Can Medisave or Insurance Be Used for Cataract Surgery Expenses?

Cataract is the most common eye condition in Singapore and surgery is the only method to treat it. Cataract surgery is performed as a day surgery procedure, which means you do not have to stay in the hospital after the surgery. The procedure usually takes 30 minutes to complete.

While it is a day surgery procedure, cataract surgery is Medisave claimable, subject to the approved surgical limit. In addition, if you have an Integrated Shield Plan, you can claim part or all of your cataract surgery cost, depending on your private insurance coverage, for both private and public hospitals.

Medisave is Singapore’s national health savings plan for all Singaporean citizens and Permanent Residents. While you work, a certain percentage of your monthly earnings will be diverted to your Medisave account for future healthcare needs.

With regards to cataract surgery, every Singaporean and Permanent Resident can claim up to $2450 per eye from their Medisave account, or from an immediate family member’s Medisave account. The process of using your medisave is a simple one, with the administrative work done before your surgery.

Integrated Shield Plans are private insurance plans that you can choose to add on to your basic MediShield Life plan, which all Singaporeans and PRs have. Depending on your choice of IP, there will be additional coverage for B1 and A class wards in public hospitals and even for private hospitals.

If you have purchased a rider for your Integrated Shield Plan, depending on your rider plan, the claim limit would be higher. For individuals with full riders purchased before 1 April 2019, you will not have to pay anything out of pocket for the surgery*.

*If your full rider is purchased after 8 March 2018 but before 1 April 2019, you will have full coverage on co-insurance and deductible portions of your bill until 1 April 2021. After this date, a 5% co-payment will apply. All full riders sold after 1 April 2019 all have a 5% co-payment minimally.

You can use MediSave, up to prevailing limits, to pay for the deductible and co-insurance portions that are not paid by your insurance policy. The deductible is the initial fixed amount of the medical bill that you need to pay before you can claim anything from your insurance (the deductible is reset each policy year). The deductible ranges from $1,500-3,500, depending on plan and ward class.

After paying your deductible, you may still have to pay for co-insurance. Co-insurance is the amount that you have to split with your insurer after subtracting the deductible from your medical bill. It is usually expressed as a percentage. For example, if you have a co-insurance of 10%, you will pay 10% of the medical bill after the deductible, whereas your insurer pays the remaining 90%.

For individuals with full Integrated Shield Plan Rider purchased, it will cover your co-insurance and deductibles.