What is An Integrated Shield Plan (IP) Rider & Why Do You Need One?

¹ Panel or preferred partner means a registered medical practitioner, specialist, hospital or medical institution approved by us.

Our list of approved panels also includes all restructured hospitals, community hospitals and voluntary welfare organisations (VWO) dialysis centres.

Extended panel means a registered medical practitioner or specialist approved by us to provide cover for the benefits under this rider. The registered medical practitioner or specialist must not also be on our lists of approved panels or preferred partners and must meet other criteria, including being on another Integrated Shield Plan provider’s panel list.

The list of our approved panels, preferred partners, and extended panel can be found at income.com.sg/specialist-panel. We may update this list from time to time.

² This benefit covers the main outpatient hospital treatment received by the insured from a hospital or a licensed medical centre or clinic. For cancer drug treatment, only cancer drug treatments listed on the Cancer Drug List (CDL) and used according to the indications for the cancer drugs, as specified in the CDL on Ministry of Health (MOH) website (go.gov.sg/moh-cancerdruglist) will be covered. For each primary cancer, if the cancer drug treatment on the CDL involves more than one drug, we allow a particular drug to be removed from the treatment or replaced with another drug on the CDL that has the indication ‘for cancer treatment’, only if this is due to intolerance or contraindications (for example, allergic reactions). In such cases, the claim limit of the original cancer drug treatment on the CDL will apply.

For each primary cancer, if more than one cancer drug treatment is administered in a month, the following will apply.

• If any of the cancer drug treatments that are on the CDL has an indication that states ‘monotherapy’, only the treatments on the CDL that have the indication ‘for cancer treatment’ will be covered in that month.
• If none of the cancer drug treatments that are on the CDL has an indication that states ‘monotherapy’:
• if more than one of the cancer drug treatments administered in a month hasan indication other than ‘for cancer treatment’, only cancer drug treatments that are on the CDL and have the indication ‘for cancer treatment’ will be covered in that month; and
• if one or none of the cancer drug treatments administered in a month has an indication other than ‘for cancer treatment’, all cancer drug treatments that are on the CDL will be covered in that month.

Cancer drug treatments not on the CDL will be considered as having an indication other than ‘for cancer treatment’.

For insured receiving treatment for one primary cancer, we will pay up to the highest limit among the covered cancer drug treatments on the CDL that are administered in that month.

The cancer drug treatment on the CDL benefit limit is based on a multiple of the MSHL Limit for the specific cancer drug treatment. For the latest MSHL Limit, refer to the CDL on MOH’s website under “MediShield Life Claim Limit per month” (go.gov.sg/moh-cancerdruglist). MOH may update this from time to time. The revised list will be applicable to the cancer drug treatment which occurred on and from the effective date of the revised list.

You do not have to pay a deductible for outpatient hospital treatment benefit.

³ For outpatient cancer drug treatments not on the CDL, we cover only treatments with drug classes A to E (according to the Life Insurance Association, Singapore’s (LIA’s) Non-CDL Classification Framework). Refer to https://www.lia.org.sg/media/3553/non-cdl-classification-framework.pdf for more details. LIA may update the list from time to time.

⁴ Cell, tissue and gene therapy benefit pays for all reasonable expenses for inpatient hospital treatment (including day surgery) and outpatient hospital treatment for cell, tissue and gene therapy (CTGTP) not on MOH’s CTGTP list (go.gov.sg/ctgtp-list) provided to the insured, up to the limits shown in the policy conditions, as long as the cell, tissue and gene therapy is approved by the Health Sciences Authority (HSA). When we pay the cell, tissue and gene therapy benefit under this rider, we add together all reasonable expenses for the cell, tissue and gene therapy treatment (including inpatient hospital treatment and outpatient hospital treatment), and pay up to the limits shown in the policy conditions.

You may make a claim under this benefit as long as you have not fully used the benefit payable up to the benefit limit in the policy conditions. We will pay the claim amount based on the following:

- If the claim amount after applying the co-payment is higher than the remaining benefit payable under this rider, we will pay up to the remaining benefit limit.

- If the claim amount after applying the co-payment is lower than the remaining benefit payable under this rider, you will have to make a co-payment of the benefits due under your policy as shown in the policy conditions and we will only pay the amount of your claim which is more than the co-payment.

⁵ Pre-hospitalisation and post-hospitalisation benefit is only applicable if your plan is either the Enhanced IncomeShield Preferred plan or the Enhanced IncomeShield Advantage plan. This benefit applies on top of the pre-hospitalisation treatment benefit and post-hospitalisation treatment benefit covered under your Enhanced IncomeShield Preferred plan or Enhanced IncomeShield Advantage plan (where applicable), up to the limits shown in the policy conditions. Please refer to the policy conditions for further details.

⁶ Applicable only when you add the Optima Care rider to your Enhanced Preferred or Enhanced Advantage plan.

⁷ Autism testing benefit is only payable for insured up to age 18 (next birthday) for the relevant plan. This benefit is payable if the insured undergoes an autism test, on a reimbursement basis, up to the limits for the relevant plan shown in the policy conditions. There must be a referral from a paediatrician for the autism test. This benefit is only payable once in the lifetime of your policy. You will have to make a 10% co-payment for each claim for this benefit due under your policy. Please refer to the policy conditions for further details on the co-payment limit.

⁸ Critical care benefit is only payable for insured up to age 18 (next birthday) for the relevant plan. If the insured requires a stay in an intensive care unit (ICU) or high dependency unit (HDU) for a total of 4 days or more in one hospital admission, we will pay the benefit as shown in the policy conditions. The stay in the ICU or HDU must be confirmed as necessary medical treatment. We will not consider a stay in ICU or HDU as necessary medical treatment if the insured can be safely and adequately treated in any other facility. This benefit is not payable for the following:

- the insured suffered symptoms of, had investigations for, or was diagnosed with illness any time before or within 90 days from the start date of this rider (except for accidents).

- claims for overseas treatment, including emergency overseas treatment.

This benefit is only payable once in the lifetime of your policy. Co-payment is not applicable for this benefit.

⁹ If, during the insured’s stay in hospital, their parent or guardian stays in the same room as the insured, we will reimburse up to $80 for each day the parent or guardian stays. We will only pay for the stay of one parent or guardian. This applies if the insured is a child aged 18 or younger during their stay in hospital. We will pay up to 10 days for each stay in hospital. If the insured is in hospital for only part of a day, we will pay half of this benefit for that day. Co-payment is not applicable for this benefit.