For Singaporeans or PRs using the public healthcare system in the Restructured Hospitals, how you are classified in the system – private or subsidised patient – will result in a big difference in your out-of-pocket costs. If you are admitted to a public healthcare system like Khoo Teck Puat Hospital how you are referred during your first consultation matters — and will determine your classification until you are discharged. Remember, once it is in the system, it is normally not possible to change! The classification is not related to any “means testing” or whether you are rich or poor, but how you enter the system. Here is what you must do to be classified in the system as subsidised patient.

• If you need specialist consultation at a public hospital, a common mistake is to obtain a referral from your private neighborhood GP(with the exception of a CHAS card holder referred by a CHAS doctor) or even do a “walk-in” to the specialist clinic. Both will result in you immediately being classified as a private patient. To be classified as a subsidised patient, your referral must come from a Restructured Hospital under subsidised status, A&E, Polyclinic or SAF — any other referrals will be classified as private.
• Remember, the classification starts with your first consultation. If you are discharged and then has to seek treatment again, it will be considered a new and first consultation — in determining your patient status. Same applies if your last consultation lapses for more than 12-months. After that, you will start all over!
• Even if you are a subsidised patient and then choose to be admitted to the Restructured Hospital’s A or B1 ward, upon discharge as an in-patient, your subsequent follow-up at the specialist outpatient will reclassify you as a private patient. However, if you are already a subsidised patient admitted to a B2 or C class ward, upon discharge, your status will remain as subsidised.
• If you want to choose your own doctor in the Restructured Hospital either by name, gender or rank, that will also result in the change from subsidised to private status. If you are a subsidised patient, you will have to accept any qualified doctor that is assigned to treat you. One of the main reason why a patient would give up the subsidised status is to be able to select his or her doctor.

You may ask – “Why should I care?”. The difference to your out-of-pocket costs can be significant. For A&E, the subsidy is 50% difference between private and subsidised (of course, no referral is needed for A&E!). For other services including surgery and in-patient acute care, the subsidy can range from 70%-80%, and even more for the Pioneer and Merdeka Generation card holders.

Understanding the system can save you a lot of money – but learn it FIRST. If you make a “mistake” in your first consultation and gets classified as private, remember you cannot easily change your status after that. You will then be classified as private for all subsequent treatments for the same medical condition.