What are the pros and cons of providing “Per disability” and “As charged” medical insurance policy?

The two most common medical insurance policies offer by insurance companies for employee’s benefits program are (i) Per disability benefits (ii) As charged benefits. So which is the best hospitalization insurance in Singapore?

As charged benefits program

This employee medical insurance plan are more commonly set in predetermine premium table based on age bracket and level of benefits,

Per disability benefits program

They are more flexible in term of premium and types of benefit can be tailor to the needs of the company.

With these two programs we will share some of the common features and compare the pros and cons of the health insurance benefit.

Common Features

Both programs are design to cover medical expenses in the event if the employee is hospitalized due to an accident or illness.

These two programs will cover expenses incurred in

• Daily Room & Board

• Intensive Care Unit

• Hospital Miscellaneous Expenses

• Surgeon’s Fee

• Pre & Post Hospitalization specialist consultation and services

However, every insurance company may have their own variant of benefits incorporated into the program to make it more comprehensive.

The pros and cons of per disability and lump sum benefits program

As Charged Benefit Policy

Annual Policy Limit

- Pros

Most of the hospitalization expenses will fall under the annual limit, as such in most cases there is no need for patient to pay out of his pocket.

- Cons

All inpatient medical expenses are subjected to annual limit (aggregated).

If the policy has a low annual limit, patient may not has sufficient limit for one inpatient claim.

Daily Room & Board

- Pros

Is part of the per year aggregate limit. So insured employee may use any class of ward he chooses to.

-Cons

Medical expenses may increase if insured employee chooses to use private hospital and single bedded ward

Surgeon’s Fee

- Pros

Surgical Fee is one of the highest expenses in any medical bill. So as part of the annual limit, insured employee has a peace of mind when they are required to have a surgery.

- Cons

Depending on the annual limit that the insured employees are entitling to, as such one may run out of limits of benefits before the coverage reach its 12 months period and due for next renewal.

Per Disability Benefit Policy

Annual Policy Limit

- Pros

Annual limit is not applicable. When the per disability limit is exhausted it will be refresh after the predetermine number of days after the day of discharge for the same illness or accident. Different incident of illness or accident that needs inpatient care will have its fresh limit.

- Cons

Per disability limits are tag to the type of room & board schedule.

Daily Room & Board

- Pros

The medical expenses can be better manage since we can predetermine who is entitled to the type of ward base on his seniority

- Cons

Insured employee can still choose to use a better ward then his entitlement but he may need to pay out of his pocket on the different.

Surgeon’s Fee

- Pros

In the event if the limit is exhausted, the policy will refresh its limit after a predetermine number of days after the date of discharged for the same illness or accident. Insured employee is entitled to fresh limit each time he is hospitalized for different illness or accident.

- Cons

Insured employee may need to pay out of his pocket or claim under his personal insurance in the event if the surgical fee is more than his entitlement.