Forum: MOH will review MediShield Life coverage for prophylactic mastectomy
W e thank Dr Tan Yia Swam for her letter 'Insurance agents asking doctors to change codes to ensure claims go through' (April 17), on insurance coverage for prophylactic mastectomy in breast cancer patients with pathogenic gene mutations such as the BRCA gene mutation.
In general, MediShield Life does not cover primary prevention, which refers to medical services for generally healthy individuals to prevent diseases, such as screening tests and vaccinations.
This is because MediShield Life as a national insurance scheme is focused on protecting individuals when they receive medically necessary treatments for illness or injury. This keeps premiums affordable for policyholders.
However, with advances in medical science, the line between preventive and diagnostic care is increasingly nuanced, particularly in cases involving genetic predisposition to serious conditions like breast cancer.
Extending MediShield Life coverage for both genetic testing and subsequent preventive interventions needs careful study, as any policy changes can have broad implications and impact on premiums for everyone. The Ministry of Health is therefore reviewing and will issue claim rules to guide practitioners on breast-related surgical claims later this year.
We agree fully with Dr Tan that medical professionals should not misrepresent or be pressured to misrepresent medical codes for claims, including those under government schemes and insurance.
Medical professionals who encounter situations where they disagree with the advice given by insurance agents to their patients should report these cases to the insurers for follow-up investigation and appropriate disciplinary action where misconduct is established.
Lydia Loh
Group Director, Healthcare Finance Group
Ministry of Health
More on this Topic Forum: What readers are saying
Join ST's Telegram channel and get the latest breaking news delivered to you.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Straits Times
4 hours ago
- Straits Times
Vaccine group Gavi seeks to broaden donor base as aid budgets shrink
RABAT - Global vaccine group Gavi is seeking new donors for its work funding childhood immunisation in the world's poorest countries, its chief executive told Reuters, as many traditional funders cut international aid budgets. Gavi is aiming to raise $9 billion at a summit in Brussels later this month for its work from 2026-2030, but countries including the United States, the United Kingdom and France have all signalled that they plan to slash global aid funding in the coming years, and their pledges remain uncertain. "We want to broaden our donor base," Gavi's Sania Nishtar told Reuters in Rabat, where she met officials to encourage Morocco to join as a new donor. She said that India and Indonesia, which had previously been supported by Gavi, were now contributing as donors to the organization, which works with low and middle-income countries to buy vaccines for diseases from measles to cholera. Other countries like Portugal have also increased their funding commitment, she said. During her Morocco visit, Nishtar toured a vaccine manufacturing facility near Casablanca under development by Marbio, a biopharmaceutical venture backed by Morocco. She said the plant had "a good chance" of benefiting from Gavi's $1.2 billion African Vaccine Manufacturing Accelerator, a scheme aimed at boosting vaccine production on the continent. Gavi has already sought out more private sector donors, initiated cost-saving initiatives, and discussed closer collaboration with other global health groups as part of plans to try to tackle potential shortfalls in funding. Nishtar said the organization was making contingency plans, but she hoped that donors at the June 25 summit would give enough that they would not be needed. A U.S. government document showed in March that the U.S., which has previously given around $300 million to Gavi annually, did not plan any future funding. Nishtar said that Gavi has not yet received this year's funding, which has already been approved by Congress. Gavi is currently focused on combating a global measles outbreak and is responding to cholera outbreaks in Sudan, South Sudan, and Angola, where it has made special arrangements to supply vaccines from its stockpiles, Nishtar said. It is also supporting Sierra Leone, where the spread of mpox has accelerated. REUTERS Join ST's Telegram channel and get the latest breaking news delivered to you.
Straits Times
8 hours ago
- Straits Times
Players undergoing fertility procedures to get protected ranking, says WTA
Female players who choose to undergo a fertility protection procedure will be allowed to take time away from the sport and return to competitive action with a protected ranking, the governing body of women's tennis (WTA) said on Wednesday. The new rule aims to support women athletes to balance their family goals and career ambitions and comes three months after the WTA offered players up to 12 months of paid maternity leave for the first time. "The new rule means that players can now take time away from professional tennis for a fertility protection procedure such as egg or embryo freezing and safely return to competition with a protected ranking," the WTA said in a statement. "Eligible players will receive a Special Entry Ranking (SER), which can be used to enter up to three tournaments, based on the 12-week average of their WTA Ranking from eight weeks prior to the start of their out-of-competition period." Sloane Stephens, the 2017 U.S. Open champion, has previously called for egg freezing to be recognised as a protected ranking activity and called Wednesday's announcement a "ground-breaking" move. "I'm incredibly proud of our sport in recognising the importance of fertility treatments for female athletes. For any woman, the conversation of family life versus a career is nuanced and complex," the former world number three said. "The WTA has now created a safe space for players to explore options and to make the best decisions for themselves." The WTA also said players will benefit from paid maternity leave and grants for fertility protection through the WTA Maternity Fund sponsored by the Saudi Public Investment Fund. REUTERS Join ST's Telegram channel and get the latest breaking news delivered to you.
Straits Times
11 hours ago
- Straits Times
Palestinian boy who lost nine siblings due to arrive in Italy on Wednesday
Palestinian boy who lost nine siblings due to arrive in Italy on Wednesday MILAN - A group of about 80 Palestinians, including an 11-year-old boy who lost nine siblings in an Israel strike in Gaza last month, will arrive in Italy later on Wednesday for hospital treatment, Italy's foreign minister said. Accompanied by his mother, Adam Al-Najjar will be transferred to Niguarda Hospital in the northern city of Milan, while others will be moved to nearby Bergamo, and Rome. "Adam will arrive in Milan and be treated at Niguarda hospital because he has multiple fractures," Foreign Minister Antonio Tajani said in an interview with RTL 102.5 radio. Tajani said the group would number about 80, including injured people and those such as family members accompanying them. Tajani's spokesman later said the group was made up of 17 injured people, accompanied by 52 others. The May 23 attack left Adam in a serious condition at Nasser Hospital, one of the few operational medical facilities in southern Gaza. Adam "is stable, has a head wound that is healing but his left arm is bad, the bones are fractured and the nerves damaged," his 36-year-old mother, Alaa al-Najjar, a paediatrician, told Italian newspaper la Repubblica. Adam's father, Hamdi al-Najjar, who was also a doctor, died a week after the attack. "The damage is in my left hand, there is a problem with the nerves, I can't feel my fingers. There's still a lot of pain," Adam told Turkish news agency Anadolu. According to the United Nations Children's Fund (Unicef) website, more than 15,000 children have reportedly been killed and over 34,000 injured in almost two years of war in Gaza. REUTERS Join ST's Telegram channel and get the latest breaking news delivered to you.
