SINGAPORE — From November this year, middle- to high-income Singaporeans who have chronic conditions such as diabetes will stand to benefit from the Community Health Assist Scheme (Chas).

Chronic-disease sufferers with a per capita household income greater than S$1,800, or a home with an annual value of more than $21,000, will each be getting a green Chas card. This will add to the blue and orange Chas cards already available for Singaporeans below that income or home value threshold. 

Mr Edwin Tong, Senior Minister of State for Health, said on Wednesday (March 6) that this provision signals "a major philosophical shift". Parliament was debating the budget for the Ministry of Health (MOH).

He added: "Singapore has never had universal subsidies for general practitioner care, but we believe this will help Singaporeans as they grow old, and also allow for a greater anchoring of chronic care in the community." 

The new green Chas card and other enhancements to Chas subsidies are part of efforts to ensure primary care remains affordable for Singaporeans, MOH said.

What subsidies will holders of the green Chas card receive at participating clinics?

• Acute conditions: None

• One chronic condition: Up to S$28 for each visit, capped at S$112 a year

• Complex chronic conditions (two or more chronic conditions, or a single condition with complications): Up to S$40 each visit, capped at S$160 a year

• Dental: None

From Nov 1, holders of the orange Chas card will receive the following subsidy enhancements:

• Acute conditions: Up to S$10 each visit (from S$0)

• Complex chronic conditions: Up to S$80 each visit, capped at S$320 a year (from up to S$75 each visit, capped at S$300 a year)

For blue Chas card holders:

• Complex chronic conditions: Up to S$125 each visit, capped at S$500 a year (from S$120 each visit, capped at S$480 a year)

Like the Pioneer Generation, all Merdeka Generation seniors will receive Chas subsidies from Nov 1, regardless of their household income or the annual value of their homes. These are the subsidies they can get with the new Merdeka Generation card:

• Common illnesses: Up to S$23.50 each visit

• One chronic condition: Up to S$85 each visit, capped at S$340 a year

• Complex chronic conditions: Up to S$130 each visit, capped at S$520 a year

• Dental: S$16 to S$261.50 for a procedure, depending on the type of procedure

From September this year, Singaporeans can apply for Chas online, too.

Prime Minister Lee Hsien Loong announced at last year’s National Day Rally that Chas will cover all Singaporeans — regardless of income — for chronic conditions such as diabetes and osteoarthritis.

Presently, about 1.2 million lower- to middle-income Singaporeans and about 1,000 private general practitioners (GPs) and 700 dental clinics are part of Chas.

In 2018, some 630,000 Singaporeans received about S$152 million in Chas subsidies.

OTHER ANNOUNCEMENTS BY MOH

1. Merdeka Generation Package — for Singaporeans born in the 1950s 

• From July 2019: One-off top-up of S$100 to PAssion Silver cards; Medisave top-ups of S$200 every year for five years till 2023 for Central Provident Fund members; extra premium subsidies for MediShield Life

• From Nov 2019: More outpatient care subsidies at Chas GP and dental clinics, polyclinics and subsidised specialist outpatient clinics

• From 2021: An added participation incentive of S$1,500 for CareShield Life if they sign up between 2021 and 2023

2. More healthcare facilities

• Two new polyclinics to be completed in Serangoon and Tengah by 2025

• Last year, MOH announced that two new polyclinics at Nee Soon Central and Tampines North would be completed by 2023, adding to the four in Bukit Panjang, Eunos, Kallang and Sembawang to be completed by 2020

3. More help for youth with social and mental health needs by end-2019

• MOH is looking to develop an integrated youth service with partners such as the Agency for Integrated Care, Health Promotion Board, the Institute of Mental Health and National Council of Social Service

• MOH will also review and update the 2017 Enhanced Community Mental Health Masterplan

4. Better diabetes management

• Educational materials for diabetic patients and members of the public, in the four national languages, to be published on HealthHub by the middle of this year

• MOH will seek feedback from the public on what other in-depth materials will be helpful

• Training of professionals and volunteers to help diabetic patients manage their condition using the educational materials

• Risk-stratified framework, which will reduce diabetes-related lower limb and toe amputations, to be launched from the second quarter of this year

5.  More accurate screening test for cervical cancer for women aged 30 or above

• Moving towards human papillomavirus (HPV) tests that can detect the presence of cancer-causing HPV, rather than Pap smears

• Lowering frequency of tests from three to five years

• Under the Screen for Life programme, costs will remain unchanged — free for Pioneer Generation seniors, S$2 for Chas blue or orange cardholders, S$5 for other Singaporeans

6. More help for caregivers

• Those looking after seniors with dementia: A night respite service pilot programme will be rolled out in the second half of this year

• Those caring for end-of-life cancer patients receiving home palliative care: A pilot home-based custodial care respite service will start from the middle of this year

• Quicker access to respite services: The Agency for Integrated Care will pilot a pre-enrolment system with a few senior care centres and nursing homes, from the first quarter of this year

• Flexible work arrangements to be strengthened

7.  Assisted living in public housing

• MOH, the Ministry of National Development and the Housing and Development Board will conduct focus-group discussions this year on proposed concepts. More details will be released later.

• Assisted living means care services are available alongside housing. The MOH said that seniors can buy into a senior-friendly home and pick from a range of programmes and services such as housekeeping, 24/7 emergency support and personal care.

8. More career pathways for nurses

• Institute of Technical Education (ITE) diploma in nursing can take two years to complete instead of two-and-a-half years

• New virtual platform, the National Nursing Academy, to coordinate and support lifelong-learning offerings for nurses and nursing leaders

• Rolling out of Community Nursing Competency Framework