An Introduction to Extended Panel for Integrated Shield Plans

From April 2022, insurance companies offering Integrated Shield Plans started to introduce Extended Panel to policyholders. What is Extended Panel? Why was it introduced? After the introduction of Extended Panel, what will the impact be for policyholders? This article talks about it.

Photo by NCI on Unsplash

Background

In April 2021, insurance companies added in anti-abuse mechanism (mostly co-payment) to Integrated Shield Plans according to the recommendation by Ministry of Health. At the same time, every insurance company has its Panel of Private Specialists. If a life assured sees a doctor inside the Panel, there may be more benefits, and there is an annual co-payment cap of S$3,000 for the policyholder, so the money out of pocket is foreseeable. If the life assured sees a doctor outside the Panel, there is no annual co-payment cap for the policyholder, so the money out of pocket is unforeseeable. This mechanism resulted in complaints from some policyholders. Because some life assureds have chronic diseases. They have been following up with the same doctor for years. But unfortunately this doctor is not in the Panel. Under the new mechanism, the annual money out of pocket for the policyholder becomes unforeseeable.

To address this issue, Ministry of Health invited representatives from healthcare providers, payors, consumers and the Government to form a Multilateral Healthcare Insurance Committee (MHIC). In November 2021, the MHIC provided a series of recommendations. One of them is to introduce Extended Panel.

General Guideline for Extended Panel

Based on the recommendation by MHIC, an insurance company’s Extended Panel should consist of doctors in other Integrated Shield Plan providers’ Panel. Each insurance company can decide its own way to implement Extended Panel.

The Implementation by Different Insurers

As far as I know, there are two ways to implement Extended Panel by insurance companies:

Method 1: Some insurance companies directly invite doctors in other Integrated Shield Plan providers’ Panel to join their own Panel. In this way, the Panel size of this type of insurance companies will become bigger and bigger.

Method 2: Some insurance companies do not change their own Panel. If a life assured sees a doctor not inside the insurer’s Panel but inside other Integrated Shield Plan providers’ Panel, the policyholder can apply pre-authorisation with the insurer. Once the pre-authorisation is approved, the life assured can enjoy Panel benefit when seeing this doctor.

Policyholders Should Take Note

As a policyholder, first of all you should find out the way that your insurer implements Extended Panel.

If your insurer implements it by Method 1, and your life assured’s doctor is not inside the insurer’s Panel, you should invite this doctor to join the insurer’s Panel as early as possible. It takes about one month for the doctor and the insurer to sign a Panel agreement. During the process, the doctor and the insurer negotiate healthcare expenses standards and claim procedures.

If your insurer implements it by Method 2, and your life assured’s doctor is not inside the insurer’s Panel, you should set aside at least one week before the hospital admission for the insurer to conduct pre-authorisation with the doctor. Once the pre-authorisation is approved, the life assured can enjoy Panel benefits.

That’s all about Extended Panel for Integrated Shield Plans. Welcome contacting me if you need a further discussion.