Hospitalisation insurance for families: who pays which part of the bill

For most families, hospitalisation insurance starts before you buy anything. If you're Singapore citizens or PRs, MediShield Life already covers each of you for life, and it's sized for B2 and C wards in public hospitals. An Integrated Shield Plan (IP) is the optional private layer for higher wards and private hospitals. Below is who pays which part of a bill, and what to check for each person at home.

How to sort out your family's hospital cover, step by step

1. List who in the house is already in MediShield Life. CPF says every Singapore citizen and PR is covered automatically, and a citizen baby is covered from birth once the birth is registered.
2. Log in to CPF's Healthcare dashboard with Singpass, as MOH suggests, to see whether anyone already holds an IP.
3. Pick the ward you would choose for a planned stay. CPF says MediShield Life is enough for B2 or C wards, where subsidies go up to 80%, while an IP adds A or B1 wards, private hospitals and your own doctor. Our gynae guide explains the ward classes.
4. Compare IPs on MOH's comparison page, which groups every plan by the ward it targets, from B1 to private hospital, or use CPF's Health Insurance Planner.
5. Work out how much MediSave can pay. The MediShield Life part of an IP is fully payable by MediSave, and MOH lets MediSave pay up to $300 a year towards the private part if you're 40 or under next birthday. The limit is $600 from 41 and $900 from 71.
6. Read the exclusions in the policy contract. MOH links sample policy contracts for each insurer's IPs, so look for pre-existing conditions, which the private part may leave out, and for pregnancy and maternity costs.
7. Weigh a rider against MOH's 2026 rules: new riders can't cover the minimum IP deductible, you co-pay at least 5%, and the yearly co-payment cap is at least $6,000.
8. Ask whether your doctor is on the insurer's panel before a planned stay, since MOH says using panel doctors can bring pre-authorisation and lower co-payment.
9. Agree who pays each premium, because CPF lets close family, such as a spouse or a grown-up child, pay your MediShield Life premium from their own MediSave.

How a hospital bill gets paid, layer by layer

The Government subsidy comes off first if you're in a B2 or C ward. MediShield Life pays next, within its claim limits, then MediSave within CPF's limits, then cash.

For admissions from 1 June 2026, MediShield Life pays up to $830 a day in a normal ward, plus $800 a day for the first two days. The cap is $200,000 a policy year, with no lifetime limit. Two terms set your share. The deductible is the fixed amount you pay first, once each policy year. Co-insurance is the percentage you pay on the rest of the claim: 10% on the first $5,000 (the deductible counts towards it), 5% on the next $5,000 and 3% above $10,000.

For anyone 80 or under next birthday, CPF lists a deductible of $2,000 for Class C, $2,500 for B2 or B1, and $3,500 for Class A or a private hospital.

CPF's own worked example shows the split. A citizen aged 35 spends 10 days in a C ward and has a stomach operation, with a bill of $9,850 after subsidy. MediShield Life pays $7,307.50, or 74%. The $2,000 deductible plus $542.50 of co-insurance, $2,542.50 in all, comes from MediSave or cash.

Higher wards get pro-rated first. In CPF's Class A example, a citizen aged 60 has a hip replacement with a $24,500 bill. Only $6,365 of it counts towards the claim, so MediShield Life pays $2,646.75, about 11%. The other $21,853.25 is MediSave or cash. PRs' bills are pro-rated too, because PRs get smaller subsidies.

CPF's ward sheet, based on 2023 bills with no IP payout, puts the median cash a pneumonia patient pays, after subsidies and both schemes, at $0 in a C or B2 ward, $4,000 in an A ward and $14,000 in a private ward. That gap is what an IP is built to fill. For birth costs by ward, try the delivery cost calculator.

MediShield Life and an IP, side by side

An IP has two parts, MOH says: the MediShield Life part, sized for B2 and C bills, and a private part aimed at higher wards or private hospitals. MOH adds that the two don't pay for the same thing twice.

Among IP claims that MOH lists as not paid out, 69% were at or below the deductible. Look at a plan's deductible as closely as its ward.

Riders and MOH's 2026 rules

A rider is an optional add-on to your IP that lowers the cash you co-pay when you're admitted. You pay for it in cash only, since it isn't part of the IP or MediShield Life.

MOH changed the rules for riders sold from 1 April 2026. A new rider can't cover the minimum IP deductible, which MOH sets at $1,500 to $3,500 a policy year by ward class. You still co-pay at least 5%. The minimum yearly cap on that co-payment rose from $3,000 to $6,000, and it applies to eligible claims such as panel or pre-authorised ones.

Already have a rider? MOH leaves riders bought before 27 November 2025 to each insurer. One bought from 27 November 2025 to 31 March 2026 moves to the new rules no later than your next renewal after 1 April 2028.

Pre-authorisation means the insurer tells you before a planned treatment how much it covers. A Letter of Guarantee, which MOH says all IP insurers provide, lets the hospital waive part or all of the cash deposit.

Cover for each person in your family

Your baby. MOH says every citizen baby, including those with congenital and neonatal conditions, is covered by MediShield Life for life. Babies born after 1 April 2025 get a $5,000 MediSave grant that can pay those premiums. Our newborn insurance guide covers the optional extras.

You, while pregnant. MediShield Life doesn't pay maternity charges, caesareans included. It does cover inpatient care for serious pregnancy and delivery complications on MOH's list. On IPs, MOH names pregnancy and maternity expenses as a general exclusion. For delivery bills, read our MediSave Maternity Package guide, and for private cover, our maternity insurance guide.

Grandparents. Premiums rise with age, for MediShield Life and IPs alike. CPF says an IP's private part could cost up to five times the MediShield Life premium in your 70s or 80s.

These MediShield Life premiums include 9% GST and apply from 1 April 2025. Households with a monthly income of $3,600 or less per person can get a premium subsidy of up to 60%, CPF says.

A spouse or child on a pass. MediShield Life is for citizens and PRs. MOH says family on a Long Term Visit Pass or Dependant's Pass may buy plans from IP insurers and pay in cash or from a citizen or PR relative's MediSave. They may also have an employer's medical benefits.

Your helper. Her cover runs on separate rules, set out in our helper insurance guide.

Do you need an IP? What MOH and CPF say

MOH says the choice is yours, weighed against your healthcare needs and whether you can afford the plan in the long term. CPF's IP sheet notes that 7 in 10 residents bought an IP aimed at unsubsidised wards, yet about half stayed in B2 or C wards, which MediShield Life already covers sufficiently.

For the wider money picture, see budgeting for a baby and our insurance guide for new parents.

Where to get help

• MediShield Life claims, cover and premiums: CPF's MediShield Life page, and MOH's benefits page for claim limits.
• Comparing IPs: MOH's list of plans with sample policy contracts, or CPF's Health Insurance Planner.
• Comparing life policies: compareFIRST covers term, whole life and similar plans, not IPs.
• Checking who's advising you: MAS's Financial Institution Representatives Register lets you search any representative a financial institution has appointed.
• A dispute with your insurer: go to the insurer first, then to FIDReC, which is free, within six months of the insurer's final reply.
• If an insurer fails: SDIC's Policy Owners' Protection Scheme covers life and certain general insurance policies with member insurers.
• A bill beyond your reach: MOH's MediFund helps citizens who are subsidised patients. Ask the hospital's medical social worker, and see our financial help for families guide.

Frequently asked questions

MediShield Life vs Integrated Shield Plan: what's the difference?

MediShield Life is the basic plan every citizen and PR has for life, sized for B2 and C wards. An Integrated Shield Plan wraps MediShield Life with a private part for B1, A or private hospital stays. You pay for the private part yourself, from MediSave up to a yearly limit and the rest in cash.

Do I need an Integrated Shield Plan if B2 wards are fine for us?

Per CPF, MediShield Life is sufficient if you plan to use subsidised treatment in public hospitals only. You'd want an IP for a higher ward or a private hospital, or to choose your own doctor.

What do Integrated Shield Plan riders cover after the 2026 changes?

Riders sold from 1 April 2026 lower your co-payment but can't cover the minimum IP deductible. You pay at least 5%, up to a yearly cap of at least $6,000 on eligible claims such as panel ones. You pay the rider's premium in cash, not MediSave.

Is there family hospital insurance in Singapore that covers everyone on one policy?

Hospital cover works person by person. Each of you has your own MediShield Life cover, and CPF says you can only be covered by one Integrated Shield Plan at a time. Family members can still pay each other's MediShield Life premiums from MediSave.

What hospitalisation insurance does a Singapore family need for a new baby?

MediShield Life covers a citizen baby for life from birth, congenital and neonatal conditions too. For babies born after 1 April 2025, the $5,000 MediSave grant can pay its premiums. An IP is optional, and our newborn insurance guide covers the choices.