Singapore:Proposal for long-term care insurance plan to be made mandatory

The government-backed ElderShield, a severe disability insurance scheme which provides basic financial protection to those who need long-term care, should be made compulsory, according to the ElderShield review committee.

In an interim update released yesterday, the committee made the following key recommendations:

• ElderShield to be a universal and inclusive scheme for future cohorts
• Inclusion age to be lowered to 30 to ensure more affordable premiums
• ElderShield should be administered by the government as a key pillar of the social safety net
• The ElderShield claims process should be made more accessible and convenient for policyholders and their caregivers.

The panel said that in carrying out the review, it heard a wide representation of views from over 800 Singaporeans, across 26 focus group discussions. These include long-term care service providers, financial advisors, academics, industry professionals, community partners such as unions and self-help groups, and youths. Public feedback, suggestions submitted to the ElderShield website’s online feedback form and email recommendations have also been taken into consideration. The full set of recommendations is expected to be finalised by the middle of this year.

The committee, appointed in 2016 by the Ministry of Health, recommended that people join the scheme at age 30 rather than 40 (as is the case at present) and suggested that the government, rather than private insurance providers, should be the single administrator. It also called for the claims process to be simplified.

The update said: “With a rapidly ageing population and shrinking family sizes, there is a need to plan ahead for our future long-term care needs. The demand for long-term care is set to increase. About one in two Singaporeans who is healthy at the age of 65 is at risk of having a severe disability over their lifetime.”

It added: “Universal ElderShield coverage for future cohorts is aligned with our principle of collective responsibility and supports our aim to be a caring and inclusive society.

“With universal coverage, Singaporeans in future cohorts with pre-existing severe disabilities would be included in the enhanced ElderShield scheme. This supports our aim to be a caring and inclusive society, and the low prevalence of severe disability at younger ages means that this can be achieved without significant impact on premiums.”

The panel recommended that the government provide premium support for low-income Singaporeans and those in financial difficulties, so that no Singaporean will lose ElderShield coverage due to financial difficulties.

Currently, ElderShield is administered by three private insurers on behalf of the Health Ministry. Singaporeans are auto-enrolled onto ElderShield at age 40 and are randomly assigned to one of the three private insurers—Aviva, Great Eastern or NTUC Income—and allowed to switch insurers at the point of enrolment.

Money is paid out when people cannot perform three of the six “activities of daily living”, which are: washing oneself in the bath or shower; wearing and unfastening all garments and putting on braces, artificial limbs or medical devices where required; to eat and drink without help; use the toilet to relieve themselves and manage the use of any protective undergarments or surgical appliances; move from room to room on level surfaces; and to transfer oneself from a bed to a chair or wheelchair, and vice versa.