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Do you have the right surgical insurance coverage in Singapore?

The health benefits people use the most when they hold insurance are generally outpatient-related; GP visits, physiotherapy, or chiropractic treatments. In fact, it’s actually these types of benefits that drive a lot of what we call “overutilization of healthcare” in the sector, usually because of their quick and generally easy-to-acquire nature. One of the more important forms of coverage when it comes to medical plans for expats however, is surgical insurance coverage.

While it’s not the most commonly used, ensuring surgical benefits are in place when something more significant happens is a priority for most people – because of their often high cost. In this article, we’re taking a look at just where different surgical treatment coverage lies within the various types of health insurance plans and what you should look out for when purchasing a plan in Singapore.

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What exactly are surgical insurance benefits?

As the name suggests, surgical benefits cover care where you’re admitted to a hospital or day clinic for a surgery. They can cover a range of hospitalization expenses; from surgery and doctor’s fees, to room and board, diagnostic testing, and other incidentals related to extended stays at a facility. Or they can simply cover the cost

Charges for hospitalization and surgical treatments can be extremely high, particularly when compared with the costs of visiting a GP. For example, the cost of seeing a GP could be as little as SGD 20, with a maximum of about SGD 55 for residents, and over SGD 100 for foreigners. Seeking out cancer treatment in Singapore however, can be estimated to cost as much as SGD 100,000-200,000 a year, with surgery for heart disease being as high as SGD 12,657 for one treatment.

Surgical insurance benefits can come with gaps. Due to their high costs, insurers may place low limits (the maximum amount that can be claimed for a specific surgical treatment) or restrict coverage for certain injuries/illnesses to reduce their risk – meaning patients can still find themselves on the hook for a decent out-of-pocket payment, even with health insurance. When buying insurance, you should always be clear about what your benefits and limits are to avoid any unexpected surprises should you need to use it in future.

What types of surgeries exist and in what sort of insurance plan will I find them?

Surgeries can fall under either inpatient or outpatient benefits in your health insurance plan. Both can be performed at a hospital with their main point of difference being whether or not you’re required to stay the night. Inpatient benefits cover surgical treatments where you’re admitted for one or more nights, where outpatient surgeries are also called day or ambulatory surgeries.

Inpatient surgical insurance benefits

Inpatient surgeries are often more complex and involved than their day surgery counterparts. Common surgeries that can be covered by inpatient surgical insurance benefits include:

  • Appendectomy
  • Coronary Artery Bypass Surgery
  • Hemorrhoidectomy
  • Knee and hip replacements
  • Endoscopy of small or large intestines
  • Reduction of fracture

What’s important to remember is that inpatient surgical benefits usually only cover urgent, emergency or required treatments – elective or optional cases are commonly excluded under most health insurance plans.

The benefits of having an inpatient plan include not only the costs associated with receiving care (doctor’s fees, room and board, operating room costs) but also the post-care treatments that might be necessary. Having surgery on a dislocated shoulder, for example, can mean that subsequent physio or other specialist appointments for the next 30 days will also come under the inpatient coverage.

Outpatient surgical insurance benefits

Same day surgical treatments cover a wide range of routine or minor conditions that don’t usually require admission to a hospital or facility. These treatments include:

  • Arthroscopy
  • Breast biopsy
  • Cataract surgery
  • Small skin grafts
  • Removal of plates and screws
  • Tonsillectomy
  • Ventral hernia

Dental surgeries can also be considered as a day surgery however, they’re often excluded from coverage under outpatient or inpatient insurance benefits unless required in an emergency. Getting covered for non-urgent dental surgery will require additional dental insurance benefit cover.

How do I know if I have the right surgical insurance coverage?

If you already have health insurance, your table of benefits will outline just what exactly will be covered when it comes to surgeries. If you only have basic inpatient coverage, you’ll find that the costs of day surgery procedures will have to be paid out-of-pocket. This can be fine if you’re able to budget and save for any potential routine or minor treatments you might need whilst trying to keep your premiums low.

It’s also a good idea to be aware of the limits and levels of your surgical insurance coverage. Most post-care treatment coverage is time-based; meaning you’ll be covered for things like physio or rehabilitation for a period of, say, 30-60 days after being discharged as an inpatient. Other limits include the total amount an insurance plan will pay out in the event you need either inpatient or outpatient surgery. Being aware of these means being forewarned in case a costly procedure charges more than your insurance covers.

Those of you who don’t have surgical benefits or aren’t sure about the benefits you have, reading your policy documents is a good place to start. An even better solution for wrapping your head around what is and isn’t covered by your plan is to talk to an experienced insurance broker, like Pacific Prime Singapore.

Getting the right coverage for your needs in Singapore

We’re the experts in all things insurance; whether it’s medical plans for expats or locals looking for more comprehensive and extensive benefits than what the public system can provide. Our leading team of insurance advisors can help you navigate the wide range of insurance providers and plans in the market to make sure you get the exact level of coverage, surgical insurance or otherwise, that you need.

For a no obligation, free quote, visit our website today or simply contact our team to find out more about Pacific Prime Singapore.

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Content Strategist at Pacific Prime Singapore
Jessica Lindeman is a Content Strategist at Pacific Prime. She comes to work every day living and breathing the motto of "simplifying insurance", and injects her unbridled enthusiasm for health and insurance related topics into every article and piece of content she creates for Pacific Prime.

When she's not typing away on her keyboard, she's reading poetry, fueling her insatiable wanderlust, getting her coffee fix, and perpetually browsing animal Instagram accounts.