Co-Insurance Singapore: The Percentage You Still Pay After Your Shield Plan Deductible
Co-insurance (also called co-payment) is the percentage of an eligible medical bill you must pay yourself, after your deductible has been met, before your Integrated Shield Plan or rider pays the remaining balance.
Not financial advice. All figures for educational reference only. Data as at July 2026. Last updated: July 2026.
Key Takeaways
- Standard Integrated Shield Plans (IPs) in Singapore apply a base co-insurance of around 10% of the bill after the deductible; riders typically reduce this to a minimum of 5%.
- From 1 April 2026, MOH raised the annual co-payment cap on new IP riders to a minimum of S$6,000 (up from S$3,000), meaning policyholders now bear more of very large bills out of pocket.
- Co-insurance is separate from the deductible — the deductible is a fixed dollar amount paid first (S$1,500–S$3,500 depending on ward class), and co-insurance applies as a percentage of what’s left after that.
- New IP riders sold from 1 April 2026 can no longer cover the MOH-set minimum deductible, a change designed to keep policyholders sharing more of the cost and moderate rising claims.
- As compensation for the reduced coverage, new private hospital riders are around 30% cheaper on average than the older, fuller-coverage riders they replace.
What Is Co-Insurance Singapore?
Co-insurance is a cost-sharing mechanism built into every Integrated Shield Plan (IP) in Singapore, designed by MOH and insurers to discourage over-consumption of healthcare (sometimes called “moral hazard”) by ensuring policyholders still feel a portion of every large medical bill, even after insurance kicks in.
Without co-insurance, a fully-insured patient has no financial reason to question whether a longer hospital stay, a pricier ward, or an optional procedure is truly necessary — the insurer pays for all of it. By requiring the policyholder to bear 5–10% of the bill themselves (after the deductible), MOH’s Integrated Shield Plan framework keeps a check on total claims costs across the industry, which in turn helps keep everyone’s premiums from rising even faster.
This concept became a bigger talking point for Singapore consumers after the April 2026 IP rider reforms, when MOH explicitly cited runaway claims growth from riders that covered “as-charged” (100%) as a key driver of premium inflation, and moved to make co-insurance harder to fully insure away.
How Does Co-Insurance Singapore Work in Singapore?
Co-insurance in Singapore works in three layers, all set out under MOH’s Integrated Shield Plan framework and MAS Notice 321:
- Deductible first — you pay a fixed amount (S$1,500–S$3,500 depending on ward class and plan) before any insurance applies.
- Co-insurance next — of the remaining bill after the deductible, the base IP typically requires you to pay around 10%, while a rider (an add-on policy) usually reduces this to a minimum of 5%.
- Co-payment cap last — your total co-insurance exposure in a policy year is capped. From 1 April 2026, that cap is a minimum of S$6,000 for new riders (up from S$3,000 previously), so once you’ve paid S$6,000 in co-insurance for the year, the rider covers 100% of further eligible bills.
The April 2026 reforms also removed insurers’ ability to sell new riders that cover the MOH minimum deductible itself — so even with a rider, you’ll always pay at least the deductible amount from your own pocket (or MediSave, subject to withdrawal limits) before co-insurance calculations begin.
Co-Insurance Singapore Example
A Singapore policyholder is hospitalised in a Class B1 ward with a S$50,000 total bill, and holds an IP with a S$6,000 rider co-payment cap (post-April 2026 rules):
- Step 1 — Deductible: S$2,000 (typical B1 ward deductible) is paid first, not covered by the rider under the new rules.
- Step 2 — Co-insurance on the remaining S$48,000: at a 5% rider co-payment rate, that’s S$2,400 payable by the policyholder.
- Step 3 — Check against the cap: S$2,400 is below the S$6,000 annual cap, so the full S$2,400 applies.
- Total out-of-pocket: S$2,000 (deductible) + S$2,400 (co-insurance) = S$4,400, with the IP and rider together covering the remaining S$45,600.
If the same policyholder had a much larger S$150,000 bill in a private hospital, their co-insurance on the remaining amount after the deductible could easily exceed S$6,000 — in which case the annual cap kicks in and they pay no more than S$6,000 in co-insurance for that policy year (plus the deductible).
Advantages of Co-Insurance Singapore
- Keeps overall claims costs — and therefore premiums — lower by giving policyholders a reason to avoid unnecessary treatment or ward upgrades.
- The co-payment cap limits your worst-case exposure — even for a very large bill, your co-insurance liability stops growing once you hit the annual cap.
- Riders still meaningfully reduce your share — moving from a 10% base co-insurance to a 5% rider rate roughly halves your out-of-pocket exposure on large bills.
- Encourages panel hospital and lower-ward-class choices, which in turn keeps claims — and eventually premiums — more sustainable industry-wide.
Risks and Limitations
- The April 2026 cap increase to S$6,000 means higher out-of-pocket exposure than under the previous S$3,000 cap for policyholders with large hospital bills.
- Co-insurance stacks with the deductible, so your true first-bill exposure is always higher than co-insurance alone suggests — many policyholders underestimate this.
- New riders can no longer cover the deductible itself, meaning even a fully-loaded (as-charged) older rider you’ve held since before April 2026 may eventually be phased out or repriced to reflect the new rules if you switch or upgrade.
- MediSave withdrawal limits still apply — you may need cash on hand to cover co-insurance and deductible amounts if MediSave withdrawal caps for that treatment type are reached.
Co-Insurance vs Deductible
| Aspect | Co-Insurance | Deductible |
|---|---|---|
| What it is | A percentage (5–10%) of the bill after the deductible | A fixed dollar amount (S$1,500–S$3,500) paid first |
| When it applies | After the deductible has been fully paid | Before any co-insurance calculation begins |
| Can a rider cover it? | Yes, riders reduce co-insurance to as low as 5% | No — new riders from April 2026 cannot cover the MOH minimum deductible |
| Annual cap | Minimum S$6,000 for new riders (from April 2026) | No cap — paid in full every hospitalisation episode |
The Bottom Line
For Singapore policyholders, co-insurance is the mechanism that keeps you financially engaged even with a rider — you’ll still pay a percentage of every large bill, capped at a minimum of S$6,000 a year under the April 2026 rules. Understanding this cap, and stacking it correctly with your deductible, is the only way to know your true worst-case hospital bill exposure.
Frequently Asked Questions
What is co-insurance in Singapore health insurance?
Co-insurance is the percentage of your medical bill — typically 5–10% — that you pay yourself after the deductible has been met, with your Integrated Shield Plan or rider covering the rest up to an annual cap.
What is the current co-insurance cap in Singapore?
From 1 April 2026, MOH requires new Integrated Shield Plan riders to set the annual co-payment (co-insurance) cap at a minimum of S$6,000, up from the previous S$3,000 minimum.
Does a rider remove co-insurance entirely?
No. A rider typically reduces co-insurance from the base plan’s 10% down to a minimum of 5% — it doesn’t eliminate it. You’ll still pay that percentage until you hit the annual co-payment cap.
Is co-insurance the same as the deductible?
No. The deductible is a fixed dollar amount paid first; co-insurance is a percentage applied afterward, on the remaining bill. Your total out-of-pocket cost in a hospitalisation episode is the deductible plus co-insurance, up to the annual cap.
Why did MOH increase the co-payment cap in 2026?
MOH cited unsustainable claims growth from “as-charged” riders that covered nearly 100% of bills, arguing this insulated policyholders from cost and drove up ward upgrades and treatment intensity, which pushed premiums higher industry-wide.
Can I still buy a rider that covers 100% of my bill?
New riders sold from 1 April 2026 must include the higher minimum co-payment and cannot cover the MOH minimum deductible. Older riders bought before this date may still offer fuller coverage until they lapse, are cancelled, or the insurer reprices them.