Health Insurance and Healthcare in Singapore Explained

How Healthcare Works in Singapore?

Singapore has one of the best healthcare systems in the world.  Expats can enjoy access to world-class specialist medical staff and excellent healthcare facilities. To do so, however, non-residents need to be prepared to do their research and invest in decent medical insurance.

Singapore Healthcare Facts

• 100% of the population has access to healthcare.
• By 2018 there were over 6,200 health-related clinics in Singapore, 57% of which were Western.
• In 2019, the country was ranked as the 6th  best healthcare  system  in the world.
• The country has over 270 licensed pharmacies available.
• Singaporean  citizens  have the world’s  5th longest life expectancy: over  84 years  old.

Key Terms:

You should make note of these key terms to easily navigate the Singapore healthcare system.

• Central Provident Fund (CPF): A mandatory social security savings scheme that Singapore permanent resident employees contribute to.
• Medisave: A compulsory savings account created specifically for healthcare; part of your monthly CPF payments are placed into this account.
• Polyclinic: A “super-clinic” that has many different doctors practicing in one building or network, providing check-ups, x-rays and so on, as well as some out-patient services.
• Ward A/B/C: Singapore hospitals have three types of wards, called “A,” “B,” and “C.” The cheapest are standard class C wards, with nine beds. The most expensive are class A wards, which are single bed  en-suite rooms.

Does Singapore Have Free Public Healthcare?

In a word: no.  The system is similar to how Medicare works in the US.

Singapore had a free healthcare system until the 1970s, when the government realized the country faced an aging population. Since then,  citizens and permanent residents  have  supported the system via their monthly Medisave contributions, taken automatically from their wages as part of their CPF contributions.

What Are Medisave Contributions?

Employees generally pay 9% of their monthly wage towards Medisave. Unlike with Medicare, Medisave payments come directly out of your paycheck before you receive it.

The money is saved specifically for hospitalization and outpatient costs and automatically pays for a basic health insurance plan.  This is to make sure that if you fall ill, most of your costs are already paid for.

Healthcare Contributions

1. Medisave: These are compulsory contributions. You will use this account to pay for most routine medical assistance and operations.
2. Medishield: You are automatically opted in for this insurance. It is used to cover more expensive procedures.
3. Medifund: This is voluntary and by application only. It is for people without enough funds to pay for their medical care, or without insurance.

What Does Public Healthcare Cover?

Medisave contributions are paid by the employee (from their wages) and by employers (in addition to employee wages). These monthly payments ensure  Singapore’s government can support the medical system. They help to keep public  hospitals open and staffed by doctors and nurses  employed by the state.

Your Medisave contributions are also put towards a basic healthcare insurance package. Permanent residents who contribute to the CPF find this means most of their bills from public hospital are subsidized by the government, drastically reducing the price paid for care. For example, staying for a day in a public hospital Ward C will cost you an average of up to 320 SGD (230 USD). A day in a private hospital can cost an average of up to 2,550 SGD (1,835 USD).

A huge range of physical and mental health services are available under Singapore public healthcare.  This includes dental treatments, surgeries, and  cancer treatment.  Medisave savings can also be used to cover costs if your dependents are hospitalized.

How Does Healthcare Work in Singapore?

If you fall ill in Singapore and it is not an emergency, your first stop will be at a local doctor (general practitioner or GP) clinic. The city-state has a range of  GP clinics  and  public hospitals to choose from. For most issues including immunization, outpatient care, follow-up checks, and health screening, you can head to a polyclinic.

The government offers subsidized care at these medical institutions if you are a permanent resident paying into the CPF.  Whether you are a resident or not, expats  do  not need to register for a specific healthcare facility as on-site registration is quick and straightforward. Once you have filled in the relevant form on your first visit, your details should be stored digitally for future convenience.

Referrals

A local GP can provide referrals for specialist healthcare, or expats can research their treatment independently. This is often recommended, to ensure that you find the right specialist to match your needs. For example, you can search for a specialist with an ability to communicate in your native language.

Emergency Care

The emergency number for an ambulance in Singapore is 995. There are emergency rooms (Accident and Emergency or A&E Departments) across the city, though they often have longer wait times.

Prescriptions

If you take medicine on a repeat prescription, you  should note that international prescriptions are not accepted in Singapore. You will have to visit a doctor and get a Singapore prescription for your medication. If it is covered by private healthcare, it is important that you get this organized as soon as possible.

Singapore Healthcare Costs

Healthcare costs in Singapore can seem staggeringly high to expats, especially for those who are not permanent residents. The pricing difference is huge between public and private hospitals: appendix surgery in Mount Alvernia private hospital might set you back over 17,000 SGD (12,200 USD) whilst the same surgery and a stay on a B ward in Changi General Hospital might cost around 4,500 SGD (3,200 USD).

If you are a permanent resident paying into the CPF, most of your healthcare costs should be covered already. The government will subsidize treatments at public hospitals and expensive extras and surgeries are covered by your Medishield insurance.

However, people who require extensive healthcare treatment or specialists might not be so pleased;  public insurers only  pay out for government approved treatments, drugs, and specialists. Costs can escalate quickly  if you choose to go outside of the government  mandated  options. If this is your preference,  it is better to have private medical insurance.

Costs for Non-Residents

Non-resident expats do not contribute to the CPF and therefore do not receive government subsidies. Without the subsidies, the public healthcare costs can rise to levels similar to private healthcare.  As such, expats  should invest in  international private healthcare  insurance to make sure they are not hit with a hefty bill. You can read more about this in private healthcare overview below.

Why is Singapore Healthcare so Expensive?

For people from countries like the US, the healthcare in Singapore might not seem so expensive. There has been an increase in medical tourism to Singapore from the US, with a heart bypass that would cost 140,000 USD costing around 25,000 USD in Singapore.

What’s more, the healthcare system (both public and private) has highly trained doctors and high-tech equipment, meaning expats are receiving high standards of care for the cost. If you are a permanent resident, your CPF contributions, government subsidies, and auto-enrolment into insurance can greatly reduce your hospital bill.

For people from countries with subsidized healthcare, or non-resident expats in Singapore who do not qualify for reduced bills, these costs can seem astronomical.

As public hospitals can often cost the same as private hospitals without Medisave and subsidies, non-resident expats will often use private hospitals. Private hospitals and doctors set their own costs, meaning  surgery in a private hospital can  cost  even ten times the price  of surgery  for subsidized Singapore citizens in a  public hospital.  This requires non-resident expats to have private health insurance, or to make upfront payments if they become ill.

Singapore Healthcare System Pros and Cons

Pros

Thanks to government subsidies, Singapore’s healthcare system is clearly a lot cheaper for permanent residents or citizens versus non-residents.

For one, Singapore is considered to have one of the best medical systems in the world. Western medicine is more widely practiced, but hundreds of non-Western clinics are also available around the country. Wait times are also very short, particularly at some private clinics where it is possible to walk-in and be seen immediately.

Cons

Perhaps the biggest complaint held with Singaporean healthcare is that everyone still has to pay for their care, even if they are covered by Medisave. This means extra payments towards health insurance are necessary. Residents who do not earn enough to contribute towards Medisave also have the potential to fall between the cracks of the system, although they can apply to the government for financial assistance with medical costs.

An Overview of Private Health Insurance

Now we have covered public healthcare, it is time to ask: how does private health insurance work in Singapore?

Expats who are not permanent residents of Singapore do not contribute to the  Central Providence Fund (CPF)  and therefore do not have access to the government’s  basic healthcare  insurance. This access is the key difference to be aware of between private and public health insurance in Singapore.

But do you need private healthcare insurance instead? For almost everyone, the answer is yes.

Do You Need Health Insurance in Singapore?

Most employers in Singapore include a basic private healthcare package as a perk. Some will even cover medical and dental check-up expenses.  The bigger the company, the more coverage employees are likely to have.

However, it  is not compulsory  for businesses to provide medical insurance for anyone other manual laborers and foreign domestic help.  Employees should check carefully to see if healthcare is included in their contract.

Extra Healthcare Coverage

With Singapore healthcare being costly, it is important that non-resident expats have private healthcare insurance  outside of any basic insurance provided by their employer.  This  is not just for health reasons, though you should always feel able to access healthcare. Extra cover will provide for you in case any unexpected healthcare issues create large expenses, without  affecting your personal  savings.

Even if your employer provides you with a basic form of private health insurance, you might need to look at buying additional private cover.

Some things that might not be included in your plan are:

• critical illness cover;
• dental care;
• vision care;
• cover for any dependents;
• maternity care.

Maternity care can be costly in  Singapore and  is unlikely to be covered by your employer-provided insurance, unless you work for a large company. For more information, please see the Working section of our guide.

Health Insurance for Self-Employed Workers

You must be a resident of Singapore to become self-employed. As residents, it is mandatory that self-employed people contribute to the CPF. They can choose to purchase private healthcare on top of their government benefits.

How Does  Health Insurance Work  in Singapore?

If  you are  an expat without access to a Medisave account, there is no need to worry. Buying private health insurance means you can get access to the same system as a Singapore resident, though often with fewer benefits.

Having private health insurance in Singapore means you have automatic access to the private hospitals and specialists in the area.  In this way, not receiving government subsidies is often seen as a blessing in disguise; the healthcare that many expats would choose is private, thanks to the shorter wait times and above average standard of care.

Buying Health Insurance

Obtaining health insurance is a similar process worldwide. As an expat, the considerations are greater than for locals whose insurance plans are government mandated. You should take the time to fully research your plan type, its coverage, and if it specifically suits your lifestyle.

Private Health Insurance in Singapore

Expats have multiple options for health insurance in Singapore. You can choose between  local insurers, Singapore-based international insurers, or insurers from outside of the nation.

Five of the largest private health insurance providers in Singapore are:

• AIA
• Aviva
• AXA
• NTUC Income
• Great Eastern Life

It is generally easiest to find an insurer who is based in Singapore. Above all else, the insurer will understand the intricacies of the Singapore healthcare system well. You will also be on the same time zone as them and in the same city, making it more convenient for claims.

Types of Health Insurance Plans

While expats with valid visas can access the plans available for local Singapore residents, the best plan for foreigners in Singapore is likely to be an international health insurance plan.

These  plans are popular as they  are  tailored for  people  who live abroad  and therefore offer  greater benefits than local Singapore plans.  For instance, international plans often cover outpatient treatment and visits to GPs. Local plans usually only cover you if you are hospitalized.  Local plans will also usually ask that you pay the hospital out of pocket before being reimbursed for your claim.

Health Insurance and Business Travel

People who travel often for work should  consider  insurance that is  more comprehensive. Some insurers offer  plans that pay out in multiple currencies  or insure you in specific areas of the world. For instance, if most of your business is done within ASEAN countries you can search for insurance that only covers these territories.

Integrated Shield Plans

If you are planning to stay long-term in Singapore, you should be aware that it is relatively simple to buy additional health insurance once you start paying into the CPF.  An Integrated Shield Plan effectively upgrades  the automatic  Medishield  coverage  and can cost as little as 70 SGD (50 USD) extra per month.

All the main Singapore insurance providers offer an Integrated Shield plan. You  can narrow the list down by deciding which  type of ward you would want to  stay in while hospitalized.

Average Cost of Health Insurance in Singapore

In one of the most expensive cities in the world, an important question is always how much is health insurance?

On average, a 45-year-old expat living and working in Singapore will pay 3,200 SGD (2,300  USD) per year for a health insurance plan. A 25-year-old will usually pay 40% less, and  premiums  begin to  skyrocket after the age of 65. A 75-year-old, for instance, might pay over 200,000 SGD (145,000  USD) per year for a health insurance plan.

As with all medical insurance, the cost  of your plan  will vary based on the  type of insurance you chose, the  provider,  your  previous medical history, and  your  lifestyle.  Worldwide plans that exclude the United States are also  on average  75% cheaper than plans with the US included.

Ultimately,  it  is worth shopping around  for insurance  that is tailored to your lifestyle.

How to Find a Doctor or Dentist

When it comes to figuring out how to find a doctor or dentist, expats in Singapore have no need to worry. There are plenty of options to choose from, with over 1,500 GP clinics  available and usually open between 09:00-17:00 Monday through Friday. There are also over 2,200 dentists in Singapore.

All doctors will speak  and write in  English. Most will also speak  in another one of the  official languages, such as Mandarin.

How to Find a Family Doctor

One important aspect of expat life that often is not considered in advance is finding a reliable family doctor. Having a doctor in place before you show any signs of illness will make your life simpler because researching and spending a day on a scavenger hunt for a practitioner is even more stressful when you are already ill.

Easy Ways to Find a Doctor in Singapore

• Ask around. Neighbors and colleagues should have recommendations, as should parents at your children’s school.
• Speak to fellow expats. Singapore-specific forums on sites like  InterNations  will usually have recent recommendations for good clinics.
• Search directories. Sites like  SingHealth  have lists of doctors, where you can even search in your neighborhood.

How to Find Specialists

There are many specialists in Singapore covering a huge range of different conditions. You should be able to contact the necessary person quickly and be seen within a week.

If you are using public hospitals that are covered with your health insurance, seeing a specialist in Singapore can involve long waiting lists. In these cases, your GP, or first point of contact, will probably recommend a specialist for you.

If you are going privately, or outside of insurance, you can choose your specialist and approach them without a referral. This is particularly true for cosmetic procedures, but also general ones. Once you know who you want to be treated by you can call the clinic directly to book an appointment.

Average Wait Times to See a Doctor in Singapore

Private clinics in Singapore have the shortest waiting times. Most accept walk-ins depending on how busy they are, and appointments are often granted within a couple of days. The longest you should have to wait is around a week.

Public hospitals have longer waiting lists, with polyclinics often having the longest wait times  in Singapore. While wait times are supposed to be no longer than a month, there have been complaints of patients at polyclinics waiting up to six months for an appointment.

 How to Find a Dentist

Dental costs can vary widely in Singapore.  The biggest differences will be seen with a public versus private clinic and how long your dentist has been practicing.  Specialists will also cost more per visit.

If you are looking for less costly options, some procedures are covered by Medisave.  Public dental treatment centers are usually cheaper but have longer waiting times. Walk-in clinics are available, as are emergency treatments.

Dental Specialists

To see a specialist dentist at a public clinic, you need a referral and you may have to wait up to six weeks. Private clinics usually have appointments available within a couple of days and often allow walk-ins.

The  National  Dental  Center  Singapore  database  lets  you  search for dentists, based on either the dental issue or the institution  they are part of. There is an option to make and manage  appointments  directly from the website.  You can also make  independent  enquiries at multiple dentists, to see which is the best fit for your needs.

Giving Birth in Singapore

Giving birth in Singapore as a non-resident is relatively straightforward. If  you have health insurance and the funds to cover your care, you should meet few logistical difficulties.  This does change, however, for people on a work permit. Unskilled or semi-skilled workers are not permitted to get pregnant or deliver a child for the duration of their permit.

Giving Birth in Singapore as a Permanent Resident

There are no restrictions on having a baby in Singapore as a foreigner if you are a permanent resident.  The birth should be registered within two weeks of the baby being born. Registration costs 18 SGD (13  USD)  and the baby will be given a Singaporean birth certificate.

Documents Needed to Register a Birth

• Notification of Live Birth (issued by the hospital/doctor/midwife);
• the identity cards and original marriage certificate of the child’s parents;
• passports and long-term pass of the child’s parents;
• disembarkation/embarkation cards of the child’s parents.

You will also need a letter of authorization from the child’s parents if you are registering a birth via proxy.

Documents must be written in English. Translations must be provided by an embassy where the document was issued or a notary public in Singapore (or country in which the document was issued).

 Giving Birth in Singapore for Non-Residents

If you are a non-resident of Singapore, you are free to give birth in the hospital of your choice. This is true of dependents and holders of employment passes. Again, the costs will be more expensive than for permanent residents as it is not subsidized by the government.  You will be expected to cover all costs through personal finances or your health insurance.

You will need to obtain a passport for your baby within six weeks of birth and apply for a valid dependent’s pass as soon as it is ready. If you do not get a passport, your baby’s Special Pass is only valid for six weeks after birth. You can extend the special pass if you need more time to organize the passport. For more details on how to do this, see the Ministry of Manpower website.

Please note that unskilled work permit holders cannot become pregnant or give birth in Singapore during the period their work permit is valid for. This is generally two years.  This  applies even  if  their Work Permit is expired, cancelled, or revoked. Exceptions are made for people who have married a Singapore citizen or permanent resident with approval from the Ministry of Manpower.

Benefits of Giving Birth in Singapore

• There is full fee transparency, with all your payments detailed.
• Hospitals are well-practiced with deliveries. KK Women’s and Children’s Hospital delivers around 30 babies a day.
• A standard stay for a normal delivery is 2 nights, and 3 nights for a cesarean section.
• You can claim up to 16 weeks maternity leave if you are a permanent resident.

Cost of Having a Baby in Singapore

The cost of giving birth will vary depending on the hospital you choose and the type of delivery you have. Public hospitals charge much lower rates than private and the difference can be as much as 1,000 SGD versus 10,000 SGD (720  USD vs  7,200  USD). These costs rise for a cesarean section.

Parents who contribute to Medisave insurance should be eligible for the Medisave maternity package  for their first four children. This covers  some  expenses related to the birth across private and public hospitals, including 900 SGD (640 USD) towards pre-delivery expenses, such as neonatal care. You can also withdraw up to 750 SGD (535 USD) from your Medisave towards a normal delivery, and 2,150 SGD (1,520 USD) towards a cesarean section.

Giving Birth in Singapore Without Health Insurance

Non-resident expats in Singapore will be expected to pay the entire bill for giving birth. With pre-natal costs of around 4,000 SGD to 8,000 SGD (2,900  USD to 5,800  USD). A normal birth with no complications will cost up to 10,000 SGD (7,200  USD).

If you or your partner are likely to give birth in Singapore as a non-resident, it is recommended that  you  buy private health insurance  with maternity coverage  to ensure  your  costs are covered.

Giving Birth in Singapore for Citizenship

It is relatively common for expecting mothers to travel to Singapore to give birth. This is particularly true for mothers from surrounding countries due to the quality of the Singapore healthcare system.

A baby born in Singapore does not have an automatic Singaporean citizenship. Only children of Singapore citizens can obtain Singapore citizenship.