Deductible vs Co-payment vs Co-insurance in Singapore

Updated on Oct 23, 2026

5 min read

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Key Takeaways

A deductible is the fixed amount of eligible expenses you must bear before insurance benefits apply. It generally applies per policy year, rather than per admission.
A co-payment may be a fixed amount per visit or a percentage of eligible expenses, depending on the plan. In Singapore, MOH uses the term for the percentage patients must bear under IP riders.
Co-insurance is your percentage share of eligible expenses after the deductible. MediShield Life uses rates of 10%, 5% and 3%, based on accumulated claimable amounts within the policy year.

Your hospital’s payment estimate or insurer’s claim statement may mention a deductible, co-insurance or co-payment. These terms describe how you share medical costs with your insurer, but they are not necessarily three separate charges that you add together.

The amount you pay depends on your coverage, the expenses eligible for a claim and your policy’s payment rules. A rider may also change the share you must bear.

This guide explains the terms, shows how they work in practical examples, and helps you understand which applies to your bill.

What is a deductible?

A deductible is the fixed amount of claimable or eligible expenses you must bear before insurance benefits apply. It is part of your bill, not an additional charge.

Under MediShield Life, deductible payments can accumulate across claims within the same policy year. For admissions or treatments received on or after 1 June 2026, deductibles range from $500 to $4,500, depending on your age next birthday at the start of the policy year and your ward class or treatment setting.

If you have an Integrated Shield Plan (IP), check its benefits table. Your IP’s deductible may differ from the MediShield Life schedule. MOH sets minimum IP deductible requirements, but these do not necessarily equal the deductible in every policy.

You may use MediSave towards eligible expenses, subject to withdrawal limits and your available balance. Any amount that cannot be covered by insurance or MediSave must be funded separately.

What is a co-payment?

A co-payment is the portion of a covered medical expense that you pay yourself. It may be a fixed dollar amount or a percentage, depending on your insurance plan.

Some employer or group health plans charge a fixed co-payment for each visit, for example, $10 for a GP consultation. In this arrangement, you pay the specified amount and the insurer covers the remaining eligible charges, subject to the plan’s terms.

In Singapore’s Integrated Shield Plan (IP) rider context, co-payment refers to a percentage of eligible expenses. MOH requires a minimum 5% co-payment for new IP riders sold from 1 April 2026. Your actual percentage and any annual cap conditions depend on your rider’s terms.

The key is to check how your policy calculates the co-payment: a fixed amount per visit or a percentage of eligible expenses. It is not necessarily a separate charge added on top of co-insurance.

What is co-insurance?

Co-insurance is your percentage share of eligible expenses after the deductible has been met.

MediShield Life uses tiered co-insurance rates based on claimable amounts accumulated within the policy year:

10% on the first $5,000.
5% on the next $5,000.
3% on amounts above $10,000.

The deductible counts towards determining the applicable tier, but co-insurance is charged on the claimable amount remaining after the deductible.

For an IP, check your policy’s co-insurance rate and calculation rules. MOH’s illustrations use 10% base-plan co-insurance, but your payment also depends on the expenses eligible under your policy.

If you have a rider, it may cover part of the amount you would otherwise pay. The rider’s retained co-payment is not automatically an additional percentage on top of the base plan’s co-insurance.

Unlike a fixed deductible, percentage-based cost-sharing can increase as the eligible amount increases.

Deductible vs Co-payment vs Co-insurance

	Deductible	Co-payment	Co-insurance
What it is	A fixed amount you pay before insurance benefits begin	A fixed amount you pay each time you use a healthcare service under your employer’s plan	A percentage of the remaining eligible bill that you pay after the deductible. Typically applied for IP
How it is calculated	A set dollar amount, usually payable once per policy year	A set dollar amount per visit or service	Usually a percentage, such as 10% or 5% depending on the policy and claim amount
When it applies	Mostly MediShield Life and IPs, before insurance pays	Mostly employer group plans, per visit	After the deductible, on the remainder
Typical range	$500 – $4,500 per policy year	$5 – $50 per visit	5% – 10% of the eligible bill
Resets	Each policy year	Each time you use a service	Each policy year, with tier accumulation on MSL
Who sets it	CPF Board (MSL) or your insurer (IP)	Your employer / group plan insurer	CPF Board (MSL) or your insurer (IP)

Co-payment and co-insurance are often used interchangeably, but strictly speaking, they differ. A co-payment is a fixed amount per visit or service, while co-insurance is a percentage of the eligible bill.

Not sure which figures are on your bill? WhatsApp our Care Team can read your insurance documents and your hospital bill side by side, and tell you what each line represents.

Worked example (all three on one patient's year)

Meet Mei Ling. She visits a GP under her employer’s plan, then has an inpatient admission to a private hospital under her IP with a rider. This hypothetical example shows how different payment rules can apply to different episodes of care.

Visit 1: GP for a sore throat (under employer plan)

Her employer's group plan covers GP visits with a $10 co-payment per visit.

Line	Amount
GP consultation and medication	$85
Group plan pays	($75)
Mei Ling's co-payment	$10

That $10 is a co-payment in the classic sense: a fixed amount per visit.

Visit 2: Day surgery at a private hospital (under IP + rider)

Three months later, Mei Ling has a day-surgery procedure. Her bill is $15,000 and her IP is a private-hospital plan with a rider.

Line	Calculation	Amount
Hospital bill	–	$15,000
Less: IP deductible (private hospital, under 80)	–	($3,500)
Remaining eligible bill	$15,000 − $3,500	$11,500
Less: Co-insurance under new rider (5% of remainder)	5% × $11,500	($575)
IP + rider pays	$15,000 − $3,500 − $575	$10,925
Mei Ling's share	$3,500 + $575	$4,075

Her $4,075 share has two parts:

$3,500 deductible – the fixed first slice of the bill
$575 co-insurance – 5% of what was left after the deductible

MediSave can cover both subject to CPF withdrawal limits, so she may pay little or no cash out of pocket.

What this means

In one policy year, Mei Ling encountered all three mechanisms:

A co-payment per visit on her GP consultation
A deductible and a co-payment / co-insurance on her hospital bill

They all count as "her share". They sit on different parts of her bills, calculated in different ways.

Which one applies to your bill?

Use this quick guide to work out what's on your bill, based on what insurance you have:

If you have	What applies to your hospital bill
MediShield Life only	MSL deductible + MSL tiered co-insurance (10% / 5% / 3%)
An IP (no rider)	IP deductible + flat 10% co-insurance
An IP + rider (post-April 2026 terms)	IP deductible + flat 5% co-payment, capped at $6,000/year
An IP + rider (pre-April 2026 terms)	May vary – some older riders covered the deductible and co-insurance in full
Employer group plan (outpatient visit)	Co-payment per visit
Employer group plan (hospitalisation)	Depends on the plan – may have its own deductible, co-insurance or co-payment

Woman calculating expected treatment and insurance costs with a calculator and notebook

Deductibles, co-insurance and co-payments share healthcare costs between policyholders and insurers.

Why insurers use three different mechanisms

Each mechanism exists for a different reason:

The deductible filters out small claims. If every $200 claim went to the insurer, the admin cost of processing would eat the premium pool. The deductible keeps the insurer focused on bigger bills.
Co-insurance keeps you cost-aware. If insurance paid 100% of every bill above the deductible, there would be no reason to care about which hospital or specialist you choose. A percentage share makes you a participant in the cost.
The co-payment (per visit) keeps outpatient use reasonable. Without one, routine visits for minor issues would overload a plan built for occasional use.

None of them exists to punish patients. They exist to keep the premium pool sustainable. Understanding that framing makes it easier to plan around them rather than being surprised by them.

Can MediSave cover all these payments?

Deductible: Yes, for eligible treatment expenses, subject to MediSave withdrawal limits and your available balance.
Co-insurance or IP rider co-payment: Yes, for eligible treatment expenses, within the applicable withdrawal limits.
Routine acute GP co-payment: Generally no. MediSave can be used for specified approved outpatient services, but a routine GP visit is not claimable simply because your employer plan calls your payment a co-payment.

Before treatment, ask for a breakdown of the expected insurance payout, allowable MediSave withdrawal and remaining amount you must fund separately.

How HiA can help

If you have a specific bill in front of you, or you are planning an admission and want to know what the three charges will look like for your plan, our Care Team can walk you through the breakdown.

Our Care Team is led by ex-hospital staff who have worked inside Singapore's private healthcare system. We can help you:

Identify what the deductible, co-payment and co-insurance on your bill actually mean
Work out what your IP or group plan will cover
Clarify which parts can be paid from MediSave and which stay as cash
Prepare a cost estimate before a planned admission

Not sure what your plan covers?

Send us your plan details and we'll check what your plan covers, what it doesn't, and where you may be out of pocket.

WhatsApp us

insurance agent explaining insurance policy to customer

Frequently asked questions

Not strictly. A co-payment is a fixed dollar amount; a co-insurance is a percentage. But MOH and IP rider documents use "co-payment" to describe the 5% share under new IP riders, which is technically a co-insurance. In that specific context, the two terms get used interchangeably.

No. The deductible is per policy year, not per admission. Once you've paid it in a policy year, MediShield Life or your IP pays from the first dollar of your next claim, subject to co-insurance and claim limits.

Not under the April 2026 rules. New IP riders cannot cover the minimum IP deductible set by MOH, you pay it yourself. The rider reduces co-insurance to a flat 5%, capped at $6,000 per policy year. Older rider holders may still have broader cover, depending on their policy terms.

A new IP starts a new policy year, so its deductible applies from the start. Amounts already paid towards your old policy’s deductible generally do not carry over. Switching can also affect cover for pre-existing conditions, waiting periods, rider terms and the deductible you need to pay, which may be higher under your new plan. You can only hold one IP at a time, so check the new plan’s terms before cancelling your current one.

Disclaimer

This article and its contents are provided for educational and informational purposes only and do not constitute medical advice or professional services specific to you or your medical condition. For decisions about your health or treatment, speak with a qualified doctor who knows your situation. An…

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