Central Provident Fund (MediShield Scheme) (Amendment) Regulations 1997

No. S 343

Central Provident Fund Act

(Chapter 36)

Central Provident Fund (MediShield Scheme) (Amendment) Regulations 1997

In exercise of the powers conferred by section 57 of the Central Provident Fund Act, the Minister for Labour hereby makes the following Regulations:

Citation and commencement

1.—(1) These Regulations may be cited as the Central Provident Fund (MediShield Scheme) (Amendment) Regulations 1997 and, with the exception of regulations 5 and 6, shall be deemed to have come into operation on 27th November 1995.

(2) Regulations 5 and 6 shall be deemed to have come into operation on 1st July 1997.

Amendment of regulation 2

2. Regulation 2(1) of the Central Provident Fund (MediShield Scheme) Regulations 1995 (G.N. No. S 361/95) (referred to in these Regulations as the principal Regulations) is amended —

(a)

by deleting the definition of “assured amount” and substituting the following definitions:

“ “approved hospital” means any hospital, clinic or centre providing medical treatment approved by the Minister for Health for the purposes of these Regulations;

“assured amount”, in relation to each item of medical treatment received by a person insured under —

(a)	the Scheme in Division 2 of Part II, means the amount specified in the second column of the Third Schedule in respect of that item of medical treatment;
(b)	Plan A of the Scheme in Division 3 of Part II, means the amount specified in the third column of the Third Schedule in respect of that item of medical treatment;
(c)	Plan B of the Scheme in Division 3 of Part II, means the amount specified in the fourth column of the Third Schedule in respect of that item of medical treatment;

“claim limit”, in relation to each item of medical treatment, means the charge levied by the approved hospital for that item of medical treatment but not exceeding the assured amount for that item of medical treatment;

“day surgical treatment” means any surgical treatment received by a person who is admitted and discharged on the same day, and includes any ancillary medical treatment received by that person between such admission and discharge, but shall not include any excluded medical treatment;”;

(b)

by inserting, immediately after the definition of “excluded medical treatment”, the following definition:

“ “gamma knife treatment” has the same meaning as in the Central Provident Fund (Medisave Account Withdrawals) Regulations (Rg 17) and shall not include any excluded medical treatment;”;

(c)

by inserting, immediately after paragraph (e) in the definition of “insured out-patient medical treatment”, the following paragraph:

“(f)	gamma knife treatment;”; and

(d)

by deleting the words “or renal dialysis treatment” in the second line of the definition of “medical treatment” and substituting the words “, renal dialysis treatment or gamma knife treatment”.

Amendment of regulation 10

3. Regulation 10 of the principal Regulations is amended by deleting paragraphs (2) and (3) and substituting the following paragraphs:

“(2) Subject to paragraph (1), where in any policy year an insured person has received at an approved hospital any medical treatment as an in-patient or day surgical treatment or gamma knife treatment, he shall be entitled to claim from the Board in respect of such medical treatment an amount ascertained in accordance with the formula:

where A

is the total of the claim limits for each item of such medical treatment;

is the insured’s contribution specified in item (I) of the Fourth Schedule.

(3) Subject to paragraph (1), where in any policy year an insured person has received any insured out-patient medical treatment (excluding gamma knife treatment), he shall be entitled to claim from the Board in respect of such medical treatment an amount equal to 80% of the total of the claim limits for each item of such medical treatment.”.

Amendment of regulation 14

4. Regulation 14 of the principal Regulations is amended by deleting paragraphs (3) and (4) and substituting the following paragraphs:

“(3) Subject to paragraphs (1) and (2), where in any policy year an insured person has received at an approved hospital any medical treatment as an in-patient or day surgical treatment or gamma knife treatment, he shall be entitled to claim from the Board in respect of such medical treatment an amount ascertained in accordance with the formula:

where A

is the total of the claim limits for each item of such medical treatment;

is the insured’s contribution specified in item (II) of the Fourth Schedule according to the Plan under which he is insured.

(4) Subject to paragraphs (1) and (2), where in any policy year an insured person has received any insured out-patient medical treatment (excluding gamma knife treatment), he shall be entitled to claim from the Board in respect of such medical treatment an amount equal to 80% of the total of the claim limits for each item of such medical treatment.”.

Amendment of regulation 19

5. Regulation 19 of the principal Regulations is amended by deleting the words “during any policy year” in the third line of paragraph (1) and in the third and fourth lines of paragraph (2).

Amendment of regulation 20

6. Regulation 20 of the principal Regulations is amended —

(a)

by deleting the word “Regulation” in the first line of paragraph (1) and substituting the words “Subject to paragraph (2), regulation”;

(b)

by deleting paragraph (2) and substituting the following paragraph:

“(2) Where an insured person is insured as a dependant of a member of the Fund and —

(a)	has not attained the age of 16 years; or
(b)	the Board has reason to believe that he is unable by reason of mental disability to make the decision to terminate his insurance cover for himself,

only a member of the Fund who is a parent of the insured person or such other person as the Board considers fit may terminate the insurance cover of the insured person by lodging with the Board a written notice in such form as the Board may require stating that he no longer wishes the insured person to be insured under the Scheme.”; and

(c)

by deleting the words “during any policy year” in the fourth line of paragraph (3) and in the fourth line of paragraph (4).

Amendment of Third Schedule

7. The Third Schedule to the principal Regulations is amended —

(a)

by inserting, immediately after the words “miscellaneous charges” in the first column of items 1 and 2, the words “, unless listed under any other item”;

(b)

by inserting, immediately after the word “Dialysis” in the first column of item 4, the words “, received as out-patient medical treatment”;

(c)

by inserting, immediately after the word “transplant” in the first column of item 8, the words “, received as out-patient medical treatment”;

(d)

by inserting, immediately after the word “treatment” in the first column of item 9, the words “, received as out-patient medical treatment”; and

(e)

by inserting, immediately after item 9, the following item:

“

10.	Gamma knife treatment

$4,800 per treatment for claims made on or after 27th November 1995

$12,600 per treatment for claims made on or after 27th November 1995

$9,600 per treatment for claims made on or after 27th November 1995

”.

Amendment of Fourth Schedule

8. The Fourth Schedule to the principal Regulations is amended by deleting item (I) and substituting the following item:

“

Amount (in any policy year)

(I) MediShield

(a)	where all claims in the policy year relate to medical treatment received in Class ‘C’

$500

(b)	where all claims in the policy year relate to medical treatment received in Class ‘B2’ and above, day surgical treatment or gamma knife treatment

$1,000

(c)	where some claims in the policy year relate to medical treatment specified in paragraph (a) and other claims in the policy year relate to medical treatment specified in paragraph (b)

where D

is the aggregate of the claim limits of all preceding claims in the policy year relating to medical treatment specified in paragraph (a) and, where the current claim relates to medical treatment specified in paragraph (a), the claim limit of the current claim;

is the aggregate of the values of the claim limits of all preceding claims in the policy year relating to medical treatment specified in paragraph (b) and, where the current claim relates to medical treatment specified in paragraph (b), the claim limit of the current claim;

is the sum of D and E.

”.

[G.N. No. S 450/96]

Made this 25th day of July 1997.

MOSES LEE KIM POO

Permanent Secretary,
Ministry of Labour,
Singapore.

[ML.S.10.1/82 V3; AG/SL/19/95/16]

(To be presented to Parliament under section 78(2) of the Central Provident Fund Act).

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