Exclusions & Limitations: What Health Insurance Doesn’t Cover In Singapore
Health insurance in Singapore provides essential financial protection against medical expenses, but it doesn’t cover everything. Many people assume their policies offer complete coverage, only to face unexpected out-of-pocket costs when making a claim.
Understanding the exclusions and limitations of your health insurance plan is important to avoid surprises. This article breaks down what’s typically not covered under health insurance in Singapore, helping you make informed healthcare decisions.
Pre-Existing Conditions
Most health insurance plans exclude pre-existing conditions, meaning any illness or medical condition diagnosed before purchasing the policy may not be covered. Some Integrated Shield Plans (IPs) offer coverage for certain pre-existing conditions but often come with higher premiums. According to a Life Insurance Association (LIA) Singapore report, about 8% of IP applications are rejected due to pre-existing health issues.
Elective & Cosmetic Procedures
Treatments that are not deemed medically necessary, such as cosmetic surgeries, elective treatments, and alternative therapies, are generally not covered. For example:
- Plastic Surgery (unless for reconstructive purposes after an accident or illness).
- LASIK eye surgery (unless deemed medically necessary)
- Dental and orthodontic treatments (unless covered under specific riders)
- Alternative medicine like acupuncture or chiropractic care (except under selected plans)
Maternity & Fertility Treatments
Standard health insurance plans do not cover maternity-related expenses, prenatal care, or childbirth unless a maternity rider is purchased separately. Fertility treatments such as IVF, IUI, and egg freezing are also excluded. Singapore’s Ministry of Health (MOH) states that fertility treatments can cost between SGD 10,000 to SGD 20,000 per cycle, which is why couples seeking these treatments need alternative financial planning.
Experimental Treatments & Unapproved Drugs
Medical procedures that are still in the experimental stage or drugs that are not approved by the Health Sciences Authority (HSA) are typically not covered. This includes new cancer treatments, off-label drug use, or clinical trial participation. Patients seeking these options may need to rely on personal savings or alternative financing methods.
Overseas Medical Treatment
Most health insurance policies in Singapore are designed to cover medical expenses within the country. If you seek medical treatment abroad, coverage is usually limited or excluded, unless you have a rider or an international health insurance plan. Some exceptions exist for emergency medical evacuation, but planned treatments overseas are rarely covered.
Mental Health & Long Term Care
Although mental health awareness is growing in Singapore, coverage for psychiatric treatments and mental health consultations remains limited. Only a few insurers provide mental health benefits, and coverage is often capped. Long-term care for chronic illnesses or disabilities, such as nursing home stays or home caregiving, is generally excluded, though government subsidies like ElderShield and CareShield Life provide partial support.
Find a Trusted Financial Consultant For Your Health Insurance Needs
Understanding what your health insurance doesn’t cover is just as important as knowing what it does. Exclusions vary between policies, so it’s essential to read the fine print and seek professional advice before choosing a plan.
If you want to ensure the best coverage for your needs, contact us through the button below for an introduction to a trusted financial consultant in Singapore who can guide you in making the right decision.
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This article is informative only and is not intended to be a substitute for professional medical advice, diagnosis, or treatment, and should never be relied upon for specific medical advice.