More to get help to cope with disability

April 12, 2007

By Yap Su-Yin

NEW HOPE: With counselling and emotional support from the Society for the Physically Disabled's case management programme, Mr Jimmy Tan, seen here with his mother, Madam Ang, has become less demanding and is considering taking up vocational training. -- DESMOND WEE

HOUSEWIFE Ang Ah Poh, 62, was at a loss when her son Jimmy suffered a stroke at the age of 32 that impaired his movement.

Depressed and unable to cope, he refused to speak. His temper soured and his mother, his main caregiver, bore the brunt of it.

Those were tough times, recalled Madam Ang in Hokkien.

'I waited on him hand and foot after his stroke, but I'm old and it was difficult to manage,' she said.

Luckily, five months ago, the Society for the Physically Disabled (SPD) put Mr Jimmy Tan on its new specialised case management programme, which turned things around for both mother and son.

Madam Ang said: 'With counselling and emotional support, he has become less demanding and more independent and is even considering taking up vocational training in future.'

The society hopes to repeat this early success with those who need help to cope with the stress and challenge of living with disability.

Previously, there was no service providing continuous counselling, case management and early access to resources and services after discharge from hospitals, said SPD's head social worker, Ms Lim Lutin.

At present, hospital staff can link a disabled patient to services offered by different voluntary welfare organisations (VWOs), depending on his needs.

But it is done on an ad hoc basis and, since there is no follow-up, there is no way of knowing whether the patient is using these services.

'Some have told us they would not have felt so lost if someone had followed through that journey with them,' said Ms Lim. Her team has come across cases where disabled people have shut themselves away from society for years because they do not know how to get help.

'We need to be there to motivate the client to think about what to do with his life after his disability, because life has not ended yet,' said Ms Lim.

Catching them when they are 'in transit' between hospital and home is critical because this is a difficult period of adjustment, when both the patient and caregiver need plenty of support, she said.

So the SPD will put in place a system whereby hospitals or VWOs can refer such cases directly to SPD for 'holistic' help.

If necessary, SPD will link the clients - mostly adults - to other services it offers, such as therapy or vocational training.

More networking is needed though.

Currently, just Tan Tock Seng Hospital Rehabilitation Centre in Ang Mo Kio has tied up with SPD. It connects patients to SPD's 'specialised case management programme' about a week before patients who suffer physical disabilities are due for discharge.

Since last October, when the pilot programme was rolled out, the team has seen about a quarter of its annual target of 400 patients.

The pilot programme was given $300,000 in funding, to last two years, from the National Council of Social Service.

Said Madam Ang: 'For poor folk like me, unable to read English, having a social worker show me how I can help my child help himself makes me happy.'

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How to avoid being overcharged

April 5, 2007

Think doc has overcharged you? Turning to Case only recourse now

SMA decision was made with 'great reluctance'

Other professional groups relooking fee guidelines

# Before choosing a doctor, shop around if possible.

Both the Singapore Medical Association (SMA) and the Consumers Association of Singapore (Case) recommend that patients call a few clinics to get an idea of how much the market rate might be for a certain treatment.

# Check surveys of actual charges and bill sizes for an idea of what reasonable rates are.

The Health Ministry's website has information on average bill sizes for the 70 most common hospital procedures.

By the end of this year, it will also publish on its website the average bill size of treatment for chronic conditions like diabetes, high blood pressure, high cholesterol and stroke at private clinics.

Later this year, the SMA will publish results of its survey of charges in primary care clinics.

Next year, it will make public survey results for charges for more common procedures in private specialist clinics.

# Check the clinic's counter, signboards or brochures for consultation charges.

Doctors have been advised by the SMA to display them prominently.

# Whenever possible, ask your doctor beforehand for the expected range of costs for consultation, tests and treatment.

The SMA has recommended that doctors conduct financial counselling with patients

With Eldershield revamp, is that enough?

May 4, 2007

CHANGES TO ELDERSHIELD

3rd insurer bids to be provider

Aviva joins Great Eastern, NTUC Income in tender for new five-year term

By Salma Khalik, Health Correspondent

A THIRD player may enter the market to provide severe-disability insurance cover for those aged 40 and up.

Aviva has joined Great Eastern Life and NTUC Income in tendering for one or more openings as providers of ElderShield insurance plans.

The other two insurers have been ElderShield providers since its 2002 debut. Tenders for the new five-year term, which starts on Sept 30, closed last Monday.

The Ministry of Health (MOH) appoints insurers in five-year blocs, although they are required to guarantee payouts to policyholders for the rest of their life. Premiums and payouts remain unchanged during the five years, but insurers must hand out rebates if their payouts are less than projected in that time frame.

Health Minister Khaw Boon Wan said yesterday the premiums proposed by the rival companies look competitive 'at first glance'.

Current ElderShield premiums stand at about $149 a year for men and $190 for women, who join the scheme at age 40. These have turned out a little high for a current payout of $300 a month for up to five years.

Rebates are therefore on their way. The amount will be announced in August.

Unlike in ElderShield's first five years, insurers will be allowed to offer enhanced schemes in the coming five years, besides the basic plan.

From Sept 30, the basic scheme will likely pay out $400 a month for up to six years. Premiums should not rise by more than $10 a month.

Criteria for a payout remain the same. An individual has to be disabled enough to need help with any three of the following: bathing, walking, eating, going to the toilet, dressing or moving from bed to chair.

Any insurer that wants to offer add-on schemes must also offer the basic one. This is to prevent insurers from cherry-picking and offering only the enhanced schemes, where profits are likely to be higher.

It is believed all three companies have submitted plans for enhanced schemes, which may offer higher payouts, payouts over longer terms or at lower levels of disability.

MOH said yesterday the number of insurers picked will depend on the competitiveness of the bids, insurers' experience with long-term care plans and how much they are willing to put into ElderShield.

Mr Khaw added that this tender is breaking new ground, so his ministry will take its time to pick the best deal for Singaporeans.

About 750,000 people are insured under ElderShield. At the end of last year, 2,366 had made successful claims.

What happens after the Eldershield pay out ends?

To a disabled person, who can’t even manage his/her daily activities, will payouts from five to six years really matter?

If the person is permanently disabled, it is remote that this person will ever recover! Can this person work for a living?

How then is this elderly disabled person going to get funds to support themselves?

I hope this revamp will really benefit the elderly disabled.

Alternative is to have a plan should oneself be on the disabled! What are your options? Contact us on your planned health needs.

Does your company have a theft insurance?

May 18, 2007

Case File

$26K IN CASH, GEMS STOLEN IN BREAK-IN

THE office of a furnishing company at LHK Building in Sims Drive was robbed after it had been locked by staff members on Tuesday evening.

The break-in was discovered about 9am the next day when a staff member reporting for work noticed a glass window pane facing the common corridor had been forced open and left ajar.

A number of workstations had been ransacked and drawers forced open. Cash amounting to $130 was missing from a cash box. An assortment of foreign currencies totalling $6,000 and jewellery worth $20,000 were also stolen.

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Look out for add-ons to supplement ElderShield

April 23, 2007

Look out for add-ons to supplement ElderShield

They can be bought separately and may pay higher benefits over longer periods

By Salma Khalik, Health Correspondent

EXPECT a slew of insurance plans to protect the elderly against disability in their later years.

With the introduction of supplementary schemes for ElderShield that can draw on Medisave accounts for as much as $2,000 a year in premiums, insurers can afford to be creative in what they offer.

Tenders for such schemes were put up on April 2.

The anticipated new schemes will be on top of the basic ElderShield - the national severe disability scheme - which will be changed to provide people who qualify with payouts of $400 a month for up to six years.

Several insurance companies plan to offer supplementary schemes when the new five-year period for ElderShield starts in September.

They can be bought separately by anyone who already has ElderShield. Thus, someone insured by one company for basic ElderShield may buy a supplementary scheme from another insurer.

The five-year-old disability insurance, meant for the elderly who need full-time help to do simple things like going to the toilet or eating, has come in for heavy criticism over the low payouts and the need to have at least three disabilities before a claim is allowed.

While the basic scheme will likely stick with the current criteria, supplementary ones are expected to be open to creative enhancements.

According to the tender documents, they could offer higher benefits, pay over longer periods, be less strict on the definition of disability, and offer no-claim discounts too.

But the underlying principle remains - so they may not offer surrender value which allows a policy holder to collect a lump sum payment if he stops the insurance after a certain number of years.

After all, the scheme is meant to provide coverage for the rest of a person's life.

But the supplementary schemes are allowed to offer an initial lump sum payment of three months' worth of benefits, since the initial period of disability may be a greater financial drain.

They may also extend payment for up to three months after the death of the person, to help with funeral and other expenses.

Dr Lam Pin Min, a member of the Government Parliamentary Committee (GPC) for Health, said that with people living longer, 'the importance of the disability insurance scheme will be even greater'.

Allowing as much as $2,000 from Medisave to be used on premiums, he said, would encourage people to 'take up appropriately and adequately covered disability insurance schemes'.

Madam Halimah Yacob, who heads the GPC, noted that such enhancements 'will not be suitable for older Singaporeans with low savings'.

Health Minister Khaw Boon Wan has proposed that the basic scheme should also be improved, by increasing the monthly payouts from the current $300 to $400, and the period of payment should go up from five to six years.

This will mean higher premiums, even for the basic scheme. But he has pledged that this will not exceed $120 more a year. Premiums paid depend on the age at which a person joins ElderShield.

At age 40, women pay about $190 and men $150 a year. If they join at 60, women pay $845 and men $630 a year. Payment stops when they are 65 years old, but coverage will be for life.

The tender document also stated that current policy holders who want to remain on the existing plan may do so. There is also a scheme which allows people who stop after paying a minimum amount, to get a pro-rated payout starting at $100 a month, should they become disabled.

salma@sph.com.sg

Changes to improve ElderShield proposed

April 4, 2007

Among them: Higher payouts and a two-tier scheme

By Judith Tan

Proposed changes

A TWO-TIER ElderShield has been proposed by the Ministry of Health (MOH) - the basic plan, and an add-on providing for higher payouts.

The basic ElderShield scheme, in place for the past five years, will be retained for all Singaporeans to pay for long-term disability care.

The second tier, referred to by Health Minister Khaw Boon Wan as 'ElderShield Supplements', will be offered by insurers at higher premiums, payable in part by Medisave.

In addition to the proposed new tier, several other tweaks to improve ElderShield have also been suggested (see box), and MOH launched a public consultation exercise yesterday to gather feedback on the changes.

Among the main revisions: A proposal for payouts on the basic scheme to go up from $300 to $400 a month, with repayment periods extended to six years, from the current five. This will raise payouts to a maximum of $28,800, up from the present $18,000.

But Mr Khaw said yesterday that 'this big jump would require a few dollars' increase in premium'. Because of this increase, he said, there was a need to consult Singaporeans.

Proposed changes

Current ElderShield

· Payouts - $300

· Payment period - Five years

· Insurers - NTUC Income, Great Eastern Life

· Supplementary products - Not allowed

· Assessment fees - Out-of-pocket payment: $25 at clinics, $100 for house calls

Proposed ElderShield

· Payouts - $400

· Payment period - Six years

· Insurers - Open to more insurers

· Supplementary products - Allowed (subject to MOH guidelines)

· Assessment fees - Fees reimbursed to successful claimants