The president of the Singapore Medical Association (SMA) has voiced concern over Great Eastern’s recent decision to suspend the issuance of pre-authorisation certificates for policyholders seeking admission to Mount Elizabeth hospitals, warning that the move may disrupt continuity of care. Speaking to CNA in his capacity as a panel specialist with the insurer, Dr Ng Chee Kwan noted that the decision restricts patient choice and may dissuade policyholders from utilising services at Mount Elizabeth Orchard and Mount Elizabeth Novena. Great Eastern implemented the suspension on 17 June, citing the need to manage escalating healthcare costs and maintain long-term affordability for all policyholders. The insurer observed that certain private hospitals have been charging significantly higher fees for comparable treatments in recent years. Pre-authorisation is a process whereby an insurer provides approval for coverage before medical treatment is administered. This mechanism allows for direct billing between the hospital and insurer, reducing the need for patients to make substantial upfront payments for hospitalisation, surgical procedures, doctors’ fees, diagnostic tests and certain outpatient treatments. Dr Ng, who practises at Mount Elizabeth Novena, remarked that many policyholders may not be able to switch insurers easily due to the non-portable nature of Integrated Shield Plans. He added that although he is still able to admit patients to Great Eastern’s preferred hospitals, these facilities may not be suitable for major procedures due to limitations in available equipment. Dr Tan Yung Khan, a urologist with clinics in both Mount Elizabeth hospitals as well as Mount Alvernia Hospital, expressed similar concerns, highlighting the uncertainty now facing patients in relation to claims processing. This uncertainty, he said, could deter patients from seeking treatment at affected hospitals. While private doctors are typically accredited to practise across multiple facilities, Dr Tan noted that familiarity with a particular hospital’s operating environment enhances efficiency and may reduce the likelihood of errors. He stated that for complex surgeries, many doctors prefer to operate in facilities they trust and have previously worked in. Oncologist Dr Peter Ang, who practises at OncoCare Cancer Centre, described Great Eastern’s move as disheartening. He indicated that the change complicates the decision-making process for cancer patients, who now have to weigh financial considerations alongside urgent medical decisions. Although Dr Ang, who is also on Great Eastern’s panel, had not encountered any affected patients since the suspension, he explained that some patients may require hospital admission for tests or treatment, necessitating logistical adjustments across the group’s clinics, which also operate at Mount Alvernia and Gleneagles. Dr Tan said the immediate impact on his clinic has been limited due to the absence of Great Eastern patients scheduled for procedures at Mount Elizabeth. Nonetheless, he acknowledged that future patient decisions could shift toward hospitals offering more certainty around claim approvals, especially given the rising cost of private medical care. He added that while the move was unexpected, it was understandable given the upward trend in healthcare expenses. Dr Tan observed that cost control benefits all parties in the insurance ecosystem, including policyholders concerned about increasing premiums. In response to media queries, Great Eastern clarified that the suspension does not affect policyholders’ coverage or entitlements. Patients may still seek treatment at Mount Elizabeth hospitals. For scheduled procedures, the hospitals may issue an electronic Letter of Guarantee, which serves to waive or reduce the required deposit and assures partial payment from the insurer. The insurer emphasised that eligible claims will continue to be honoured following assessment and that pre-authorisation remains available for procedures at other private hospitals, including Mount Alvernia, Farrer Park, Gleneagles and Raffles. A medical care concierge service is also available to assist customers in identifying appropriate treatment options across both private and public sectors. Separately, Dr Ng commented on the removal of panel specialists, noting that Great Eastern reduced its panel more significantly than other insurers this year. According to Ministry of Health data, Great Eastern’s panel decreased by 52 specialists in 2024, representing a 15 per cent reduction. This was the largest contraction among insurers, with AIA recording a net drop of 13. Great Eastern responded that its annual panel review is aimed at ensuring quality care and alignment with Ministry of Health guidelines on reasonable fees. Despite the reduction, Great Eastern continues to maintain the third largest pool of panel specialists, with 779 practitioners. Dr Ng suggested that the insurer’s recent partnerships with selected hospitals might explain a decline in policyholder visits to his clinic. He expressed hope that discussions between Great Eastern and the affected hospitals would lead to a reinstatement of the pre-authorisation arrangement.
