- Cancer Drug List and Update of PRUShield and PRUExtra Benefits
- Keeping Premiums Affordable for PRUShield base plans and premium adjustment to PRUExtra (private plan) riders
A. Cancer Drug List and Update of PRUShield and PRUExtra Benefits (Effective from 1 April 2023)
The Ministry of Health (MOH) has released new guidelines on the cancer drug treatments that can be covered by Integrated Shield Plans.
As part of efforts to reduce the cost of cancer drug treatment and keep premiums sustainable in the long-term, MOH has developed a Cancer Drug List (CDL). The CDL comprises clinically proven and more cost-effective cancer drug treatments (i.e., drugs paired with specified clinical indications, dosage form & strength, for which the drugs can be administered). It currently covers most cancer drug treatments approved by the Health Sciences Authority (HSA). MOH will update it every few months to keep up with medical advancements and the latest clinical evidence.
From 1 September 2022, only cancer drug treatments that are listed on the CDL and administered as per the CDL will be claimable from MediShield Life (MSHL) and MediSave (MSV). For Integrated Shield Plans (including PRUShield), the same change will take effect for policies renewed or purchased on or after 1 April 2023.
If a cancer drug treatment is not listed or not administered exactly as described in the CDL, it will not be claimable. However, customers with a PRUExtra rider will still receive up to S$150,000 coverage on selected cancer drug treatments not listed per the CDL.
With these changes, your policy’s Outpatient Cancer Treatment benefit will be replaced with 2 new benefits; Cancer Drug Treatment benefit and Cancer Drug Services benefit; for policies renewed or purchased on or after 1 April 2023.
- Cancer Drug Treatment benefit – Only cancer drug treatments administered as specified on the CDL will be claimable under your Policy, up to the treatment-specific claim limits. Selected outpatient cancer drug treatments beyond the CDL will be claimable under riders. If you are currently undergoing cancer treatment, please consult your doctor early on whether your treatment is on the CDL.
- Cancer Drug Services benefit – Services that are part of a cancer drug treatment (including treatments not on the CDL), such as consultations, scans, lab investigations, treatment preparation and administration, supportive care drugs and blood transfusions, will be claimable under the Cancer Drug Services benefit, up to specified claims limits.
Changes will apply to PRUShield Premier, PRUShield Plus, PRUShield Standard Plans and PRUExtra riders.
Revised Claim Limit (Updated on 31 Jan 2023)
The claim limit will be a multiple of the MediShield Life Claim Limit (denoted as x), which will vary depending on the plan you have.
Base Plan (i.e. PRUShield) Claim Limit
(Inclusive of payout from MSHL) | PRUShield Premier | PRUShield Plus | PRUShield Standard | PRUShield A | PRUShield B |
| Cancer drug treatment (monthly limit) | 5x | 5x | 3x | 3x* | 3x** |
| Cancer drug services (annual limit) | 5x | 5x | 2x | 3x* | 3x** |
* Total claims payable for both Cancer drug treatment and Cancer drug services is subject to a combined annual limit of S$42,000.
** Total claims payable for both Cancer drug treatment and Cancer drug services is subject to a combined annual limit of S$36,500.
PRUExtra Plan Claim Limit
(in addition to base plan (i.e. PRUShield) limit) | Private Plan (Premier, Premier Lite, Premier Lite Copay, Premier Copay, Preferred Copay) | Public Plan (Plus, Plus Lite, Plus Copay, Plus Lite CoPay) |
| Cancer drug treatment listed on the CDL (monthly limit) | 15x |
| Cancer drug treatment not listed on the CDL *** (annual limit) | S$150,000 |
| Cancer drug services (annual limit) | 15x |
The limits are defined as a multiple of MSHL limits available on MOH’s website https://go.gov.sg/moh-cancerdruglist, under “MediShield Life Claim Limit per month”. “5 x MSHL limits” means the insured is covered up to 5 times the MSHL limits.
*** PRUExtra riders will cover non-CDL treatments under drug classes A to E based on LIA’s Non-CDL Classification Framework, up to the annual claim limits, for cancer drug treatments not listed on the CDL. This may be updated from time to time so please refer to the FAQ below for more information. The stop loss feature of S$3,000 will not apply to non-CDL treatments.
Multiple Cancer Drug Treatments
If multiple cancer drug treatments (on the CDL) for the same primary cancer are used within a month, the maximum claim payable from a PRUShield plan that month will be up to the highest claim limit among the treatments, if they are prescribed according to the indications listed on the CDL. However, if multiple cancer drug treatments are used but not according to the indications on the CDL, Only CDL treatments will be claimable.
If multiple cancer drug treatments (on the CDL) for multiple primary cancers are used within a month, the maximum claim payable from a PRUShield plan for that month will be up to the sum of the highest claim limits among the treatments prescribed according to the indications listed on the CDL for each primary cancer.
Support for Patients Undergoing Cancer Treatment
To allow sufficient time for affected individuals to adjust to the changes, customers who made a valid inpatient or outpatient claim under their PRUShield Plan for cancer drug treatment administered between 1 January 2023 to 31 March 2023, will continue receiving their current coverage until 30 September 2023 or later:
- Customers whose policies are renewing between 1 April 2023 and 30 September 2023, will continue to receive the current coverage of their PRUShield Plan until 30 September 2023;
- Customers whose policies are renewing between 1 October 2023 to 31 March 2024, will continue to receive the current coverage until their policy renewal date.
Thereafter, these customers will not be able to make a claim on their PRUShield Plan for any treatments not on the CDL, and their claims for CDL treatments will be subject to the revised limits.
Customers who are undergoing treatments not listed on the CDL may wish to discuss with their doctors whether there is a suitable alternative treatment on the CDL. However, if switching to a CDL treatment is not feasible, there is support available for those facing difficulties affording treatment.
- If you are a subsidised patient, you can approach a Medical Social Worker in your public healthcare institution (PHI) for financial assistance such as MediFund.
- If you are a non-subsidised patient in a PHI or a patient in a private medical institution, you can approach your doctor to refer you to subsidised care in a PHI, where financial assistance may be available. The PHI medical team will review your treatment plan and provide financial counselling (e.g., eligibility for subsidies) before you decide whether to proceed with the transfer.
For details on:
- Multiple Cancer Drug Claims Limits and
- Support Available for Patients Undergoing Cancer Treatment
Please refer to our Frequently Asked Questions
B. Keeping Premiums Affordable for PRUShield base plans and premium adjustment to PRUExtra (private plan) riders
To better support you through these changes, we will not increase your PRUShield base plan premiums from 2 September 2022 to 31 August 2024. This does not apply to premiums of IP riders like PRUExtra rider, including riders which have existing claims-based pricing features.
Do note however, that you may still observe an increase in your premiums due to GST which will be adjusted upwards from 7% to 8% in 2023 and 9% in 2024 or if you own PRUExtra riders under Private Plan. You may also observe a premium increase if you are moving up to a higher age band.
There will be premium adjustments to PRUExtra Premier CoPay, PRUExtra Preferred CoPay, PRUExtra Premier Lite CoPay, PRUExtra Premier* and PRUExtra Premier Lite* riders.
* Withdrawn riders – only applicable for renewals.
