[MinMin]

Problem of 'consumables' in medical insurance claim

I REFER to the letter by Ms Cheam Teo Seng, 'Medical insurance' (Oct 10), and AIA's reply, 'Her insurance plan was meant to cover government hospitals' (Oct 24).

I had the same problem with my MediShield claim as Ms Cheam. My mother had surgery in March and spent one night in a B2 class ward. Although her MediShield plan was for the designated class B ward, the insurer paid only $300 while she paid $2,700 (that is, she bore 90 per cent of her bill). We had expected the MediShield plan to cover at least 50 per cent of a hospital bill after deductibles and co-payment, so we were appalled as she had paid annual premiums of about $1,000.

The problem is the definition of the term 'consumable'. 'Hospital medical consumable' charges include consumables incurred during surgery (about 50 per cent of the bill). Yet the insurer does not consider this item under the MediShield plan benefit - 'approved medical consumable', which has a higher claim limit - but classifies it under the room benefit, which has a lower claim limit.

Thus, the insured will always be in a disadvantaged position because the 'consumable' in the hospital charges is normally quite high but not really covered by MediShield - unless the patient stays longer in hospital to get more room benefit to cover this consumable item.

We felt the hospital, insurer and Ministry of Health should look into this discrepancy as this was not clearly spelt out and would not be expected by those who signed up for the MediShield plan.

Rachel Lee (Miss)

Problem of consumables in medical insurance claim

[Bonn]

I guess the authorities really need to review this issue and also clarify on 'consumables' used in the surgery room and what is used in the ward. Can't mix both together since its for different purpose. That will make claims more transparent and clear to everyone.