Tuesday, June 12, 2018

Long Term Healthcare Cost In Singapore - Are Subsidies Enough?

In a previous article, I wrote about the real issues which people face when having to care for a family member with disabilities at home. You can read the previous article here. Also, as what I have said previously, the purpose is to bring the issues of long term healthcare cost to the government. I have managed to contact the Agency for Integrated Care and Ministry Of Health and I attended a session on the enhanced Eldershield (Careshield life) to learn more about it as well as give my thoughts on the recommendations.

In this article, I will dive into the various subsidies available for this group of people and whether they are adequate? Also, I will talk about what we can possibly do to prepare for the future in the event if this happens to us or our loved ones.

On 6th February 2017, NCMP Mr Dennis Tan Lip Fong asked the Minister for social and family development: " how many persons with disabilities and/or special needs are there in Singapore;". The reply was as follow:
  • Student Population: 2.1%
  • 18-49 years old: 3.4%
  • 50 years and above: 13.3%
Based on the above statistics, this is almost 20% of the population with disabilities. It was further added that persons with sensory (blind and deaf) and physical disabilities would constitute half of the disability group. The remainder comprises those with Intellectual Disabilities and Autistic Spectrum Disorder. 

Furthermore, the committee in-charged of reviewing the Eldershield scheme estimates that 1 in 2 healthy people age 65 today run the risk of becoming severely disabled before they die. This is quite a high percentage and I can imagine if nothing is done in the future, it will be a disaster. 


Subsidies Available for Long Term Healthcare cost - Are they adequate?

There are various subsidies available which can alleviate the financial burden of those who need it.

To be honest, AIC and MOH has done a good job to try to set up a system and compile the information for subsidies into one place. Most subsidies can be applied through a medical social worker who will be assigned to each patient. All hospitals including community hospitals have full time medical social worker for this purpose. If you need subsidies for long term healthcare cost, do remember to approach one at your hospital.

Let's take a look at the various subsidies available:

1. Foreign workers concession levy

The normal levy which is required to be paid for hiring a maid is $265. However, if we are hiring a maid to care for a family member with disabilities, the concession levy will be only $60.

2. Enhancement for Active Seniors (EASE)

EASE is a subsidised home improvement program offered by HDB. Improvement items such as grab bars in the toilet, slip resistent floor tiles and ramps can be installed to make your home more elderly friendly especially for persons with disabilities.

If you're eligible, the cost is reduced from $2000+ to $100+ only depending on your HDB flat type. You can refer to HDB website here for more information.

3. Intermediate and long term care (ILTC) subsidies

This ILTC is the most common form of subsidy which covers both home care services such as home nursing and home therapy and residential services such as community hospitals and nursing homes.

What you can expect is at least 20% subsidy for nursing home if your household per capita monthly income is less than $2600. For home care services, it is at least 30% for household per capita monthly income of $2600 also. You can refer to the subsidies for ILTC here.

As much as there are subsidies already available, the cost is still a huge burden for families. Nursing homes in Singapore cost somewhere between $2500-$3000+ per month. Even with a 20% subsidy, the cost is still at around $2000-$2500+. Most nursing homes fees also do not include disposables such as diapers.

For those who brought their family members home and require home care services, I did check with some home care service providers on their cost and the estimate cost is as follow:

  • Home Medical – $223
  • Home Nursing – $95
  • Home Therapy – $125

The cost above is per session and before subsidies. After a 30% subsidy, as you can see, the cost will still be high.

4. Community Health Assist Scheme (CHAS)

The CHAS is essentially a card to get subsidies when we see a doctor at a private clinic. There are 3 different types of card namely the CHAS blue card, the CHAS orange card and the CHAS for pioneer generation  card.

The blue card is for low income households with household monthly income per person of $1100 and below while the orange card is for households with monthly income per person of $1,101 to $1,800. For pioneer generation, there is no income criteria so as long as someone qualifies as a pioneer generation person in Singapore, he or she will get all the CHAS subsidies.  There are subsidies for common illnesses, chronic conditions and even dental services. For more details on the scheme, you can refer to the CHAS website here.

5. Seniors mobility and enabling fund (SMF)

The SMF is a fund which subsidises 3 groups of items and services. They are home healthcare items, assistive devices and transport. For home healthcare items and assistive devices, the income criteria is household monthly income per person of $1800 and below while for transport it is $2600 and below. For more information on the SMF, you can refer to AIC website here.

Long Term Healthcare Cost In Singapore - Are Subsidies Enough?

Indeed there are already various schemes which act as social safety net to support those who are burdened with long term healthcare cost in Singapore. However, I would think the schemes mostly benefit more for the extremely low income people only. For those with middle class income, it is hard to get help on this.

In a survey which I conducted previously, I asked the percentage of subsidies which people receive for the most common scheme which is the ILTC. To my surprise, most people do not receive or do not know such scheme existed and a minority get low subsidies amount with some lower income households getting higher subsidies amount.

For middle class households, the financial burden and stress is real. Some are just slightly above the income level criteria and most of them are in situations where their parents become disabled suddenly and the children have to take up the responsibility. While the children want to give the best for their parents, they also have to plan ahead for their future especially with the high cost of owning a home and also having their own children in Singapore.

To me, it is a negative cycle that if more and more people are caught up in this situation and the young adults cannot move ahead in life, there will be more social problems in the future.


What can we do to prepare?

While we hope for more schemes to support those with disabilities, we may also do our part especially if we are still healthy now. Getting hit by critical illness and becoming disabled is more real than we think. 

1. Be insured with Eldershield (Careshield life from 2020) or disability income insurance

Firstly, we can look into getting Eldershield or disability income insurance. Eldershield is an auto opt in scheme when we reach 40. The basic plan pays out $400 per month for up to 72 months (6 years) in the event of disability if we cannot perform 3 out of 6 daily living activities. There are supplement plans which offer higher monthly payouts for life also. Aviva, NTUC income and great eastern provide the supplement plans. You can refer to MOH website here for more information on Eldershield.  

Starting from 2020. there will be a new enhanced Eldershield which is renamed as Careshield life. All those born on or after 1980 will be included in this compulsory scheme which pay out $600 pr month for life in the event of severe disability. I've written a separate article for Careshield life which you can read here

For disability income insurance, it can be bought separately and can possibly replace our income in the event of disability. The premiums may be quite high so make sure you can afford it before purchasing. 

2. Term plans which covers critical illness

The second and most important thing we can get for ourselves is to purchase an insurance with critical illness and total permanent disability coverage. There are probably about 36 critical illness covered which includes stroke, heart attack and many of the different cancers. A Straits times article recently wrote about a study which suggest that working adults in Singapore have inadequate cover if critical illness strikes. The study by Life Insurance Association (LIA) showed that an average working adult in Singapore only has critical illness cover of just $60,000 which is well under the LIA recommendation of $316,000. 

I would think the problem is people generally buy whole life policies and the premiums are too much if we want to get a high coverage. Buying a term insurance with critical illness will be much more affordable. It probably will only cost around $1000-$1500 a year to be insured sufficiently with term insurance for those 30 years old and below so its good to get some term insurance if you're still young.


Conclusion

This ends the 2 part series on creating awareness on the issues of long term healthcare cost in Singapore. The government actually has a 3rd enabling masterplan to support persons with disabilities but how long all these will get implemented is another question. The ageing population problem in Singapore is real. Disability is real too and that's why we have all the wheelchair accessible initiatives all around the nation now.

I understand that there is an ongoing review for the various support schemes under the health ministry. I feel that some of the middle class families still fall through the cracks when it comes to support for unforeseen circumstances. Family members becoming disabled is one of them and this often comes with huge long term healthcare financial burden to deal with. Hopefully we will see more support along the way as our society progresses. Nevertheless, it is impossible for the government to support everyone as it would mean the younger generation have the bear the cost instead.


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Wednesday, June 6, 2018

Should I Get A BTO or Resale Flat?

There are pros and cons of getting a BTO vs a resale flat. In Singapore, a BTO flat is heavily subsidised by the government and we try our luck to ballot for a chance to select a unit. These flats are build to order (BTO) meaning those who managed to get a unit will have to wait about 3-5 years before they can collect the keys to their flat.

I would think most people will go for the BTO option first if they have the time to wait. However, even if you have the time to wait doesn't mean you will have the luck to get one of the units. The next best choice will be to go for resale flats which will ultimately cost more as compared to a BTO flat.



The Process of getting a BTO flat

BTO flats are launched every quarter which means we have 4 chances a year to try our luck. I have tried since 2016 but till now I didn't manage to get a good number. When people say its hard to get a good location through BTO, it is really true. Non-mature estates such as Sengkang & Punggol are generally easier to get precisely because the demand is not so high there. I did managed to get a queue number to select a flat in Sengkang but in the end decided to give it up as after consideration for the long term, the location is still important for me and my partner.

The process to getting a BTO flat can be quite long so if you're planning to get married in the next 3 years, then its better to start your BTO process earlier. The balloting process is fuss free. It can be done online and no documents need to be submitted in the early stages. You just have to fill in some information of yourself which takes less than 10 minutes.

BTO balloting guide

Have you wondered how the BTO balloting process work and how people are chosen to select a flat? Let me try to explain it based on the information I managed to find.



Firstly, first timer applicants will always have the priority in the balloting process. 85% of the 4/5 room flats and 70% of the 3 room flats are set aside for first timer applicants for non mature estates. For mature estates, 95% of the 3/4/5 room flats are set aside for first timers. If you think that its easier for first timers to get a unit in mature estates since 95% of the flats are set aside, its not true as there are many other first timers also aiming for a flat in the popular mature estates.

How the BTO balloting process works is unclear to many as HDB did not really state clearly how it is done. I tried to find as much information as I could and summarise my findings in this post. In essence, there is no way to get any advantage from the balloting process. HDB tries to ensure fairness to all parties in this process. As a first timer, even though you get to enjoy priority in getting a queue number, it does not mean you will get a good queue number. I will explain this in the next section below.


Why its so hard to get a good queue number?

The balloting process is completely random and it very much depends on our luck in order to get a good queue number. After the application closes, HDB will first shortlist first timer applicants based on the percentage of flats set aside for them. Then, HDB will shortlist second timer applicants based on the percentage of flats set aside for them. After the applicants are shortlisted, they will all go into a computer system and be assigned random queue numbers. Both first timers and second timers are in this pool. This means that even if you are a second timer applicant and you managed to get shortlisted into the ballot pool, you may still get a better queue number than a first timer.

There are also other priority schemes. The 2 main schemes are the Parenthood Priority Scheme (PPS) and the Married Child Priority Scheme (MCPS). For BTO, 30% of the flats are set aside for PPS and another 30% set aside for MCPS. Let me explain more on these 2 priority schemes.


Parenthood Priority Scheme (PPS) 

The PPS is for those who have kids or are going to have soon.

The eligibility condition as stated on HDB website is as such:

"You must be a first-timer applying as a married couple. In addition, you must either be expecting your first Singapore Citizen child at the time of your application, or have at least 1 Singapore Citizen child aged below 16 (natural offspring from the lawful marriage or legally adopted)."


Married Child Priority Scheme (MCPS)

The MCPS in essence is for those who apply for a flat to stay with their parents or near their parents. For those who apply to stay with their parents, the parents name must be included in the application. For those who apply to stay near their parents, as long as it is within 4km of your parents house, you will be eligible for it. Do note that for staying near parents, there is a restriction that your parents must continue to live in the same town or within 4km of your new BTO flat for 5 years after you collect your keys.

For more information on the priority schemes, you can refer to HDB website here.


Balloting process scenario

Now, let's get back to the balloting process and why its so hard to get a good queue number. As a first timer applicant, 70%-95% of the flats are set aside for you depending on the type of flat and the location. Within the 95%, 30% are set aside for PPS and another 30% for MCPS.

Let's take for example the following scenarios:

Location: Toa Payoh (Mature Estate)
Flats available: 1000
Total number of applicants: 2000 (Oversubscribed)
  • PPS applicants: 400
  • MCPS applicants: 400
  • Other first timers: 400
  • Second timers: 800

1. Flats for first timer: 950 (95%)
  • Flats for PPS: 300
  • Flats for MCPS: 300
  • Flats for other first timers: 350

2. Flats for second timer: 50 (5%)

Now, with the above scenarios, we can predict how the ballot process will work. This is just based on my understanding but it may not be exactly how it is done.

First, HDB will shortlist applicants up to 100% of the flat supply. There are 1000 flats available in this instance. 

Step 1: 
PPS applicants will be shortlisted first. 400 PPS applicants are shortlisted for 300 units set aside for them. This means that 100 PPS are out of the shortlist. 

Step 2: 
MCPS applicants will be shortlisted. 400 MCPS applicants are shortlisted for 300 units set aside for them. This means that 100 MCPS are out of the shortlist. 

Step 3: 
Other first timer applicants will be shortlisted. There are 400 other first timer applicants plus 100 PPS who failed in step 1 and 100 MCPS who failed in step 2. They will probably be shortlisted in this step 3 as well. This part is unclear as I could not get any information from HDB. If the PPS and MCPS are put in this pool as well, we have a total of 600 applicants who will fight for 350 units. This means 250 first timers (regardless of priority schemes) will be out of the 1000 queue number. 

Step 4:
Now, second timers will be shortlisted. 800 second timer applicants will be shortlisted for 50 units set aside for them. This means that 750 second timer applicants will be out of the shortlist. As a second timer applicant, you must be really lucky if you can get shortlisted within the 100% supply of flats. 

Final step:
The final step is all those who are shortlisted (first and second timers) will now be assigned random queue numbers. A first timer applicant can still get the last queue number 1000 and a second timer applicant can get queue number 1. Those who are out of the 1000 flat supply will still be assigned queue numbers as HDB gives out queue numbers for 300% of the flat supply. 


By now, if you managed to follow the above scenario, you would have realised that the balloting process is completely based on luck to get a good queue number. It doesn't matter if you applied under any priority schemes. The priority schemes only increase your chance of being assigned a queue number but not your chance of a good queue number. 

Increasing your chance to get a BTO flat

Even though the ballot process is completely based on luck, there are still ways to increase our chance to get a BTO flat. 

Firstly, we can consider non mature estates which are not too high in demand. If you don't mind that its far from the city and not near the MRT, applying for a flat in a non mature estate will definitely increase your chances of securing a unit. The prices are much cheaper too. A 4 room flat in a non mature estate cost about $300K to $350K while the same flat in a mature estate can cost more than $500K. 

Secondly, if you still want to get a BTO in a good location, you can consider applying for a 3 room flat instead of a 4 room or larger flat. The demand for 3 room flats is definitely much lower even in mature estates and I think it is probably due to the fear of not enough rooms if you have more than one kid. However, I think 3 room flats in a good location is still a good consideration at least for a start. The price of 3 room flats in good location is also much lower than a 4 room flat.  


How about resale flats?

If all else fails and there is just no luck to get a BTO, then the plan will be to get a resale flat. Resale flats although they are more expensive, there are still grants available. The resale grant for first timer families is currently $50,000 and an additional $20,000 if you stay within 4km from your parents.

A quick check on the price of resale flats in non mature estates can be selling as high as $500,000 for a 4 room flat near Buangkok MRT. If the flat is further away from the MRT, it'll be about $50K to $100K lesser. For mature estates, we should be looking at around $500K to $600K for a 4 room flat.

There is also a visible advantage when buying resale flats. We can view the actual flat itself before committing to buy the flat. This cannot be done with a BTO flat. However, resale flats tend to be older and needs more renovation as compared to a new flat. This can be overcome by buying a newer resale flat (5-10 years old) with good renovation already done by the previous owner although there is almost certainly a premium price to be paid for this kind of flats.

Buying a resale flat will let us be able to move in almost immediately as compared to the waiting time of a BTO which can range from 3 to 5 years. If we buy a resale flat and take the grants available, we will automatically be considered as second timer if we ballot for a BTO in the future. If you still want to be considered as a first timer for BTO even after buying a resale flat, you have to make sure you do not take any CPF housing grants when you buy the resale flat. In this way, you can still have a higher chance of balloting for a BTO flat while staying in your resale flat. However, do take note that the 5 years MOP will still be applicable before you can sell your resale flat and buy another HDB.


Should I Get A BTO or Resale Flat? 

Buying a flat can be a long process so opening up this conversation early with your partner is important. There is much planning to do in terms of deciding on a location, planning for the finances and also deciding whether to go for a BTO or resale flat.

If you and your partner decides to go for a BTO flat, it is always better to apply earlier as it can be quite long before you can get your desired flat. If you fail to get a BTO or running out of time, resale flat is definitely another option worth a consideration. Nevertheless, having a stable relationship before committing to a flat purchase is important too since this is a long term commitment with great financial responsibilities.

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Saturday, June 2, 2018

Hear From Financial Bloggers Live At Investors Exchange 2018

The financial blogging community is not a very big one in Singapore. Most of us do know each other in the real world.  This year, you'll have the opportunity to hear from some of the financial bloggers where they will share about how they invest their personal money and also their journey to achieve financial freedom.

My friends at BIGScribe is back with another edition of Investors exchange. Last year, there was one and it was a sold out event. This year, they are making it different. Investors exchange 2018 will feature only bloggers who walk the talk by investing their own money. The criteria for this year's speakers is:
"They should be active investors who are willing to share the same strategy that they are using to grow their own money and portfolio."

Let me introduce you to 5 speakers and bloggers who will be speaking live at the event:

1. Stanley, Value Invest Asia

Stanley is currently the chief editor of Value Invest Asia. Over the course of his career, he has written close to 2000 articles online, on investment education and market analysis. Stanley is the co-writer of the Asia-focused investment book: “Value Investing In Asia“.

He'll be sharing about "Spotting growth stocks in today's market".


2. James, Small Cap Asia

James Yeo is the founder of Small Cap Asia, where he and his team aims to help investors get the best deals out of their investments.

He is a financial analyst by profession and focuses on growth investing through small cap stocks.

We're up for a treat as he reveals his 'GARP' Investing Strategy and give you the steps to use the strategy to grow your money


3. Brian Halim, ForeverFinancialFreedom (3Fs)

Brian is the writer behind foreverfinancialfreedom. He is currently pursuing his choice of financial freedom and he has a passion for dividend investing and loves traveling together with his family.

I've known Brian for quite a few years now since I started blogging. His blog has been around much longer than mine. His strategy on dividend investing is definitely a solid one as he himself has managed to achieve a dividend income of more than 5 figures annually.

He will be revealing "The Evolution of Dividend Strategy" and give you a peek to his current portfolio as well as bring you through real life stock case studies.


4. Rusmin, Fifth Person

Rusmin is the co-founder of The Fifth Person, and the co-author of the book 'Value Investing in Growth Companies'. He had been featured on Channel News Asia and 938 Live multiple times for his views and opinions on how to invest successfully in the stock market.

The Fifth Person shouldn't be an unfamiliar name in the financial blogging world. Rusmin is a down to earth guy who really has the passion for investing. I managed to meet and talked to him in one of  SGX's dinner event just a few months back. He has picked quite a few stocks successfully and I believe his investing method works.

He'll reveal: How You Can Build A Consistent Stream Of Passive Income and Maximise Your Dividends with Stock Investing.


5. Christopher, Growing Your Tree of Prosperity

Christopher is the financial blogger behind the blog Growing Your Tree of Prosperity. He earned his financial independence at age 39 and has recently completed his Juris Doctor degree. Christopher was featured in Me and My Money sections in the Sunday Times, and has written about his journey in 3 popular personal finance books. I've known Christopher as a person who never gives up. Even after achieving financial independence, he quit his job and then went on to study law and recently just graduated. He's definitely a good speaker and an experienced investor too who has achieved his dreams.

Christopher will be sharing how he attained financial independence at 39 using the concept of F.U. Money (Freedom Unlimited).

Here are the details to the event:

Investors Exchange 2018

14th July 2018 (Saturday)
1 pm to 5 pm
DBS Auditorium, Marina Bay Financial Centre Tower 3

Ticket Price: S$65

Early Bird Discount: S$49 [Only valid till 30th Jun]
*Light snacks will be provided during tea break

For more information and to get a ticket for the event, please click here



P.S: I'll probably be there too to support my friends. If you're going for the event, feel free to drop me an email.