How I lost the insurance game

I have always been a firm believer in insurance and that everyone should always buy depending on your need.

Term if you have dependents , hospitalization with rider if you want to stay in private hospital. Most of the time, it is very easy to purchase what you need. Understand your needs and go shopping, however sometimes we tend to downplay our actual needs.

And it looks like I am going to be paying dearly for it.

Earlier this week, we brought baby domo for her first pediatric visit at KKH. It was quite a long wait, as we had to bring her to do a ultrasound of her head and check out her RBC count to make sure she is producing them on her own. As the pediatric doctor was examining her, she seemed quite happy with baby Domo’s growth. But when she attempted to hear her heart beat, she paused and listen for an extra while. She calmly told us that she has a heart mumur and she will need to see a cardiologist. In my heart, I was like “aiya, it is common to have heart mumur. Now, I need to waste more time” . After paying almost 200+ (she is considered as a private patient as my wife is considered as private under my gynae), we got the appointment for the following Monday.

The cardiologist was very quick, after a few seconds of listening to the heart beat. He came to a diagnosis that baby Domo have a ventricular septal defect VSD or also commonly known as hole in the heart. The cardiologist told us to bring baby Domo for the echocardiogram scan first before he can comment further.

After many struggling and crying from baby Domo , the scan was finally completed. The sonagrapher asked the cardiologist to take a look at the results. He told us that the VSD was a moderate – large one and there is a chance that she will need to be operated to close the hole. The doctor then went though some signs and symptoms we need to watch out for (eg: not feeding well and fluids in the lungs) and she will need to take medication for it. He even grew an anatomy of the heart and explained to us in detail over her condition. She will require to come back (and back and back I am pretty sure) for reviews to see if the hole closes. Even if she require an operation , it will be better if its done when she is bigger.

The doctor quoted that the open heart operation will cost about $40,000 and after medishield, it will be about $8,000 which can pay with medisave and cash.

A search online, however does not tally with the information that he had provided. Using an example of an heart bypass (probably the closest I can find to an open heart surgery), I got this result. It is definitely close to $40,000 if I am staying in ward A or B1 but if I am staying in those. I will not be deemed as a subsided patient, which leads to another set of issue.

Medishield life will not be able to let me claim as much as what the doctor have mentioned to me. Using the picture below as reference, I will not even be able to claim 50% of the bills.

Taken from medishield life booklet

Adding on to it, this second picture clearly shows that the patient can only claim about 20% only.

19% only OMG

Based on the information from the cardiologist and what I manage to search online, I came to these two options

  1. Continue as a private patient and end up probably paying my kidney for the operation. (*It might be actually be possible to request to go in as a subsidised patient when one is going for the operation but if that’s the case, the bill should not even be $40,000)
  2. Become subsided and greatly reduce the bills to come

Luckily, the cardiologist suggested to us to consider downgrading to become subsidised patient so as to save on the bills. We decided to opt for it but unfortunately, the front desk was not able to do the downgrade on the spot as our income per capita was “above their range”. The very next day, my wife got the referral from the polyclinic for the next appointment. ( The doctor even mentioned that because we have the same surname, our children will be more prone to such issues. 😂)

Remember when I said that I lost the insurance game? This is why…

Baby Domo will get exclusion on her heart no matter where she go to buy her insurance. This is a very probable situation (even her medishield with private rider will probably exclude it). This would mean that should there be any issues that might happen to her heart, insurance companies will not cover it or not before charging an additional premium.

On hindsight, I could have purchase maternity insurance for my wife and baby Domo back then. These insurances would usually be converted to another insurance (such as term) when the baby is born. This can skip the underwriting part and there will be a lesser chance of exclusion of her condition. Unfortunately, I chose to gamble on the fact that we are young and so the probability is much lower. As of now, the only way is for the defect to close on its own and for the cardiologist to write a memo so as that we can request for the removal of the exclusion.

One must always remember in essence, insurance is more than just buying to cover your needs. You are in actual fact, gambling against yourself.

As of now, I can only hope that I ( and baby Domo) will not lose the favour of the lady luck during our next review.

Author: domodaddy

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