If you have not developed severe disability but require some assistance with at least three out of six Activities of Daily Living (ADLs), you may apply for Home Caregiving Grant (moderate disability scheme) should you meet the following non-disability eligibility criteria:

a. Singapore Citizen.  
Permanent Resident can qualify if either a parent, child or spouse is a Singapore Citizen. 

b. Not in a residential long-term care institution (e.g. nursing home).

c. Lives in Singapore.

d. Means-tested.

Household monthly income per person is $2,800 or less; or annual value of property for household without income is $13,000 or less.

To apply, you should visit a General Practitioner or arrange with your care provider to obtain a Functional Assessment Report and submit an application to the Agency for Integrated Care (AIC).

Under the new severe disability assessment framework and revised training curriculum, assessors will be guided more explicitly on the aspects to consider if an applicant is suspected to be cognitively impaired. As assessors are better equipped to take into account the impact of cognitive impairment on an applicant’s functional abilities, cognitively impaired applicants with higher levels of functional impairment will more consistently qualify for severe disability scheme(s).  

Applicants with dementia or other cognitive impairments will still need to undergo a disability assessment in order to qualify for severe disability scheme(s) payouts, as dementia/cognitive impairment could affect the applicant’s functional abilities to varying extents. The ElderShield disability assessment form today states that an individual’s cognitive capacity should be taken into consideration when an assessor is assessing ADL ability, but it is not clear how assessors should do so consistently. 

Under the new framework and revised training curriculum, assessors will be guided more explicitly on the aspects to take into consideration if an insured is suspected to be cognitively impaired. Assessors will therefore be better equipped to take into account the impact of cognitive impairment on an insured’s functional abilities, which will result in cognitively impaired insureds with higher care needs being able to more consistently qualify for CareShield Life claims.  

Insureds with dementia or other cognitive impairments will still need to undergo a disability assessment in order to qualify for CareShield Life claims, as their functional abilities may be affected in varying degrees by their cognitive impairment.

Not all GPs would have undergone similar rigorous training programme to learn how to assess disability. A trained, accredited severe disability assessor will be able to assess whether you meet the CareShield Life/ElderShield claims criteria of being unable to perform three or more of the six Activities of Daily Living (ADLs).

If you are staying in a nursing home, you may approach your nursing home for assistance to submit the Resident Assessment Form in place of the severe disability assessment.

The Government is looking into how to recognise functional assessment tools which are well-recognised and commonly used in the healthcare and long-term care sectors, for example the Resident Assessment Form, the Modified Barthel Index and the Functional Independence Measure. To ensure that gatekeeping remains robust, these tools should be sufficiently detailed, such that an appropriate threshold for admitting claims can be mapped to the ElderShield claims criterion of severe disability.

Applicants with dementia or other cognitive impairments will not automatically qualify for CareShield Life/ElderShield claims and will still need to undergo a severe disability assessment, as dementia/cognitive impairment could affect the applicant’s functional abilities to varying extents.

CareShield Life/ElderShield insureds with severe disability who wish to apply for claims will need to undergo a severe disability assessment by a MOH-accredited severe disability assessor.

A trained, accredited severe disability assessor will be able to assess whether the applicant meets the CareShield Life/ElderShield criteria of being unable to perform three or more of the six Activities of Daily Living (ADLs). We have expanded the list of accredited assessors to include therapists and nurses who have been trained.

All MOH-accredited assessors have undergone a rigorous training programme to learn how to assess a Patient’s level of disability. Through the training, assessors are equipped to assess an individual’s ability to perform the six ADLs, including specific components of each ADL to take into account, what factors to consider when an individual is cognitively impaired, and what should be done if any individual’s functional ability fluctuates over time. As this is a complex process, the training and accreditation is necessary to ensure that disability assessments are conducted with a high degree of rigour and consistency.

The Government is also looking into recognising equivalent assessments that have been performed by a qualified healthcare professional (doctor, occupational therapists, physiotherapists, and registered nurses) providing care to the patient. In such cases, the patient need not undergo a separate severe disability assessment. Today, those who are staying in a nursing home can already approach their nursing home for assistance to submit the Resident's Assessment Form in place of the severe disability assessment.

MOH and AIC will progressively roll out the use of such equivalent assessments and will make the information available via MOH and AIC website.

MediShield Life covers large bills incurred due to hospitalisation, so it is natural that hospitals automatically file claims on behalf of an individual.

CareShield Life/ElderShield provides monthly cash payouts that can be used for the benefit of an insured with severe disability. As the payouts will be paid to the bank account nominated by the insured, insureds or their caregivers will still need to be involved in the process of filing the claim. 

Notwithstanding this, the Government has streamlined the claims process to improve convenience for insureds with severe disability and their caregivers, by increasing the pool of assessors and progressively accepting equivalent disability assessments already conducted by the insured’s care provider. We have also made the claim application process more efficient, for instance, by introducing an electronic application system that insureds with severe disability and their caregivers can access via the internet. The portal, accessible via https://efinance.aic.sg, integrates the application for all MOH disability schemes into a single form. We will continue to review how the process can be further simplified, as we gain more experience in administering the scheme.

The fees for clinic-based and non-clinic-based severe disability assessments are $100 and $250 respectively.

If you are applying for CareShield Life
The assessment fee will be waived for the first severe disability assessment for CareShield Life claims, regardless of the assessment outcome. Otherwise, assessment fees will be reimbursed if the insured is assessed to have developed severe disability.

If you are applying for other severe disability schemes i.e. ElderFund, ElderShield, IDAPE, MediSave Care
The MOH-accredited severe disability assessor will conduct the severe disability assessment and collect an assessment fee from you. Assessment fees will be reimbursed if you are assessed to have developed severe disability.

Under CareShield Life, assessors assess an insured’s ability after the use of basic assistive devices, as this more directly measures the actual amount of assistance the insured needs from a caregiver, to help the insured with his daily activities.

However, the use of assistive devices is just one of the many considerations that assessors take into account. Other factors taken into consideration include the home and community environment, falls risk, impact of any cognitive impairment etc.

The Government provides funding for basic assistive devices through assistance such as the Senior’s Mobility Fund. We will review how we can better ensure accessibility to basic assistive devices for individuals who can benefit from them.

You can find the list of MOH-accredited severe disability assessors at the AIC’s website.

As a caregiver, you may make an application and opt to receive the monthly payouts on behalf of your family member who develops severe disability and lacks mental capacity. In order to do so, you will need to be your family member's deputy appointed by the Court, or donee appointed under a Lasting Power of Attorney (LPA), to manage his property and affairs. This requirement safeguards his interests. If your family member with severe disability does not have a donee or deputy, you can still apply for, and receive payouts on your family member’s behalf. However, to protect interests of your family member you will need to apply to be appointed as a deputy by the Court within 12 months of claims approval, failing which the payouts will be re-directed to your family member’s bank account, or suspended until a deputy has been appointed. AIC can provide you with further advice on the process of applying for deputyship.

If you are covered under CareShield Life and wish to claim from CareShield Life, you should submit your application via the Agency for Integrated Care (AIC) eServices for Financing Schemes (eFASS) Application Portal using your Singpass.

Pioneer Generation Disability Assistance Scheme (PioneerDAS) and Home Caregiving Grant (HCG) are moderate disability schemes, where the individual only needs to always require some assistance with three or more Activities of Daily Living. CareShield Life and ElderShield are severe disability schemes, where the individual needs to be unable to perform three or more Activities of Daily Living (i.e. require significant assistance) in order to make a claim.  

As the eligibility criteria for CareShield Life and ElderShield are stricter, insureds who are eligible for CareShield Life/ElderShield claims can automatically receive PioneerDAS or HCG payouts without going for a separate assessment (subject to meeting the other non-disability eligibility criteria for these schemes).

Currently, CareShield Life/ElderShield claimants are contractually required to wait for 90 days from the date of the assessment before receiving the first CareShield Life/ElderShield payout, a typical insurance practice known as the “deferment period”. This is intended to ensure that the severe disability is of a long-term nature before payouts are provided. The Government waives the deferment period for most cases, and selectively impose it where disability statuses are less clear-cut. This practice allows most claimants who develop permanent severe disability to receive their monthly payouts expeditiously, while still ensuring the sustainability of the scheme.

To qualify for severe disability schemes, an individual will need to be assessed by an MOH-accredited severe disability assessor to be unable to perform three or more of the six Activities of Daily Living (ADLs). The severe disability assessors use a different assessment tool from the FAR that enables them to capture the degree of assistance required for each ADL. To use this tool, an assessor has to undergo a rigorous training programme and be accredited by MOH. 

The FAR on the other hand is used to determine if one needs some assistance, or is fully independent, for each ADL. It is not intended to capture the degree of assistance required for each ADL. As such, the FAR is not suitable for severe disability scheme applications. However, the FAR can be used if you are only applying for mild and/or moderate disability schemes such as the Pioneer Generation Disability Assistance Scheme or Home Caregiving Grant (HCG).