PART 1 | Citation and commencement |
| 1. These Regulations may be cited as the MediShield Life Scheme Regulations 2015 and come into operation on 1 November 2015. |
2.—(1) In these Regulations, unless the context otherwise requires —| “additional private insurance coverage” means any private insurance cover provided under an integrated shield plan that is additional to the insurance cover provided by the MediShield Life Component of that integrated shield plan; |
| “admission date”, in relation to a claim for any approved medical treatment or services, means the admission date assigned to the approved medical treatment or services claimed in accordance with guidelines issued by the Minister, and “admission” and “admitted” have corresponding meanings; |
| “approved community hospital” means an approved medical institution which, in the opinion of the Minister, provides an intermediate level of care for outpatients and in-patients who have simple ailments that do not require specialist medical and nursing care; |
“approved dental treatment” means dental work or dental treatment —| (a) | owing to accidental injuries; | | (b) | certified in writing, by an approved medical practitioner, to be necessary in relation to a separate surgical treatment (excluding any surgical treatment specified in the Third Schedule); or | | (c) | certified in writing, by an approved medical practitioner, to be necessary in relation to any approved medical treatment or services (excluding any medical treatment or services specified in the Third Schedule), and assessed by the Council to be appropriate; |
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| “approved medical practitioner” means a medical practitioner who is approved by the Minister for the purposes of these Regulations; |
“approved outpatient treatment” means any of the following approved medical treatment or services received as an outpatient of any approved medical institution:| (a) | renal dialysis; | | (b) | treatment of neoplasms by chemotherapy; | | (c) | radiotherapy treatment for cancer; | | (d) | administration of immunosuppressants for organ transplant; | | (e) | administration of erythropoietin for dialysis and chronic renal failure; |
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| “approved restructured hospital” means an approved medical institution which is a restructured hospital; |
“commencement date” —| (a) | in relation to an insured person’s MediShield Life cover, means the date determined under regulation 4 from which the insured person’s MediShield Life cover has been continuously in force; or | | (b) | in relation to an insured person’s pre-existing MediShield cover, means the date from which the insured person’s pre-existing MediShield cover has been continuously in force; |
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| “CPF member” includes a CPF member who is an undischarged bankrupt; |
“cross implementation claim” means a claim under an insured person’s pre-existing MediShield cover, in respect of approved medical treatment or services received by an insured person as an in-patient, with —| (a) | an admission date before 1 November 2015; and | | (b) | a date of discharge on or after 1 November 2015; |
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| “cross insurance period claim” means a claim under an insured person’s MediShield Life cover, in respect of approved medical treatment or services received by the insured person as an in-patient in an approved medical institution, with an admission date and a date of discharge in different insurance periods; |
| “day surgical treatment” means any surgical treatment (including any radiosurgery 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; |
“dependant”, in relation to a CPF member, means —| (a) | a CPF member’s spouse, child, parent or grandparent; or | | (b) | any other person whom the Board approves as a dependant for the purpose of these Regulations; |
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“in-patient” means a patient who —| (a) | is hospitalised, for any treatment other than day surgical treatment, for a period of not less than 8 hours; or | | (b) | has died within 8 hours after being hospitalised for any treatment other than day surgical treatment; |
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“insured person” —| (a) | in relation to an insurance cover under the MediShield Scheme or an integrated medical insurance plan, means a person who was insured under the MediShield Scheme or integrated medical insurance plan, as the case may be, before 1 November 2015; or | | (b) | in relation to an integrated shield plan or a medisave-approved plan, means a person who is insured under the integrated shield plan or medisave-approved plan, as the case may be; |
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| “insurer” means an insurer which is licensed under the Insurance Act (Cap. 142); |
| “integrated medical insurance plan” means any plan, under which a person was insured before 1 November 2015, under a medical insurance policy approved by the Minister for the purposes of regulation 4(1)(b) of the revoked PMIS Regulations, with or without a MediShield Component; |
| “integrated shield plan” means a medisave-approved plan that comprises a MediShield Life Component and additional private insurance coverage; |
| “living donor organ transplant” has the same meaning as in the Human Organ Transplant Act (Cap. 131A); |
| “medical practitioner” means a medical practitioner registered under the Medical Registration Act (Cap. 174) or a dentist registered under the Dental Registration Act (Cap. 76); |
“medical treatment” includes —| (a) | any surgical treatment, radiotherapy treatment, treatment of neoplasms by chemotherapy, renal dialysis treatment or radiosurgery treatment; | | (b) | any service, investigation, medicine, curative material, medical consumable, surgical implant or other item necessary for the medical treatment; and | | (c) | where any medical treatment has been received by a person as an in-patient in an approved medical institution, the maintenance of that person in that institution; |
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| “medisave-approved plan” has the same meaning as in the MediShield Life Scheme (Private Medical Insurance Scheme) Regulations 2015 (G.N. No. S 623/2015); |
| “MediShield Component”, in relation to a person insured under an integrated medical insurance plan, means the person’s insurance cover under the MediShield Scheme which formed part of the person’s integrated medical insurance plan; |
| “MediShield Life Component” means insurance cover provided by the Scheme which forms part of an integrated shield plan; |
| “MediShield Life cover” means insurance cover under the Scheme; |
“organ transplantation costs” means —| (a) | any costs arising in relation or incidental to the removal of any organ from a non-living organ donor for organ transplant and includes the costs of —| (i) | the donor’s extended stay, before the donor’s death, in a hospital as necessitated by the donation of the organ; | | (ii) | any surgical operation to remove the organ from the donor’s body; | | (iii) | any pre-harvesting laboratory test and investigation; | | (iv) | any counselling provided to the donor’s family in connection with the donation of the organ; | | (v) | the storage and transport of the organ; and | | (vi) | such other procedures as the Minister may approve; or |
| | (b) | any costs that are reasonably or directly attributable to the removal of any specified organ from a living organ donor for organ transplant and includes the costs of —| (i) | the donor’s stay in a hospital as necessitated by the donation of the specified organ until the donor is discharged; | | (ii) | any surgical operation to remove the specified organ from the donor’s body; | | (iii) | the storage and transport of the specified organ; and | | (iv) | such other procedures as the Minister may approve, |
| (A) | any costs arising in relation or incidental to complications suffered by the donor due to the donation of the specified organ after the donor’s discharge from the hospital under sub‑paragraph (i); | | (B) | any pre-harvesting laboratory test and investigation; and | | (C) | any counselling provided to the donor’s family in connection with the donation of the specified organ; |
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“outpatient” means a patient other than —| (a) | an in-patient; or | | (b) | a patient receiving day surgical treatment; |
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“policy year” means —| (a) | in relation to any insurance cover under the MediShield Scheme in Division 2 of Part II of the revoked MediShield Regulations for a period referred to in regulation 9(1)(ca)(i), (2)(a) or (3)(a) of those Regulations, that period; | | (b) | in relation to any other insurance cover under the MediShield Scheme, a period of 12 months from the date of the commencement or renewal of that insurance cover; or | | (c) | in relation to a person’s integrated medical insurance plan (including any MediShield Component of that plan), a period of 12 months from the date of the commencement or renewal of that plan; |
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| “pre-existing MediShield cover” means insurance cover under the MediShield Scheme in force immediately before 1 November 2015 which is replaced by MediShield Life cover under regulation 19(1); |
| “premium payable” excludes any Government subsidies paid towards the amount of premium determined under regulation 8; |
| “radiosurgery treatment” means the gamma knife treatment or the Novalis shaped beam treatment of neurosurgical or neurological disorders; |
| “revoked MediShield Regulations” means the Central Provident Fund (MediShield Scheme) Regulations (Cap. 36, Rg 20) as in force immediately before 1 November 2015; |
| “revoked PMIS Regulations” means the Central Provident Fund (Private Medical Insurance Scheme) Regulations (Cap. 36, Rg 26) as in force immediately before 1 November 2015; |
| “specified organ” has the same meaning as in the Human Organ Transplant Act; |
| “treatment of neoplasms by chemotherapy” means the administration of tested and approved chemotherapeutic agents by the usual and known routes in the treatment of malignant neoplasms, certain benign neoplasms and neoplasms of uncertain behaviour. |
(2) For the purposes of these Regulations —| (a) | if the day of the month on which a person was born cannot be ascertained, the person is taken to be born on the first day of the month in which the person was born; | | (b) | if the month in which the person was born cannot be ascertained, the person is taken to be born in January. |
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| 3. An application made or a notice given to the Board under these Regulations must be made or given in such form and supported by such evidence as the Board may require. |
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