Singapore to Revamp IP Riders in 2026, Insurers to Offer Switch Without Additional Underwriting

What is changing and why it matters

Singapore will redesign Integrated Shield Plan riders from 1 April 2026. New riders will no longer be allowed to cover the minimum deductible set by the Ministry of Health, and the maximum annual copayment payable under a rider will rise to at least S$6,000. The 5 percent copayment rule remains. These changes target rising private healthcare bills and the rapid growth in rider premiums.

For consumers, this is a rebalancing. Riders that once reduced out of pocket costs to almost zero will be replaced by leaner coverage that asks patients to share more of each bill, especially for minor episodes. In return, new rider premiums are expected to be about 30 percent lower on average. That means many households can keep protection against large bills while paying less each year.

Private insurers say they support the policy shift. The Life Insurance Association Singapore has said member insurers will help customers move onto the new riders, and several insurers have indicated that policyholders will be able to switch in 2026 without additional underwriting. That makes it easier for people with existing riders to review options without a fresh assessment of their health risks.

How Integrated Shield Plans and riders work

All Singaporeans and permanent residents are covered by MediShield Life, the national basic health insurance scheme. An Integrated Shield Plan, or IP, is an optional add on sold by private insurers that sits on top of MediShield Life. It gives extra benefits, such as access to private hospitals or higher class wards in public hospitals, a wider panel of specialists, or shorter waiting times.

A rider is another optional add on paid fully in cash that reduces the patient share of a hospital bill under the IP. Two features matter most. The deductible is a fixed amount you pay each policy year before insurance pays. The copayment is a percentage of the remaining bill that you continue to bear after the deductible. In the IP system, the default copayment is usually 10 percent, and riders commonly lower this to 5 percent, subject to a cap.

The Ministry of Health sets minimum deductibles by ward class. Current benchmarks are S$3,500 for Class A or private hospital care, S$2,500 for Class B1, S$2,000 for Class B2, and S$1,500 for Class C. The minimum deductible depends on the IP coverage tier and the ward used. For example, a policy aimed at B1 will impose at least S$2,500 if you use B1, Class A, or a private ward.

Both deductibles and copayments can be paid using MediSave, subject to withdrawal limits. Many claimants do not pay cash at the counter because MediSave pays their share up to those limits.

IPs are common. About 71 percent of residents hold one, and roughly two in three IP holders also have a rider. About half of all IP policyholders are on private hospital plans, and around 80 percent of that group have riders.

Key dates and transition rules

New riders that meet the revised design must be on sale by 1 April 2026. On the same date, insurers must stop selling riders that do not comply. Existing rider products can still be sold up to 31 March 2026. Buyers who take up those products on or after 27 November 2025 will be moved to riders that meet the new rules no later than their next policy renewal after 1 April 2028.

For riders purchased before 27 November 2025, each insurer will decide how to handle coverage changes. Insurers say they will inform policyholders in advance and offer guidance. The industry body has also encouraged customers to speak with financial advisers to review coverage before the new framework starts.

Several insurers have indicated that customers will be allowed to switch to the new riders in 2026 without additional underwriting. Underwriting is the process where an insurer assesses your health risks to set premiums or exclusions. A switch with no extra underwriting is helpful for people who developed medical conditions after buying their current rider.

Official information and updates are published by the Ministry of Health on its website, including detailed timelines and case examples. You can find the announcement at this link: MOH rider requirements.

Will premiums really fall and by how much

The Health Ministry expects new rider premiums to be about 30 percent lower on average than the most comprehensive riders in the market today. Indicative savings are around S$600 a year for riders covering private hospital care and around S$200 a year for riders tied to public hospital plans. Older policyholders are likely to see larger reductions because their current premiums are higher.

For context, a 40 year old on a private hospital IP with a rider might pay about S$3,400 a year today. A 60 year old might pay around S$9,500 for the same combination. Many people drop or downgrade riders as they age because premiums climb. A cheaper rider that still caps copayment at S$6,000 could keep more people insured through retirement.

Lower premiums will also reflect changes in utilisation. Public data shows that private hospital IP policyholders with riders are 1.4 times as likely to make a claim and their average claim is 1.4 times larger than those without riders. Rider premiums rose at about 17.2 percent a year between late 2021 and late 2024, double the growth rate for private hospital IP premiums in the same period. New riders reduce the scope of coverage, so claim frequency and sizes should ease over time. Even if premium income falls, insurers may not face losses if claim costs fall as well. Industry figures suggest private health insurance margins have been around 0.5 percent across the last decade.

What you will pay at the hospital

Under the new design, a rider cannot cover the minimum deductible. You will also pay at least 5 percent of the remaining bill, but that copayment is capped at a minimum of S$6,000 per policy year and the cap excludes the deductible. Both the deductible and the copayment can be paid with MediSave, subject to limits.

Here are simple illustrations. These are approximate and do not account for all benefit limits or subsidies. They help show the order in which costs are paid.

Example 1, private hospital bill of S$30,000. The minimum deductible is S$3,500. The remaining S$26,500 attracts a 5 percent copayment of S$1,325. The rider cap is not reached. Your share is about S$4,825 in total, the deductible plus the copayment. MediSave can usually pay this amount up to withdrawal limits, so many patients do not pay cash.

Example 2, Class B2 public ward bill of S$5,000. The minimum deductible is S$2,000. The remaining S$3,000 attracts a 5 percent copayment of S$150. Your share is about S$2,150. This is often covered by MediSave. Subsidies for public wards further reduce the covered portion under the IP, which helps keep the copayment small.

MOH estimates that about 60 percent of claimants will pay zero cash after using MediSave. Around 30 percent will pay less than S$1,000. The remainder, mostly private hospital patients with larger bills, may pay more in cash depending on MediSave balances and withdrawal limits.

Why MOH is tightening coverage

Very comprehensive riders have been linked with higher use of hospital services. When insurance pays almost every dollar, patients and providers may be less sensitive to cost. That can lead to non essential admissions, routine scans being done as inpatient care, and longer stays than medically necessary. The data reflects this. Among private hospital IP policyholders, those with riders are 1.4 times more likely to claim, and their claim sizes are 1.4 times larger, than peers without riders.

At the same time, private hospital bills have grown quickly. The median private hospital bill rose from about S$9,100 in 2019 to S$15,700 in 2024. Rider premiums then jumped to keep pace with claims, which pushed many people to downgrade or drop riders entirely. The new framework aims to restore the basic purpose of insurance, protection against large bills, and to bring cost discipline back to smaller episodes of care.

This move builds on earlier steps. In 2018, MOH required all new riders to include a minimum 5 percent copayment and set a S$3,000 cap. Fee benchmarks were introduced to guide charging. The ministry has also taken action against a small number of doctors for inappropriate claims and is exploring a new not for profit private hospital. Officials say premium reductions will be felt once new riders enter the market, while broader changes in medical inflation will take time because many stakeholders need to adjust behaviour.

What insurers are doing now

Seven insurers offer Integrated Shield Plans today, AIA, Great Eastern, HSBC Life, Income Insurance, Prudential, Raffles Health Insurance and Singlife. Each will launch new riders by 1 April 2026 and cease sales of non compliant riders on that date. The Life Insurance Association says the industry supports the reform and will help customers navigate the change.

Insurers have signalled that they will allow a switch to the new riders in 2026 without additional underwriting. That is useful for customers who have developed conditions since they first bought coverage. Companies also say they will communicate changes clearly and in advance, and many will allow upgrades or downgrades during the transition window.

Premium income from riders may fall when the new design takes effect. That does not necessarily mean weaker financial results. If claim payouts and administrative costs fall by more, finances can still balance. The association has pointed out that private health insurance has run near breakeven in recent years. Competition among the seven IP insurers should also pressure prices to reflect lower coverage levels.

Who might want to switch and who may stay put

There is no one size fits all answer. The decision comes down to your health profile, hospital preferences, and budget. People who rarely claim and value protection against catastrophic bills are likely to benefit from the lower premiums of the new riders. Those who expect to use private hospitals frequently may face higher out of pocket costs under the new rules, although MediSave can cover the deductible and the copayment up to limits.

If you already have a rider, check whether your insurer is offering a one time switch in 2026 without additional underwriting. That option removes the risk of new exclusions. Consider your planned care over the next year. If you are scheduling an elective procedure in a private hospital soon, you might prefer to keep your current rider until after the procedure. If you do not expect to be warded, switching earlier lets you start saving on premiums sooner.

If you do not have a rider today, it may make sense to wait for the new riders rather than rushing to buy an older version that will be phased out. Savings from lower premiums can be set aside to cover a deductible in a future hospital stay. A financial adviser can model your expected five year premium savings against the possible increases in out of pocket costs for common scenarios.

Impact on private and public hospitals

Some patients with private hospital coverage may choose to receive care in public hospitals when they have to meet a deductible and a higher copayment. That could spread demand more evenly between sectors. Public hospitals already offer substantial subsidies in B2 and C wards, which lower covered charges and reduce the patient share under IPs.

MOH says the goal is to keep private healthcare a viable choice while restoring cost discipline. About 80 percent of policyholders do not file any health insurance claim in a given year. Lower rider premiums help this group directly. If non essential admissions decline, private hospitals can concentrate on medically necessary care and insurers can moderate premium growth for the long term.

Questions policyholders should ask

Before switching or buying a rider, consider these points with your adviser.

• What will my annual premium be over the next five years under each option, and how does that compare with my expected savings.
• What deductible applies to my IP tier and typical ward choice, and what is the 5 percent copayment limit under the new S$6,000 cap.
• How will MediSave limits apply to my situation, and will I likely pay any cash out of pocket after MediSave.
• Does my insurer offer a switch to the new rider without additional underwriting, and will my existing exclusions or loadings change.
• Are there panel requirements or pre authorisation steps that affect whether the rider cap applies.
• How would my costs differ if I receive care in a public ward instead of a private hospital.
• What happens to my current rider benefits if I wait until after 1 April 2026.

Key Points

• From 1 April 2026, new IP riders cannot cover the minimum deductible and must cap annual copayments at no less than S$6,000. The 5 percent copayment rule remains.
• Premiums for new riders are expected to be about 30 percent lower on average, with typical savings of around S$600 a year for private hospital riders and S$200 for public hospital riders.
• Insurers have said customers can switch to the new riders in 2026 without additional underwriting, and they will stop selling non compliant riders by 1 April 2026.
• Those who buy riders on or after 27 November 2025 will be moved to the new design by their next renewal after 1 April 2028. Approaches for earlier policies will vary by insurer.
• Deductibles by ward are S$3,500 for Class A or private, S$2,500 for B1, S$2,000 for B2, and S$1,500 for C, and both deductibles and copayments can be paid using MediSave subject to limits.
• Private hospital IP policyholders with riders are 1.4 times more likely to claim and have 1.4 times larger claims than those without riders, a key reason for the redesign.
• MOH is also using fee benchmarks, enforcement against inappropriate claims, and studying a new not for profit private hospital to help rein in costs.