Percentage of the bill (after deductible) that you still pay. MediShield Life co-insurance is typically 10%.
Co-insurance is the percentage of an insurance claim that you pay yourself, after any deductible. The insurer pays the remainder.
Co-insurance is most familiar in Singapore's hospitalisation context — MediShield Life and most Integrated Shield Plans require co-insurance of 10% of the bill above the deductible.
Example: S$50,000 hospital bill. Deductible S$2,500. Co-insurance 10% on the remaining S$47,500 = S$4,750. Your out-of-pocket: S$2,500 + S$4,750 = S$7,250. Insurer pays the rest.
MediShield Life co-insurance steps down for larger bills: 10% on the first S$30,000 above deductible, then 5% beyond — reducing the burden of catastrophic bills.
Without co-insurance, insurance would face moral hazard — patients have no skin in the game when choosing treatments or wards.
Since 2021, regulators mandate a minimum 5% co-payment on Integrated Shield Plan riders — you can't get coverage that pays the entire bill.
Pre-2021 riders ('full riders') paid 100%, but these proved problematic — patients had no incentive to consider cost, leading to runaway medical inflation.
Current best: an IP rider that reduces the deductible to a smaller amount and limits co-pay to 5% (regulated floor).
Effective out-of-pocket with a modern rider on a S$50,000 bill: roughly S$3,000 – S$5,000 — versus S$7,250 with no rider.
Motor insurance: 'voluntary excess' is functionally co-insurance — you choose how much you'll pay per accident, lower premium for higher excess.
Travel insurance: 10% – 20% co-insurance on certain claims (e.g., loss of personal items).
Critical Illness: typically no co-insurance — pays the full sum assured on a valid claim.
The percentage of an insurance claim you pay after any deductible, with the insurer paying the remainder. Most common in hospitalisation policies — MediShield Life and standard Integrated Shield Plans charge 10% co-insurance above the deductible.
Skin in the game. If insurance paid 100%, patients would have no incentive to consider treatment costs. Co-insurance moderates demand and keeps premiums lower. The 2021 minimum 5% co-pay rule was a regulatory response to pre-2021 'full riders' that drove unsustainable medical inflation.
Yes, with an Integrated Shield Plan rider. Modern riders bring out-of-pocket co-payment down to the 5% regulated minimum (with annual cap). Premium for the rider is meaningful but typically worth it for the protection on large bills.
Yes for certain approved outpatient services (dialysis, chemo, immunotherapy). MediShield Life co-insurance is 10% on these; IP riders can reduce it. For most everyday GP visits and routine outpatient care, you pay 100% (these aren't typically covered by hospitalisation insurance).