Updates & FAQs

AIA introduced the AIA preferred providers framework as one of the measures to manage rising healthcare costs, in line with the recommendations put forth by the Health Insurance Task Force (HITF). This helps to ensure that health insurance premiums remain sustainable in the long run.

AIA HealthShield Gold Max customers will enjoy better benefits when treated by an AIA preferred provider. The differences are as follow:

 

MOH introduced the CDL to keep cancer treatments and insurance premiums affordable in the longer term. The CDL is a list of clinically proven and cost-effective cancer drug treatments (i.e drugs which are the most effective for the cost involved for specified clinical indications, dosage form and strength).

 

For more information, please refer to the FAQs on MOH's website at

https://www.moh.gov.sg/home/our-healthcare-system/medishield-life/what-is-medishield-life/what-medishield-life-benefits/cancer-drug-list.

 

You can find the CDL on MOH's website at https://go.gov.sg/moh-cancerdruglist. MOH updates the CDL every few months to keep up with medical advancements and the latest clinical evidence.

'Multiple primary cancers' refers to two or more cancers that arise from different sites of the body or are of different histology or morphology groups (that have a different microscopic structure, form or shape), as diagnosed by an oncologist.

 

Higher claim limits for patients receiving treatment for multiple primary cancers are granted on basis of an application.

 

The treating doctor would need to send the application form to MOH (for MediShield Life (MSHL) claims) and AIA (for MediSave-approved integrated shield plan claims) for review and approval.

 

Customers may be required to submit the following for our review:

 

AIA HSG Max plan provides higher coverage for multiple primary cancers, where:  

An insured is diagnosed with lung cancer and brain cancer and given the following treatment. The total benefit payable for the cancer drug treatment on the CDL and cancer drug services under the outpatient benefits are as follow:

 

 

 

 

There is no change to the limits of compensation for cancer drug treatment not on the CDL (non-CDL treatments) and co-insurance cap.

 

 

The same will apply to AIA HSG Max B Lite with AIA Max VitalHealth B Lite. 

There is no change to the limits of compensation for cancer drug treatment not on the CDL (non-CDL treatments).

 

 

Higher claim limits for patients receiving treatment for multiple primary cancers are granted on the basis of an application, which the physician needs to send to MOH for MediShield Life claims and us (for MediSave-approved integrated shield plan (IP) claims) for review and approval.  

 

Please follow the steps below for AIA assessment.

You are strongly advised to submit your application for multiple primary cancers at least 1 month before your treatment starts. Otherwise, it may lengthen the process for assessment and reimbursement.

 

We will only provide higher coverage for multiple primary cancers after we have reviewed and approved the treatment plan. Otherwise, coverage for multiple primary cancers will be based on the limits for "one primary cancer". 

There are five premium levels in the claim-based premium pricing for AIA Max VitalCare, from standard level (the lowest premium) to level 4 (the highest premium). 

 

Standard level premium (the lowest premium level of your age band) applies at the start of the policy. At each renewal, the premium level for AIA Max VitalCare will move up or down from the existing premium level, depending on any claims made during the premium evaluation period. 

 

If no claims were made during the premium evaluation period while your premium level is at standard level, you will continue to enjoy the no-claim discount on your standard level premium at your next policy renewal.

 

Find out how the different premium levels will affect you.

Claim-based premium pricing applies only to AIA Max VitalCare. AIA Max VitalCare is a rider that is only attachable to the AIA HealthShield Gold Max A plan. It is not available for new business or switching in.

For the very first renewal, the premium evaluation period is the first 10 months from the date your insurance cover started. 

 

For subsequent renewals, the premium evaluation period is the 12-month that starts on the day after the previous premium evaluation period ends. 

 

For example, if a premium evaluation period ends on 8 November 2024, the next premium evaluation period will be from 9 November 2024 to 8 November 2025.

AIA will inform you on your premium level in the yearly premium notification letter before your policy renews. You can also login to AIA+ to find out your premium level.

Yes. The standard level premium rates are not guaranteed and are expected to be adjusted from time to time to allow for our claims experience, medical inflation and general cost of medical treatments, supplies or services in Singapore.

When there were claims made for both private hospital and public hospital treatment during the same premium evaluation period, the claims will be added together to calculate the total claim amount paid. We will determine the premium level to apply at renewal based on the total claim amount for private hospital treatments.

Standard level premium (the lowest premium level of your age band) applies at the start of the policy. At each renewal, the premium level for AIA Max VitalCare will move up or down from the existing premium level, depending on any claims made during the premium evaluation period.

 

AIA will inform you on your premium level in the yearly premium notification letter before your policy renews. You can also log in to our customer portal to find out your premium level. 

 

The lock in date for AIA Max VitalCare's renewal premium level is 2 calendar months before the next policy anniversary date.

Insureds under the following plans are entitled to the early-detection screening benefit when they have reached the eligibility age on their policy anniversary:

 

Also, the rider must have been in-force for at least 2 consecutive years and we have received the premiums paid for the next policy year.

 

Please refer to Question 3 for the age criteria.

You may do so in just 4 simple steps:

 

Step 1: Find your voucher

 

Upon receiving SMS / email notification from AIA, you may retrieve your screening voucher from AIA+.

Step 2: Make an appointment

 

Make an appointment with your preferred clinic/imaging centre from our list of participating screening partners.

 

 

Step 3: Go for your screening

 

Present the following when you register at the clinic / imaging centre on the day of your screening

 

Step 4: Collect your health report

 

Collect your health check report directly from the clinic/imaging centre where you had done your health screening.

The voucher is valid for 1 year from the policy anniversary date.

The voucher is valid for 1 year from your policy anniversary date, and it cannot be extended.

 

We strongly encourage you to make an appointment with your preferred screening partners in advance to secure your preferred date and time. You may reach them via voice call, SMS, WhatsApp, and/or email as shared in the list.

 

Please refer to terms and conditions mentioned on the early detection screening voucher.

Further investigations and treatments may be covered if they fall within the benefits of your AIA HSG Max A policy, subject to applicable terms and conditions. Claims for any such expenses will be reviewed according to the terms of the policy.

The home palliative care benefit is available for insureds who have the following riders, which are attachable to AIA HealthShield Gold Max A:

 

This benefit is payable to insureds who are diagnosed with terminal illness (including cancer) and have an expected survival period of 12 months or less.

To submit a claim, you must meet the following conditions:

 

AIA HealthShield Gold Max customers can submit a pre-authorisation request for non-emergency hospital or surgical bill (including day surgery) before admission or surgery, and for outpatient cancer treatments.

We will contact you if your pre-authorisation request is declined or partially approved and provide the reasons for rejection. We will also offer alternatives and help you on your care journey.

AIA HealthShield pre-authorisation is not applicable for emergency cases admitted through the hospital's A&E department.

You do not need to apply for eLOG as the certificate of pre-authorisation also includes a waiver of deposit at hospital admission. However, the hospital will collect the deductible and co-insurance (if applicable) when you are getting discharged. We will settle the rest of your medical bill directly with the hospital.

 

Please refer to this link for more information on eLOG.

 

Please refer to the link provided here for further details.

You may submit the original final hospital bill and a copy of our settlement letter to your company insurer to claim the balance of the hospital bill not covered under the integrated shield plan.

All medically necessary medications related to the hospitalisation prescribed by the physician is claimable, subject to the terms and conditions of the policy. This does not include supplement, experimental drugs etc.

AIA HSG Max covers the majority of your medical bill. Here is an example¹:

 

John, who is covered under AIA HSG Max A, was hospitalised in a private hospital. His total bill was S$100K.

 

 

 

¹Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HSG Max covers the majority of your medical bill while AIA Max VitalHealth A covers deductibles and co-insurance, subject to 5% co-payment.

 

Here is an example¹:

 

John, who is covered under AIA HSG Max A, was hospitalised in a private hospital. His total eligible bill was S$100K. As the policy has a deductible waiver pass, John does not need to pay any deductible. With a certificate of pre-authorisation for his treatment, the co-payment payable by John will be capped at S$3,000. Hence, John will pay S$3,000 from his own pocket and the remaining bill is covered under his policies.

 

 

 

¹Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HSG Max covers the majority of your medical bill while AIA Max VitalHealth A covers deductibles and co-insurance, subject to 5% co-payment.

 

Here is an example¹:

John, who is covered under AIA HSG Max A, was hospitalised in a private hospital. His total eligible bill was S$100K. As the policy does not have a deductible waiver pass, John needs to pay S$2,000 deductible from his own pocket. With a certificate of pre-authorisation for his treatment, the co-payment payable by John will be capped at S$3,000 per policy year. Hence, John will pay a total of S$5,000 from his own pocket and the remaining bill is covered under his policies.

 

 

 

¹Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HSG Max covers the majority of your medical bill while AIA Max VitalHealth A covers deductibles and co-insurance, subject to 5% co-payment.

 

Here is an example¹:

John, who is covered under AIA HSG Max A, was hospitalised in a private hospital. His total eligible bill was S$100K. As the policy has a deductible waiver pass, John does not need to pay any deductible. As treatment was not pre-authorised, the co-payment cap does not apply. Hence, John will pay a co-payment of S$5,000 from his own pocket and the remaining bill is covered under his policies.

 

 

 

¹Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HSG Max covers the majority of your medical bill while AIA Max VitalHealth A covers deductibles and co-insurance, subject to 5% co-payment.

 

Here is an example¹:

 

John, who is covered under AIA HSG Max A, was hospitalised in a private hospital. His total eligible bill was S$100K. As the policy does not have a deductible waiver pass, John would need to pay S$2,000 deductible from his own pocket. As the treatment was not pre-authorised, the co-payment cap does not apply. Hence, John would need to pay a total of S$6,900 from his own pocket. The remaining bill is covered under his policies.

 

 

 

¹Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HSG Max covers the majority of your medical bill while AIA Max VitalCare covers deductibles and co-insurance, subject to 5% co-payment.

 

Here is an example¹:

John, who is covered under AIA HSG Max A, was hospitalised in a private hospital. His total eligible bill was S$100K. With a certificate of pre-authorisation, the co-payment payable by John will be capped at S$3,000. Hence, John only needs to pay S$3,000 from his own pocket and the remaining bill is covered under his policies.

 

 

 

¹Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HSG Max covers the majority of your medical bill while AIA Max VitalCare covers deductibles and co-insurance, subject to 5% co-payment.

 

Here is an example¹:

 

John, who is covered under AIA HSG Max A, was hospitalised in a private hospital. His total eligible bill was S$100K. As the treatment was not pre-authorised, the co-payment cap does not apply. Hence, John would need to pay S$5,000 from his own pocket. The remaining bill is covered under his policies.

 

 

 

¹Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HSG Max covers the majority of your medical bill while AIA Max VitalHealth A Value covers deductibles and co-insurance, subject to co-payment of up to 10%.

 

Here is an example¹:

 

Example: John, who is covered under AIA HSG Max A, was hospitalised in a private hospital. His total eligible bill was S$100K.

 

 

As the treatment is from a private hospital, John needs to pay S$3,500 deductible from his own pocket. With a certificate of pre-authorisation for his treatment, the co-payment payable by John will be capped at S$6,000. Hence, John will pay a total of S$9,500 from his own pocket and the remaining bill is covered under his policies.

 

However, should John be admitted to an A-class ward of a public hospital, he does not need to pay any deductibles and a co-payment cap of S$3,000 applies, as shown below:

 

 

 

¹Please note that any claims on your policy would be subject to the terms and conditions of your policy contract.

AIA HSG Max will cover ptosis (subject to terms and conditions of your policy contract) only when the condition affects your field of vision or results in a functional problem.

 

If the severity of ptosis does not fulfil the intervention criteria set out by MOH or if the said intervention is meant for aesthetic or cosmetic purpose, it will not be covered under your AIA HSG Max policy.