Use of Medisave for Terminal Illnesses and End-stage Diseases

Assoc Prof Fatimah Lateef asked the Minister for Health whether the use of Medisave for patients with confirmed terminal illnesses and end-stage diseases with significantly limited lifespan can be liberalised more for their use.

The Senior Minister of State for Health (Dr Amy Khor Lean Suan) (for the Minister for Health): Care options for patients with terminal illnesses and end-stage diseases include palliative treatment at home or in a hospice. Palliative care is subsidised and patients can tap on Medisave to pay for the remaining copayment.

MOH recently raised the Medisave limits so that patients can tap on more Medisave for palliative care needs. In January 2015, the Medisave withdrawal limit for inpatient hospices was increased from $160 per day to $200 per day. There are no daily limits for home palliative care but there is a lifetime Medisave withdrawal limit which was increased from $1,500 to $2,500. Patients can use their own or their immediate family members' Medisave.

However, if the patient passes away in the hospice, he may use all the available balance in his own Medisave account for the final inpatient hospice bill without any daily limit. Similarly, for a home palliative patient with terminal cancer or end-stage organ failure, he can also use all the available balance in his own Medisave account for the bills, and will not be subject to the lifetime limit.

Bills may be covered by government subsidies, Medisave or charity dollars from VWOs. Overall, about eight out of 10 inpatient hospice bills did not have out-of-pocket payment; while about nine in 10 home palliative care patients did not have to make out-of-pocket payment for their bills. MOH will continue to ensure that the Medisave withdrawal limits for end-of-life care remain sufficient, along with subsidy coverage to keep these services affordable.

* *Assoc Prof Fatimah Lateef (Marine Parade): Mdm Speaker, I applaud the MOH for the recent increase in the usage of Medisave for such patients. We heard that out of 10, maybe one or two of them will actually exceed the amount. Perhaps for this group, we can have further upliftment and consideration on a case-by-case basis because cost can really be quite high for some of these patients?

Dr Amy Khor Lean Suan: Indeed, there can be exceptions to such bills. For such instances, patients could approach the social worker to apply for additional assistance under Medifund or Medication Assistance Fund. Let me assure the Member that no patient will be denied the appropriate care that he or she needs due to inability to pay. When we receive appeals, for instance, for more usage of Medisave, we will consider these on a case-by-case basis, and work out the patient's healthcare needs, as well as affordability issues with the patient and the family members.