the submission of a completed Accident and Hospitalisation Claim with other proof of loss documents as may be determined by us to our satisfaction.

Please refer to the link provided here for further details.

The deductible is the portion of costs the policyholder is liable for before any benefits are payable and is applied to the claimable amount, not the total bill amount. The claimable amount is calculated based on the schedule of benefit limits.
 
The deductible is applied on a policy year basis. Once the total claimable amount for claims arising within the same policy year exceed the deductible, the deductible will not apply to further claims arising within the same policy year. No deductible is applied for out-patient claim.
 
Co-insurance is the fixed percentage the policyholder is liable for in excess of the deductible and is applied to both in-patient and out-patient claims.

It is defined as "any pre-existing illnesses, disease or impairment from which the insured is suffering prior to the Policy Date, other than those defined in Serious Illness, unless declared in the Application form and specifically accepted by the Company".

Except in the case of an "Emergency", overseas medical treatments are not covered. "Emergency" means a serious illness or injury or the onset of a serious condition, which in our opinion requires urgent remedial treatment to avoid death or serious impairment to the Insured's immediate or long-term health.

He needs to submit the original final hospital bill to his company insurer and a copy of our settlement letter 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.
 
With AIA HealthShield Gold Max A
 
John pays deductible:
$3,500
John pays
co-insurance: $9,650
[10% x ($100,000 - $3,500)]
HSG Max A (including
Medishield Life) pays: $86,850
 
* 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 bill was $100K. As the policy has a Deductible Waiver Pass, John does not need to pay $2,000 deductible. And, in view that the treatment was pre-authorised, there is a co-payment cap of $3,000 and hence John only needs to pay $3,000 from his own pocket. The remaining bill is covered under his policies.
 
With AIA HealthShield Gold Max A and AIA Max VitalHealth A (with Deductible Waiver Pass + Certificate of Pre-Authorisation)
 
AIA Max VitalHealth A
(which covers
deductible and co-
insurance) pays:
$10,150
John pays
co-payment:
$3,000
HSG Max A (including Medishield Life)
pays: $86,850
 
* 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 bill was $100K. As the policy does not have a Deductible Waiver Pass, John needs to pay $2,000 deductible from his own pocket. There is a co-payment cap of $3,000 because the treatment was pre-authorised. In total, John has to pay $5,000 from his own pocket and the remaining bill is covered under his policies.
 
With AIA HealthShield Gold Max A and AIA Max VitalHealth A (No Deductible Waiver Pass but with Certificate of Pre-Authorisation)
 
John pays deductible:
$2,000
AIA Max VitalHealth A
(which covers the
remaining deductible
and co-insurance)
pays: $8,150
John pays
co-payment:
$3,000
HSG Max A (including Medishield Life)
pays: $86,850
 
* 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 bill was $100K. As the policy has a Deductible Waiver Pass, John does not need to pay $2,000 deductible. However, in view that the treatment was not pre-authorised, the co-payment cap of $3,000 does not apply and John would need to pay a total of $5,000 from his own pocket. The remaining bill is covered under his policies.
 
With AIA HealthShield Gold Max A and AIA Max VitalHealth A (with Deductible Waiver Pass, No Certificate of Pre-Authorisation)
 
AIA Max
VitalHealth A
(which covers
deductible and co-
insurance) pays:
$8,150
John pays co-
payment:
$5,000
HSG Max A (including Medishield Life)
pays: $86,850
 
* 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 bill was $100K. As the policy does not have a Deductible Waiver Pass, John would need to pay $2,000 deductible. And, in view that the treatment was not pre-authorised, the co-payment cap of $3,000 does not apply and John would need to pay a total of $6,900 from his own pocket. The remaining bill is covered under his policies.
 
With AIA HealthShield Gold Max A and AIA Max VitalHealth A (with No Deductible Waiver Pass, No Certificate of Pre-Authorisation)
 
John pays deductible:
$2,000
AIA Max VitalHealth
A (which covers the
remaining
deductible and co-
insurance) pays:
$6,250
John pays
co-payment:
$4,900
HSG Max A (including Medishield Life)
pays: $86,850
 
* 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 bill was $100K. As there is a co-payment cap of $3,000 because the treatment was pre-authorised, John only needs to pay $3,000 from his own pocket and the remaining bill is covered under his policies.
 
With AIA HealthShield Gold Max A and AIA Max VitalCare (With Certificate of Pre-Authorisation)
 
AIA Max VitalCare
(which covers
deductible and co-
insurance) pays:
$10,150
John pays
co-payment:
$3,000
HSG Max A (including Medishield Life)
pays: $86,850
 
* 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 bill was $100K. In view that the treatment was not pre-authorised, the co-payment cap of $3,000 does not apply and John would need to pay $5,000 from his own pocket. The remaining bill is covered under his policies.
 
With AIA HealthShield Gold Max A and AIA Max VitalCare (No Certificate of Pre-Authorisation)
 
AIA Max VitalCare
(which covers
deductible and co-
insurance) pays:
$8,150
John pays co-
payment:
$5,000
HSG Max A (including Medishield Life)
pays: $86,850
 
* Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

Example: John, who is covered under AIA HealthShield Gold Max A, was hospitalised in a private hospital. His total bill was $100K.
 
With AIA HealthShield Gold Max A and AIA Max VitalHealh A Value (with Certificate of Pre-Authorisation)
 
John pays deductible:
$3,500
AIA Max VitalHealth
A Value (which
covers the remaining
deductable and co-
insurance) pays:
$3,650
John pays co-
payment:
$6,000
HSG Max A (including Medishield Life)
pays: $86,850
 
With AIA HealthShield Gold Max A and AIA Max VitalHealh A Value (No Certificate of Pre-Authorisation)
 
John pays deductible:
$3,500
AIA Max VitalHealth
A Value (which
covers the remaining
deductable and co-
insurance) pays:
$0
John pays co-
payment:
$9,650
HSG Max A (including Medishield Life)
pays: $86,850
 
However, should John be admitted to A Ward Class of a Restructured hospital, the out-of-pocket will be capped at $3,000 as shown below:
 
With AIA HealthShield Gold Max A and AIA Max VitalHealh A Value (A Ward Class of a Restructured hospital)
 
John pays deductible:
$0
AIA Max VitalHealth
A Value (which
covers the remaining
deductable and co-
insurance) pays:
$10,150
John pays co-
payment:
$3,000
HSG Max A (including Medishield Life)
pays: $86,850

AIA HealthShield Gold Max will cover Ptosis (subject to policy conditions) only when the condition affects your field of vision or gives rise to a functional problem.
 
If the Ptosis is not serious enough or mostly for aesthetic purpose, it will not be covered.

Telemedicine

Telemedicine is the remote diagnosis and treatment of patients using telecommunications devices i.e. a smartphone with camera.

Along with the rest of our healthcare proposition, such as AIA Quality Healthcare Partners (AQHP) and Teladoc Health, Whitecoat telemedicine allows us to provide primary care that is accessible and yet affordable to our customers. AQHP and Teladoc Health supports our healthcare proposition with hospitalisation and post-hospitalisation services, forming a holistic healthcare solution for AIA HealthShield Gold Max customers.

Telemedicine is suitable for everyone who is seeking (i) treatment for non-emergency medical issues; (ii) chronic conditions; (iii) advice or a second opinion on a pre-existing condition; or (iv) support for mental wellness.
 
Please refer to table below for some examples.
 
GP consultations Mental wellness
support
Non-emergency medical issues Chronic conditions
a. flu, cough, cold or sore throat,
b. fever, or headache,
c. diarrhea, constipation or vomiting,
d. rash, or cold sores,
e. conjunctivitis,
f. urinary tract infection,
g. dermatological conditions,
h. other non-emergent medical issues.		 a. hypertension,
b. hyperlipidaemia,
c. diabetes.		 a. anxiety disorder,
b. stress,
c. depression,
d. insomnia,
e. relationship and marital difficulties,
f. abuse and trauma
g. dissociative disorders,
h. dementia
i. obsessive compulsive disorder,
j. addictions,
k. bereavement and grief,
l. geriatric psychology,
m. workplace bullying,
n. other mental disorders.

Simply download and login to WhiteCoat App to enjoy the pre-negotiated consultation fees as an AIA HealthShield Gold Max customer. 

Please see below negotiated rates for the Whitecoat Services that you can enjoy: 
 
WhiteCoat Services Consultation Mode Type of Consultation Negotiated fee
General Practitioner Teleconsult Standard Consultation S$12
Psychology Service Teleconsult Short Consultation
(As a form of "triage")		 S$55
Teleconsult Standard Consultation
(For more straightforward presentations)		 S$90
Teleconsult / In-clinic Standard Consultation
(For more complex cases)		 S$170 - 250
Psychiatry Service In-clinic First Consultation - Short (15 mins) S$108
First Consultation - Mid / Long S$180 - 324
Follow Up S$108 - 180

There are other costs like GST, medication cost and delivery cost.

WhiteCoat's GP teleconsultation is an on-demand service, and you do not need to request for an appointment. For Psychology / Psychiatry services, if your selected professional is unavailable for an on-demand tele-consult, you may choose to make an appointment instead. 

Personal Case Management

We understand that customers who have serious medical conditions often feel uncertain about the best course of action and face a lot of stress along the care journey. Through this service, we would like to help our customers get accurate diagnosis and select the best course of treatment, by providing them access to independent global expert medical advice, as well as on-going support throughout their medical journey.

Most second opinion services review medical reports and information to provide an independent diagnosis and recommended treatment plan. Following the second opinion, a patient is often left with questions, as well as the need to find the best doctor and hospital to administer the treatment. 
 
With Personal Case Management, the customer is never alone. The customer will be supported by a dedicated case management team, led by the physician case manager, at all times throughout the medical journey from diagnosis, treatment, through to recovery.

This service is exclusively available for our insured customers with AIA Max VitalHealth A, AIA Max VitalHealth A Value, AIA Max VitalCare, AIA Max VitalHealth B, AIA Beyond Critical Care, AIA Absolute Critical Cover, AIA Triple Critical Cover with Power Upgrade Rider, and AIA Power Critical Cover plans only.

This service is complimentary for our insured customers with AIA Max VitalHealth A, AIA Max VitalHealth A Value, AIA Max VitalCare, AIA Max VitalHealth B, AIA Beyond Critical Care, AIA Absolute Critical Cover, AIA Triple Critical Cover with Power Upgrade Rider, and AIA Power Critical Cover plans.
 
Tests, treatments, procedures, devices or medication recommended by Teladoc Health may be subject to additional charges that are not covered by your plan. Please consult your AIA Financial Services Consultant for more details.

Please click here for the list of eligible medical conditions.

When you choose to use Teladoc Health's Personal Case Management service, you will be required to sign the service enrolment and authorisation form, as well as submit all relevant medical information and reports at hand. This approval will also allow Teladoc Health to obtain any missing medical reports from various sources.
 
AIA and Teladoc Health recognise the importance and sensitivity of such personal data and will only share information that is required to accurately analyse the customer's condition and enable appropriate recommendations to be made.

Teladoc Health's assessment of treatment is based on medical necessity. As Singapore has a highly developed healthcare system, Teladoc Health does not expect that there will be a need to refer patients abroad. However, Teladoc Health will consider recommending consultation or treatment abroad in the rare instances where there is a lack of local expertise in relevant fields.
 
The coverage for such overseas treatment will be subject to the benefit entitlements as per the policy contract.  Please consult your AIA Financial Services Consultant for more details.

AQHP specialists are selected based on their qualifications and experience to deliver quality affordable healthcare.
 
This partnership with Teladoc Health complements the AQHP, by providing patients with additional access to local and global expertise and ongoing support. Teladoc Health does not directly treat patients but works in collaboration with the treating doctor to ensure that the best possible care is delivered. This enhances the ability of our AQHP to deliver quality care.

In such a situation, with the patient's permission, Teladoc Health will discuss the case with the treating doctor and collectively agree upon the best course of action for the patient. At the end of the day, the decision on how to proceed with the suggested treatment plan lies with the patient.

Teladoc Health provides a case management service to empower patients to make informed decisions and be proactive participants in their medical care. It is important to note that Teladoc Health does not treat patients directly, nor prescribe medications. The decision regarding treatment is made by the patient, in consultation with the treating doctor. Hence, Teladoc Health does not take on the responsibility for medical malpractice.
 
AIA Singapore is not involved in the recommendations that Teladoc Health provides as the intent is for Teladoc Health to give independent advice.

Early Detection Screening

We introduced the Early Detection Screening Benefit for AIA HealthShield Gold Max with rider* in 2019 as part of our efforts to help our customers stay healthy and manage their health for the long term. Appropriate screening can help to detect potentially serious medical condition(s) in advance to facilitate early diagnosis and treatment, helping you to lead a healthier, longer and better life. 
 
*Applicable only for AIA Max VitalHealth A and AIA Max VitalCare riders.

All insured customers under the following plans who have reached the eligibility age* on the policy anniversary are entitled to the Early Detection Screening benefit: 
 
  • AIA Max VitalHealth A
  • AIA Max VitalCare
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. 
 
*Please refer to Question 3 for the age criteria.

The screenings available under the Early Detection Screening Benefit are:
 
No.
Screening
Insured Eligibility
Frequency
1.
Colonoscopy
Males and Females, age 50 and above
Every 10 years from the policy year of the last screening voucher's issuance date
2.
Mammogram
Females, age 40 to 69
Every 2 years from the policy year of the last screening voucher's issuance date
 
The first screening voucher will be issued on the policy anniversary when the insured meets the eligibility criteria, or when the premium for the next policy year is paid and received by AIA, whichever is later. 
 
Note: This Early Detection Screening Benefit is for healthy individuals, and is not intended  for use by customers who have existing symptoms of breast or colorectal conditions, or who have a prior history of breast or colorectal conditions. Customers who are not eligible for the benefit are encouraged to continue their follow-up with their respective doctors. You may refer to the Terms and Conditions stated on the Early Detection Screening vouchers for more details. 

AIA will inform you via SMS or email. You may refer question 2 and 3 for the eligibility criteria.

No, this complimentary screening is optional. If you would like to go for the screening, please make an appointment with your preferred screening partner in advance.  

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 My AIA SG 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
  • AIA Early Detection Screening Voucher; and
  • Your NRIC / FIN / Passport
 
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. 

Home Palliative benefit

Home Palliative care refers to the provision of palliative services in the patient's home. Common palliative services include changing of wound dressings, feeding tubes, stoma care, urinary tube changes, provision of supportive medicines and nutritional feeds.
 
Home Palliative care provides patients with greater sense of independent living and comfort in familiarity for terminally ill cancer patients. The Home Palliative care benefit provides coverage for eligible items up to $15,000 per month with maximum lifetime limit of $45,000.

Home Palliative Benefit is available to Insureds who are diagnosed with terminal cancer with expected survival period of 12 months or less under the following rider: 
 
- AIA Max VitalHealth A
- AIA Max VitalHealth A Value
- AIA Max VitalCare

To apply for the service, you need a referral letter* from your oncologist to the AIA Appointed Home Palliative Care Provider(s).
 
Step 1: Insured requires home palliative care service
Step 2: Insured / referring oncologist contacts AIA Appointed Home Palliative Care Provider to submit referral letter*
Step 3: AIA Appointed Home Palliative Care Provider contacts the insured.
 
*Note: The referral letter must include a declaration that the insured is diagnosed with Terminal Cancer with an expected survival period not exceeding 12 months.

Please see below table for the Appointed Providers for this service.
 

Note: This list of Appointed Providers is correct as of 01 September 2023 and may be subject to change.

The Home Palliative benefit covers eligible items - doctor's attendance fee, nurse's attendance fee, prescription drugs and/or supportive medicine (e.g. pain relief medications, total parenteral nutrition), medical consumables (e.g. wound dressings) and procedures (e.g. feeding tube changes, stoma wound care). If other items are required, AIA reserves the right to determine whether they are considered as Reasonable and Customary.

To submit a claim, the following criteria must be fulfilled:
 
  1. Service is provided by AIA Appointed Home Palliative Care Provider;
  2. Claim is accompanied by an oncologist's referral letter with declaration that the patient has Terminal Cancer with an expected survival period not exceeding 12 months;
  3. Claim is linked to a main claim episode for which the claim has been approved. This main claim episode may be an inpatient admission or an outpatient chemotherapy episode within the last six (6) months (Note: This is determined based on the date of the first Home Palliative claim);
  4. Claim is admissible only for eligible items required for the delivery of Home Palliative. Refer to question 5 for eligible items; and
  5. All claims submitted for Home Palliative benefit should be within 12 consecutive months from date of the first Home Palliative benefit claim, subject to the Limit of Compensation stated in the Schedule of Benefits.

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

Others

Please contact your AIA Financial Services Consultant/Insurance Representative or call our AIA Customer Care Hotline at 1800 248 8000 to update your personal particulars.

You may consult your AIA Financial Services Consultant/Insurance Representative or call our AIA Customer Care Hotline at 1800 248 8000.
 
Alternatively, you can also access your policy details on the go via My AIA SG.

The MediSave accredited institution(s) / referral centre(s) and the contact details can be found on CPFB | Can I use my MediSave for overseas treatment/hospitalisation?

The list is subject to any change made on the covered healthcare providers for approved hospitalisation by Medisave.

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