MediShield Life Scheme Act 2015

MediShield Life Scheme Act 2015 2020 REVISED EDITION This revised edition incorporates all amendments up to and including 1 December 2021 and comes into operation on 31 December 2021 An Act to provide for the MediShield Life Scheme and matters related thereto. [10 March 2015: Except sections 3 to 8, 10 to 18, 31, 32 and 35 to 38 ; 31 July 2015: Section 8 ; 1 November 2015: Sections 3 to 7, 10, 31, 32(1) and 35 to 38 ; 1 November 2016: Part 3 ; 1 April 2020: Section 32(2) ] PART 1 PRELIMINARY Short title and commencement 1. This Act is the MediShield Life Scheme Act 2015. Interpretation 2.—(1) In this Act, unless the context otherwise requires — “approved medical institution” means a medical institution that is approved under section 3A; [Act 40 of 2024 wef 01/04/2025] “approved medical treatment or services” means any medical treatment or medical services approved by the Minister for the purposes of section 3; “authorised person” — (a) for the purposes of section 27, means a person authorised by the Minister to have access to information obtained under section 27(1) for the purposes described in section 27(1)(a) or (b); and (b) for the purposes of section 28, means a person authorised by the Minister to have access to means information obtained under section 28(1) for a purpose mentioned in section 28(1A); [Act 40 of 2024 wef 01/04/2025] “Board” means the Central Provident Fund Board constituted under section 3 of the CPF Act; “Central Provident Fund” means the Central Provident Fund established under section 6 of the CPF Act; “claimable medical treatment or services”, in relation to an approved medical institution, means any approved medical treatment or services — (a) in respect of which the approved medical institution is approved under section 3A; and (b) that is provided in accordance with the conditions mentioned in section 3A; [Act 40 of 2024 wef 01/04/2025] “Council” means the MediShield Life Council established under section 8; “CPF Act” means the Central Provident Fund Act 1953; “CPF member” means a “member of the Fund” or “member” as defined in section 2(1) of the CPF Act; “defaulter” means a person liable to pay an outstanding premium; “Fund” means the MediShield Life Fund referred to in section 7, and includes the MediShield Fund; “health declaration” means a declaration, as to whether a person has any pre‑existing medical condition, submitted to the Board for the purposes of determining whether premium loading under the Scheme applies to that person; “healthcare-related public scheme” means a public scheme, prescribed for the purposes of Part 5, that is established to provide any grant, subsidy or benefit for the payment of any healthcare expenses, and includes a relevant public scheme; “household composition” means information on the identity and particulars of the persons who comprise a household for the purposes of determining whether a member of that household satisfies the eligibility criteria for a grant, subsidy or benefit under a relevant public scheme or any tier or category within such eligibility criteria; “insured person” means a person who is insured under the Scheme; “investigator” means a public officer appointed under section 20(1) or an officer of the Board appointed under section 20(2); “IRAS” means the Inland Revenue Authority of Singapore established under section 3 of the Inland Revenue Authority of Singapore Act 1992; “licensable healthcare service” has the meaning given by section 3(1) of the Healthcare Services Act 2020; [Act 40 of 2024 wef 01/04/2025] “means declaration” means a declaration, submitted to a person appointed by the Minister, for the purposes of determining a person’s household income or eligibility for a grant, subsidy or benefit under a relevant public scheme; “means information” means — (a) any documents, information, returns, assessment lists or copies of such lists relating to the income or items of income of any person to which section 6 of the Income Tax Act 1947 applies; (b) any documents, information, returns and assessments relating to the business, the value of the supply of any goods and services, or the income of any taxable person to which section 6 of the Goods and Services Tax Act 1993 applies; (c) information obtained under the Property Tax Act 1960, including the Valuation List; (d) information obtained under the Stamp Duties Act 1929; and (e) information relating to income or items of income of any person in the possession of any Government department or other public authority; “medical institution” means a provider of a licensable healthcare service that is licensed under the Healthcare Services Act 2020 to provide that licensable healthcare service; [Act 40 of 2024 wef 01/04/2025] “medisave account” means a medisave account maintained under section 13 of the CPF Act; “MediShield Fund” means the fund called the MediShield Fund referred to in section 56 of the CPF Act as in force immediately before 1 November 2015; “MediShield Scheme” means the medical insurance scheme called the MediShield Scheme referred to in section 53 of the CPF Act as in force immediately before 1 November 2015; “outstanding premium” means the amount of premium due which remains unpaid, and includes any interest imposed under section 11(1)(a) in respect of the premium and any penalty imposed under section 17 in respect of the premium; “premium” means a premium payable for insurance cover under the Scheme; “prescribed public scheme” means a public scheme prescribed for the purposes of Part 5; “public authority” means a body established or constituted by or under a public Act to perform or discharge a public function; “public scheme” means any scheme to provide financial relief, assistance or support to citizens or permanent residents of Singapore, or any part of them, that is established — (a) by or under any written law and administered by a public authority; or (b) by the Government in any other manner; “recovery body” means any statutory body prescribed as a recovery body under section 18(1); “relevant authority” means IRAS, the Commissioner of Stamp Duties, the Comptroller of Goods and Services Tax, the Comptroller of Income Tax, the Comptroller of Property Tax, the Chief Assessor, or any Government department or public authority in possession of means information; “relevant public scheme” means a public scheme to provide any grant, subsidy or benefit for the payment of a premium payable under this Act; “relevant regulations” means any regulations made under this Act; “Scheme” means the medical insurance scheme called the MediShield Life Scheme referred to in section 3. (2) A person has a pre-existing medical condition in relation to that person’s insurance cover under the Scheme (called in this subsection the relevant insurance cover), if the person has a medical condition specified by the Minister for the purposes of premium loading under this Act immediately before — (a) the date that person’s relevant insurance cover begins; or (b) if that person has continuously had relevant insurance cover since 1 November 2015, and was continuously insured under the MediShield Scheme immediately before that date, the earliest date from which that person was so continuously insured under the MediShield Scheme. (3) For the purposes of this Act — (a) “premium loading” means any additional amount payable as premium, over and above the premium payable for an insurance cover under the Scheme; and (b) the Minister is to determine the criteria for whether and when premium loading is to apply to any person. (4) For the purposes of this Act, the following apply for the purposes of reckoning the age of an individual: (a) an individual is taken to have attained a particular age expressed in years on the relevant anniversary of the individual’s birth; (b) a reference to the anniversary of the birth of an individual in paragraph (a) is a reference to the day on which the anniversary occurs; (c) where an individual was born on 29 February in any year, then in any subsequent year that is not a leap year, the anniversary of that individual’s birth is taken to be 1 March in that subsequent year; (d) if the day on which an individual was born cannot be ascertained but the month of the individual’s birth can be ascertained, the individual is taken to be born on the first day of the month in which the individual was born; (e) if the month in which an individual was born cannot be ascertained, the individual is taken to be born in January. [Act 40 of 2024 wef 01/04/2025] (5) A reference to a health declaration or a means declaration in this Act includes a reference to a health declaration or a means declaration (as the case may be) made before 1 November 2015, in anticipation of the establishment of the Scheme.