Central Provident Fund (Medisave Account Withdrawals) Regulations

Central Provident Fund Act

(Chapter 36, Section 77(1)(j))

Central Provident Fund
(Medisave Account Withdrawals) Regulations

Rg 17

G.N. No. S 250/1988

REVISED EDITION 1993

(1st April 1993)

[16th September 1988]

Citation

1. These Regulations may be cited as the Central Provident Fund (Medisave Account Withdrawals) Regulations.

Definitions

2.—(1) In these Regulations, unless the context otherwise requires —

“approved centre” means any centre in a hospital or clinic approved by the Minister for Health for renal dialysis treatment;

“approved clinic” means any medical clinic which is approved by the Minister for Health for the purposes of these Regulations;

“approved community hospital” means any premises which in the opinion of the Minister for Health provides an intermediate level of care for out-patients and in-patients who have simple ailments which do not require specialist medical and nursing care and is approved by that Minister for the purposes of these Regulations;

“approved hospital” means any hospital approved by the Minister for Health for the purposes of these Regulations;

“approved medical practitioner” means any registered medical practitioner approved by the Minister for Health or such other person as he may appoint for the purposes of these Regulations;

“approved medical treatment” means such medical treatment as is specified under the first column in the Schedule;

“cancer chemotherapy treatment” means the administration of tested and approved chemotherapeutic drugs by the usual and known routes in the treatment of cancer;

“dependant” means —

(a)	a member’s spouse, child or parent; and
(b)	a member’s grandparent who is a citizen or permanent resident of Singapore;

“eye treatment” means any surgical, medical or laser procedure for diagnostic or therapeutic purposes to restore vision, to prevent deterioration of vision, to preserve vision, to improve vision or to prevent discomfort of the eye, adnexae, orbit or visual pathway;

“gamma knife treatment” means the treatment of neurosurgical and neurological disorders by way of radiotherapeutic procedure as specified in the Schedule;

“Government clinic” means a medical clinic which is wholly managed and maintained by the Government;

“in-patient” means a patient who has been hospitalised for one day or more for medical treatment and includes a patient who receives surgical treatment but who is hospitalised for less than a day;

“medical clinic” means any premises used by one or more approved medical practitioners for the diagnosis or treatment of persons but does not include any such premises which form part of the premises of an approved hospitalor a Government hospital;

“medical treatment” means any medical, radiotherapy, gamma knife treatment or surgical treatment and includes investigations, medicines, curative materials and devices and, where such treatment has been received by a person as an in-patient, includes the maintenance of that person in the hospital;

“medical treatment for conception” means assisted conception procedures, for example, Invitro Fertilisation (IVF), Gamete Intra-fallopian Transfer (GIFT), etc.;

“member” includes a member who is an undischarged bankrupt;

“out-patient” means a patient other than an in-patient;

“psychiatric treatment” includes any therapeutic procedure given to control and relieve any psychiatric symptom or to prevent its recurrences;

“radiotherapy treatment” means the treatment of any malignant disease or certain benign condition with ionising radiation delivered externally or internally by sealed or unsealed radionuclides and irradiating apparatus as specified in the Schedule;

“renal dialysis treatment” means treatment received by a member with renal failure for the purpose of purifying his blood of waste metabolites accumulated as a result of renal failure and includes haemodialysis and continuous ambulatory peritoneal dialysis received at any approved centre or at the member’s home;

“surgical treatment” means any surgical treatment listed under item 10 of the Schedule to the Government Hospitals (Fees) Rules (Cap. 119, R 1) and includes any other surgical treatment approved by the Minister for Health for the purposes of these Regulations;

“treatment for sexual sterilisation” has the same meaning as in the Voluntary Sterilisation Act (Cap. 347).

(2) For the purposes of these Regulations, a person who has been hospitalised for less than a day shall be deemed to be hospitalised for a day if he was hospitalised for a period of not less than 8 hours.

(3) For the purposes of these Regulations, a reference to a person receiving medical treatment on or after a certain date shall, in relation to any medical treatment comprising a course of such treatment, include treatment received on or after such date if and only if the person received the first treatment of the course on or after that date.

Application for withdrawal

3.—(1) Subject to the Act and these Regulations, where a member or his dependant has received any medical treatment from an approved medical practitioner in —

(a)	a Government hospital;
(b)	an approved hospital;
(c)	an approved clinic;
(d)	an approved centre;
(e)	an approved community hospital;
(f)	the Singapore National Eye Centre;
(g)	the Adam Road Hospital; or
(h)	the Raffles SurgiCentre Pte Ltd,;

the Board may, on an application by the member within the period of 12 months commencing immediately after the appointed date or within such further period as may be specified by the Board in any particular case, authorise the whole or part of the amount standing to the member’s credit in his medisave account to be withdrawn and used for the payment of the medical treatment subject to such terms and conditions as the Board may impose.

(2) Where a member —

(a)

has received any medical treatment from —

(i)	an approved medical practitioner in a Government hospital;
(ii)	an approved hospital;
(iii)	an approved community hospital;
(iv)	the Singapore National Eye Centre;
(v)	an approved hospice under regulation 8;
(vi)	an approved day hospital under regulation 6;
(vii)	the Singapore Gamma Knife Centre;
(viii)	the Senior Citizens Health Care Centre; or
(ix)	the National Dental Centre; and

(b)

is unconscious, or otherwise mentally incapacitated, and is unable to make an application under paragraph (1) himself,

the Board may, on the application by a dependant who has attained the age of 21 years and is of sound mind, authorise the whole or part of the amount standing to the member’s credit in his medisave account to be withdrawn and used for the payment of the treatment received by the member subject to such terms and conditions as the Board may impose.

[S 198/98 wef 01/01/1998]

(3) An application by a dependant of the member under paragraph (2) shall be made within the period of 12 months commencing immediately after the appointed date or within such further period as may be specified by the Board in any particular case and shall be signed by the dependant in the presence of an approved medical practitioner who shall confirm in writing that the member is unable to sign the application due to his medical condition.

(4) For the purpose of paragraphs (2) and (3), “dependant” means a member’s spouse, parent or child who has attained the age of 18 years.

(5) Every application for the withdrawal of moneys from a member’s medisave account under these Regulations shall be made in such form and supported by such evidence as the Board may require.

(6) For the purposes of this regulation, “appointed date” means —

(a)	if the member or his dependant received medical treatment as an in-patient — the date of discharge of the member or his dependant from hospital;
(b)	if the member or his dependant received as an out-patient any approved medical treatment comprising a course of such treatment — the date on which the member or his dependant received the first treatment of the course; or
(c)	in any other case — the date on which the member or his dependant received any approved medical treatment as an out-patient.

In-patient medical treatment in Government hospital or approved hospitals

4.—(1) Where a member or his dependant has received, on or after 1st August 1991, medical treatment as an in-patient from an approved medical practitioner in a Government hospital orin an approved hospital, the amount that may be withdrawn by the member for the payment of the treatment shall not exceed —

(a)

(i)	in a case not involving any surgical operation, a sum of $300 per day multiplied by the number of days he was hospitalised; or
(ii)	in a case involving one or more surgical operations, a sum of $300 per day multiplied by the number of days he was hospitalised or the actual total hospital charges, whichever is the lower, and the amount of operation fee which shall not exceed the amount as determined by the Minister for Health for such operation;

(b)

the total expenditure for the medical treatment; or

(c)

the total credit balance in the member’s medisave account,

whichever is the lowest.

(2) Notwithstanding paragraph (1), no withdrawal of any amount in excess of $50 for each day a member or his dependant is hospitalised shall be permitted under this regulation for the payment of any attendance fees of any approved medical practitioner or practitioners.

In-patient medical treatment in approved community hospitals

5.—(1) Where a member or his dependant has received, on or after 1st April 1992, medical treatment as an in-patient from an approved medical practitioner in an approved community hospital, the amount that may be withdrawn by the member for payment of the treatment shall not exceed —

(a)

(i)	in a case not involving any surgical operation, a sum of $150 per day subject to a maximum of $3,000 per year; or
(ii)	in a case involving one or more surgical operations, a sum of $150 per day multiplied by the number of days he was hospitalised or the actual total hospital charges, whichever is the lower, and the amount withdrawn for the payment of any fee which shall not exceed the amount as determined by the Minister for Health for such operation;

(b)

the total expenditure for the medical treatment; or

(c)

the total credit balance in the member’s medisave account,

whichever is the lowest.

(2) Paragraph (1) shall not apply to any form of medical treatment unless it has been approved by the Minister for Health for the purposes of these Regulations.

(3) Notwithstanding paragraph (1), no withdrawal of any amount in excess of $30 for each day a member or his dependant is hospitalised shall be permitted under this regulation for the payment of any attendance fees of any approved medical practitioner or practitioners.

Approved day hospital

6.—(1) Where a member or his dependant has received, on or after 1st July 1994, medical treatment as an in-patient from an approved medical practitioner in an approved day hospital, the amount that may be withdrawn by the member for —

(a)

the payment of attendance fees of the approved medical practitioner or practitioners shall not exceed $30 per day;

(b)

the payment of medical treatment, including attendance fees shall not exceed $150 per day; and

(c)

the payment of all such medical treatment, including attendance fees —

(i)	shall not exceed $3,000 per year; and
(ii)	shall not exceed the total credit balance in the member’s medisave account.

(2) Paragraph (1) shall not apply to any form of medical treatment unless it has been approved by the Minister for Health for the purposes of these Regulations.

(3) In this regulation, “approved day hospital” means any premises which provides for day rehabilitative assessment and treatment of patients and which is approved by the Minister for Health for the purposes of these Regulations.

Approved convalescent hospital

7.—(1) Where a member or his dependant has received, on or after 1st September 1994, medical treatment as an in-patient from an approved medical practitioner in an approved convalescent hospital, the amount that may be withdrawn by the member for —

(a)

the payment of attendance fees of the approved medical practitioner or practitioners shall not exceed $30 per day;

(b)

the payment of medical treatment, including attendance fees shall not exceed $50 per day; and

(c)

the payment of all such medical treatments, including attendance fees —

(i)	shall not exceed $3,000 per year; and
(ii)	shall not exceed the total credit balance in the member’s medisave account.

(2) Paragraph (1) shall not apply to any form of medical treatment unless it has been approved by the Minister for Health for the purposes of these Regulations.

(3) In this regulation, “approved convalescent hospital” means any premises which provides in-patient medical care for the recovery or rehabilitation of patients and which is approved by the Minister for Health for the purposes of these Regulations.

Approved hospice

8.—(1) Where a member or his dependant who is suffering from terminal illness has received, on or after 1st November 1994, medical treatment as an in-patient from an approved medical practitioner in an approved hospice, the amount that may be withdrawn by the member for —

(a)	the payment of attendance fees of the approved medical practitioner or practitioners shall not exceed $30 per day;
(b)	the payment of medical treatment, including attendance fees, shall not exceed $100 per day; and
(c)	the payment of all such medical treatment shall not exceed the total credit balance in the member’s medisave account.

(2) Paragraph (1) shall not apply to any form of medical treatment unless it has been approved by the Minister for Health for the purposes of these Regulations.

(3) In this regulation, “approved hospice” means any premises which provides for the care of terminally ill patients and which is approved by the Minister for Health for the purposes of these Regulations.

Senior Citizens Health Care Centres

9.—(1) Notwithstanding anything in these Regulations, where a member or his dependant has received, on or after 1st April 1996, any approved treatment as a day-care patient in any Senior Citizens Health Care Centre maintained by the Home Nursing Foundation, the amount that may be withdrawn by the member for the payment of such treatment, including the payment of attendance fees, shall not exceed $20 per day subject to a maximum of $1,500 per year and shall not exceed the total credit balance in the member’s medisave account.

(2) In this regulation, “approved treatment” means any form of treatment approved by the Minister for Health for the purposes of these Regulations.

Hepatitis B vaccinations received as in-patient in approved hospitals

10.—(1) Where a member or his dependant has received, on or after 1st September 1987, any vaccination against Hepatitis B as an in-patient from an approved medical practitioner of an approved hospital or of an approved community hospital, the amount that may be withdrawn by the member for the payment of the vaccination shall not exceed —

(a)	the total charges in respect of the vaccination;
(b)	the total charges that would have been incurred in respect of the vaccination if the vaccination was provided by a Government clinic; or
(c)	the total credit balance in the member’s medisave account,

whichever is the lowest.

(2) Any amount permitted to be withdrawn from a member’s medisave account under paragraph (1) shall be in addition to whatever amount that may be withdrawn under regulation 4 or 5 unless the amount that may be withdrawn under that regulation is the total credit balance in the member’s medisave account.

Surgical treatment to reverse any sexual sterilisation and for plastic surgery

11. Notwithstanding regulations 4 and 5, no withdrawal shall be permitted under these Regulations for the payment of any charges incurred in respect of —

(a)

any surgical treatment to reverse any treatment for sexual sterilisation on or after 8th June 1987 where —

(i)	the dependant is not the member’s spouse; or
(ii)	at the time such treatment was received, the member’s wife or the female member has more than 2 natural children who are alive; or

(b)

any plastic surgery which in the opinion of the Minister for Health is for cosmetic purposes.

Approved out-patient medical treatment

12.—(1) Except as provided in paragraphs (2), (3), (4) and (5), no withdrawal shall be permitted under these Regulations for the payment of any charges incurred in respect of any medical treatment afforded to a member or his dependant as an out-patient.

(2) Where a member or his dependant has received cancer chemotherapy treatment as an out-patient from an approved medical practitioner in an approved clinic on or after 1st January 1993, the amount that may be withdrawn by the member for the payment of such treatment shall not exceed such sum as is specified in the third column of the Schedule in relation to that approved medical treatment.

(3) Where a member or his dependant has received any approved medical treatment as an out-patient from an approved medical practitioner in a Government hospital or in an approved hospital on or after 1st August 1991, the amount that may be withdrawn by the member for the payment of such treatment shall not exceed such sum as is specified in the third column of the Schedule in relation to that approved medical treatment.

(3A) No withdrawal shall be permitted for the payment of any charges incurred in respect of Azidothymidine (AZT) treatment except where such treatment is for the member himself.

(4) Where a member or his dependant has received any vaccination against Hepatitis B from an approved medical practitioner —

(a)	as an out-patient in an approved clinic on or after 1st January 1988;
(b)	as an out-patient in a Government clinic on or after 1st June 1988; or
(c)	at an approved community hospital on or after 1st April 1992,

the amount that may be withdrawn by the member for the payment of the vaccination shall not exceed the amount specified in regulation 10(1).

(5) Notwithstanding anything in these Regulations, where a member or his dependant has received gamma knife treatment from an approved medical practitioner at the Singapore Gamma Knife Centre on or after 27th November 1995, the amount that may be withdrawn by the member for the payment of such treatment shall not exceed $150 per day for hospital charges, and $7,500 per treatment or the total credit balance in the member’s medisave account, whichever is the lower.

(6) In this regulation, “Singapore Gamma Knife Centre” means any premises which provides gamma knife treatment for the care of in-patients and which is approved by the Minister for Health for the purposes of these Regulations.

Delivery charges

13. Except with the approval of the Minister for Health, no withdrawal shall be made under these Regulations for the payment of any charges incurred by a female member or female dependant in respect of her confinement for the delivery of a child by an approved medical practitioner in a Government hospital or an approved hospital if at the time of such confinement the female member or dependant has 3 or more children.

Overseas treatment

14. Where a member or his dependant has received medical treatment in a hospital outside Singapore, the Minister for Health may, in his discretion, approve the withdrawal of such amount as the Minister may determine for payment of charges incurred in respect of such treatment and subject to such conditions as he may impose.

Treatment for infertility

15.—(1) Subject to this regulation, where a female member of the Fund or spouse of a male member of the Fund has received medical treatment for conception from an approved medical practitioner commencing on or after 1st November 1988 as an in-patient or out-patient from a Government hospitalor an approved hospital the amount that may be withdrawn by the member to pay for such treatment shall not exceed —

(a)	a sum of $2,000 per treatment cycle; or
(b)	the total credit balance in the member’s medisave account,

whichever is the lower.

(2) Medical investigations on the cause of infertility shall not be considered as part of a treatment cycle for the purpose of this regulation.

(3) No withdrawal shall be made under this regulation for the payment of charges incurred for more than 3 cycles of medical treatment for conception in respect of each patient.

(4) Where a cycle of medical treatment for conception has been discontinued and there is a refund of charges to a member, there shall become due and payable to the medisave account of the member, on the date the refund is received by the member, the total amount withdrawn from the member’s medisave account under this regulation or the total amount of refund received, whichever is the lower.

(5) Where a cycle of medical treatment for conception has been discontinued and the sum withdrawn from the member’s medisave account for the treatment has been repaid to the account in full, the discontinued treatment shall not be counted as a cycle of medical treatment for conception for the purpose of paragraph (3).

Renal dialysis treatment

16.—(1) Notwithstanding anything in these Regulations, where a member has received, on or after 1st July 1989, renal dialysis treatment, the amount that may be withdrawn by him from his medisave account for the payment of such treatment shall not exceed —

(a)	in the case of haemodialysis at any approved centre, a sum of $400 per month;
(b)	in the case of continuous ambulatory peritoneal dialysis, a sum of $400 per month for payment of the purchase of any approved consumables;
(c)	in the case of haemodialysis received at the member’s home, a sum of $400 per month for payment of the purchase of any approved consumables;
(d)	in the case of renal dialysis treatment received by the member as an in-patient in an approved centre, approved hospital or Government hospital, the sum permitted to be withdrawn under regulation 4;
(e)	the total expenditure for the renal dialysis treatment or for payment of the purchase of any approved consumables; or
(f)	the total credit balance in the member’s medisave account,

whichever is the lowest.

(2) Notwithstanding paragraph (1), no withdrawal of any amount shall be permitted under this regulation for the payment of any of the following:

(a)	any consultation fee incurred by the member;
(b)	the purchase of an ultra violet machine for sterilisation;
(c)	the purchase of a dialysis machine; or
(d)	the purchase of any other related equipment.

(3) For the purpose of this regulation, “approved consumables” means any of the following:

(a)	continuous ambulatory peritoneal dialysis bag;
(b)	connecting bag;
(c)	dialyser;
(d)	arterio venous blood line;
(e)	arterio venous fistula needle;
(f)	dialysate;
(g)	intervenous infusion set;
(h)	normal saline or bicarbonate solution or biofiltrate; and
(i)	any other item which is approved by the Minister for Health for the purpose of this regulation.

(4) All moneys authorised to be withdrawn by the Board under this regulation shall be paid by the Board direct to the approved centre, approved hospital or Government hospital from which the claim for payment is made.

Psychiatric treatment

17. Notwithstanding anything in these Regulations, where a member or his dependant has on or after 1st January 1992 received any psychiatric treatment as an in-patient from an approved medical practitioner in a Government hospital, in an approved hospital or in Adam Road Hospital, the amount that may be withdrawn by the member from his medisave account for the payment of such treatment for himself or his dependant shall not exceed $150 per day and shall also not exceed $3,000 per year.

Eye treatment

18.—(1) Notwithstanding any other regulations in these Regulations where a member or his dependant has on or after 15th November 1990 received any eye treatment in the Singapore National Eye Centre, the amount that may be withdrawn by the member for the payment of the treatment shall not exceed —

(a)	in a case involving one or more surgical operations, the hospital charges for one day up to a maximum of $300 and the amount of the operation fee which shall not exceed the amount determined by the Minister for Health for such operation;
(b)	the total expenditure for the eye treatment; or
(c)	the total credit balance in the member’s medisave account,

whichever is the lowest.

Day surgical treatment

19.—(1) Notwithstanding anything in these Regulations, where a member or his dependant has, on or after 1st October 1994, received medical treatment and undergone any day surgical treatment from an approved medical practitioner in an approved hospital, Singapore National Eye Centreor the National Dental Centre , the amount that may be withdrawn by the member for —

(a)

the payment of attendance fees of the approved medical practitioner or practitioners shall not exceed $30 per day;

(b)

the payment of hospital charges, including attendance fees, shall not exceed $150 per day;

(c)

the payment of operation fees shall not exceed the amount determined by the Minister for Health for the operation or operations; and

(d)

the payment of medical treatment —

(i)	shall not exceed the total expenditure for the medical treatment; and
(ii)	shall not exceed the total credit balance in the member’s medisave account.

(2) In this regulation, “day surgical treatment” means any surgical treatment received by a person who is admitted and discharged on the same day.

Authorisation of withdrawal from future contributions

20.—(1) Where a member or his dependant has received —

(a)	any medical or psychiatric treatment as an in-patient in a Class C or B2 ward of a Government hospital or in a ward of an approved hospital or an approved community hospital which is equivalent to a Class C or B2 ward of a Government hospital and which the Government makes an annual grant in aid of recurrent expenditure incurred or to be incurred in operating or maintaining the ward; or
(b)	eye treatment at subsidised rates in the Singapore National Eye Centre,

and the amount standing to the credit of the member in his medisave account is insufficient to pay for the charges incurred in respect of the medical or eye treatment, the Board may, with the approval of the Minister for Health, subject to such terms and conditions as the Board may impose, authorise the member to withdraw his future contributions to his medisave account to pay the outstanding balance.

(2) Paragraph (1) shall not apply to any surgical treatment to reverse any treatment for sexual sterilisation or any medical treatment for conception.

Obligation by other person to reimburse member

21. Where another person is under an obligation, contractual or otherwise, to pay or reimburse a member for charges incurred in respect of medical, psychiatric or eye treatment afforded to the member or his dependant, there shall become due and payable to the Fund on the date the member receives such payment or reimbursement from that person, the total sum withdrawn from the member’s medisave account under these Regulations for the payment of charges so incurred or the balance sum ascertained by the formula A + B - C, whichever is the lower —

where

A is the total sum received by the member from that other person as payment or reimbursement;

B is the total amount withdrawn from the member’s medisave account under these Regulations for the payment of the charges incurred in respect of the medical, psychiatric or eye treatment; and

C is the total sum of the charges incurred in respect of the medical, psychiatric or eye treatment.

Medical treatment provided to person other than dependant

22.—(1) The Minister for Health may, in his discretion and subject to such terms and conditions as he may impose, authorise a member to withdraw the whole or part of the amount standing to his credit in his medisave account for the payment of charges incurred in respect of medical treatment provided by an approved medical practitioner in a Government hospital or in an approved hospital or eye treatment provided by an approved medical practitioner in the Singapore National Eye Centre to a person other than a member’s dependant as if the person were the member’s dependant.

(2) Where the Minister authorises a withdrawal under paragraph (1), the person referred to in that paragraph shall for the purposes of these Regulations be deemed to be the dependant of such member.

Direct payment to hospitals, etc.

23. All moneys authorised to be withdrawn by the Board under these Regulations shall be paid by the Board direct to the Government hospital, the approved hospital, Singapore National Eye Centre, Adam Road Hospital, the approved community hospital, the approved centre, the approved clinic or the Government clinic from which the member or his dependant received medical, psychiatric or eye treatment.

Validation

24.—(1) All withdrawals from a member’s medisave account made prior to 16th September 1988 for the payment of charges in respect of —

(a)	any vaccinations against Hepatitis B afforded to the member or his dependant before that date and as an in-patient of an approved hospital;
(b)	any approved medical treatment afforded to the member or his dependant before that date and as an out-patient of a Government hospital or an approved hospital; or
(c)	any vaccinations against Hepatitis B afforded to the member or his dependant before that date and as an out-patient of an approved clinic or a Government clinic,

shall be deemed to have been made lawfully under regulation 10 or 12 (whichever is applicable) as if those regulations were then in force.

(2) Regulation 4(2) shall be deemed to apply to all withdrawals from a member’s medisave account which were made between 1st May 1987 and 16th September 1988 for the payment of medical treatment afforded to the member or his dependant as an in-patient in an approved hospital.

Revocation of approval of medical practitioner

25. Notwithstanding anything in these Regulations, where the approval of a medical practitioner is revoked at such time when a member or his dependant is receiving medical treatment from the practitioner as an in-patient in a Government hospital oran approved hospital, the member or his dependent may continue to withdraw from the medisave account for payment of any treatment authorised under these Regulations by the medical practitioner for the period of such hospitalisation as if the approval had not been revoked.

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