Hi, this is D. This post is actually dedicated to my dear GJH because he’s heading back to SG next week and he needs all these information. I figured it’s best to write it here just in case it is helpful for someone else.
His dad was diagnosed with cancer last year and we had thought he had recovered after radio and chemotherapy but unfortunately, earlier this week, we were informed that his cancer has spread to his liver and nose tip. GJH will be heading back to accompany his dad for his initial consultation and treatment next Monday. Sadly, this time, I’m not able to return with him because I have work schedule to follow. As such, I’m here to pen down all the information that is applicable for him because GJH is obviously not that in touch with different forms of assistance in SG.
But before that, let me just add that even an average Singaporean might not know where to go for help because it’s just a maze to navigate through SG’s social and financial schemes. Even social workers struggle, not to mention an average Singaporean and a permanently overseas Singaporean like GJH. I’m only lucky enough to have these information because in my previous job, I was doing service planning for a VWO with eldercare assistance. I ever plotted a whole excel chart with all eldercare services by specific VWOs just to do a ‘SWOT’ analysis. Now, I’m so thankful I did that.
So, do note that this information is mainly about assistance for an elderly in 60s of medium to low income suffering from cancer. This means that he or she might not be considered a handicap yet because he can still perform most of the ADLs (activities for daily living).
Just FYI, the 6 ADLs include washing, feeding, dressing, toileting, mobility and transferring independently.
Most people would have this on their list as the main thing to ask for because, well, it’s so costly in Singapore when one needs constant treatment, not just because of hospitalisation bills, but for other things like taking taxis to and fro hospitals to the lack of income due to intensive treatment that causes one to be unable to work. By now, most of you should know that we are covered by Medisave and more importantly, Medishield. I will not go in depth about the coverage but just know that as long as you are under Medishield (most or all singaporeans should be under this scheme), you should be able to manage the hospital bills. Do note that there’s a cap for each kind of treatment or category of payment and also an annual cap of S$100,000 under medishield claims. For chemotherapy, it’s cap at $3000 per month. Cos of this, I’m glad our generation is well aware of the need for health insurance and most of us are covered under integrated shield plans, which will provide another layer of safeguard when we are ill.
If you need more assistance, i.e. cash, I advise that you do one very important thing: tell the doctor. Not because doctors are rich and they will help you (lol) but because you can only get assess to a Medical Social Worker (MSW) through doctors’ referral letter. MSWs are around in every hospital and they will speak to you to assess your financial situation and advise accordingly what scheme you can apply for. Specific MSWs are also usually attached to specific departments in a hospital so they know best what kind of help patients with different types of illnesses most need. Just go to them and tell them your situation and they are the ones who will tell you all the assistance you can apply for. What I want to say is, THEY ARE VERY IMPORTANT. But! Just in case you get referred to a blur or incompetent MSW, it is best to know all the assistance you can get yourself, so you can ask him/her one by one to make sure he/she exhaust all options for you.
Most of the time, there’ll be one programme specific assistance for your illness e.g. assistance for cancer patients from cancer society, that may provide monthly stipend of a few hundred dollars a month, or provide treatment subsidy, drug subsidy etc. Next, there’s MediFund from Ministry of Health (MOH), and Social Service Office (SSO) assistance called ComCare from Ministry of Social and Family Development (MSF) for all Singaporeans who have low family income. Of course, most low income families would already be under CHAS. There’ll also be financial relief if you need to hire a helper and grants for purchasing of wheelchair and other mobility assistive devices.
Medifund is specific for relieving medical treatment cost while ComCare is a fund that’s open for all Singaporeans with low combined family income to apply. Both come in the form of monthly cash assistance, which is why it is also the most troublesome to apply for. Be prepared to trouble everyone in the family to surface all forms of income documents, from CPF contribution statements to payslip.
For ComCare, you might have to pay a visit to the nearest SSO in your neighbourhood to apply (check with MSW). SSOs are basically the previous CDCs.
One shady thing I dislike about MediFund is that the approval conditions are undisclosed to the public i.e. no one knows how one can qualify, except that you must be very poor. A lot of people give up applying for all these because it’s just tooooo much work to get all the documents, especially because not all families have supportive family members. Who knows who are hiding some income (income has always been a sensitive topic in Singapore), or which estranged family member is willing to provide the documents. Throw in a family member who is rich and estranged and you’ll see how a poor family may not get the assistance they so desperately need. While I understand why there are such stringent screening process, my point is, just be prepared to go through a lot trouble to apply but still get rejected in the end.
All these assistance are based on approval basis according to a family’s combine income. Note that they don’t just take your household income (i.e. people who live in 1 house, excluding married children who have moved out) but the family’s income. I highly suggest that if you need the money, just try applying anyway and state very clearly everyone’s expenses so the MSW can help you to fight your case and write in an appeal.
Unfortunately, if you are hoping that the assistance can come in so that children’s savings (i.e. your savings) won’t be affected since children have their own family and future to worry about, bad news. Singapore’s welfare assistance is not available for you unless you are really, really, really, in need. There’s a reason why elderly suicide rate in SG is so high — they’d rather die than burden their children. Singapore and Japan both have super high elderly suicide rates compared to other countries, with a common trigger being isolation and fear of being a burden. I know why policies are such in SG but really, more needs to be done. 🙁
The amount of assistance you’ll get is also dependent on ‘how poor’ you are. They call it means testing so it’s hard to advise how much each assistance is.
And that’s it for financial assistance for most people. Point is: Speak to the MSW. Yup.
Sometimes, we need help that is beyond money. An example is if you need someone to help you take care of your sick parents. It could be to assist a bedridden parent with moving around, going to the toilet, feeding, basically to do the different ADLs. One obvious way is to hire a helper. Good news is that there are grants for hiring of helper for low income families with sick family members being unable to fulfill ADLs. It’s all listed here. Important point is that usually, the condition is failing 3 out of 6 ADLs. I’m not sure if cancer patients will be considered so, because weakness may not render one disabled unless one is bedridden. You’ll need to check with the doctor.
But one help that many family need will be Medical Escort and Transport service. Children may not have the time or be available to make frequent trips to the hospital with their parents, so this will come in place, especially if their parents are wheelchair bound. It is charged per trip between $62 to $90 before subsidy, so it might be more worth it than cabbing to and fro after the subsidy, which is again through means testing. This way, we have peace of mind that our parents are taken care of and receiving proper treatment while we are working to keep the family afloat.
What if your parents are too sick and you can’t be around temporarily? If you need temporary care for a parent who is really ill and require medical care, you can always send them for respite care. It is basically a short term nursing home stay (at least 7 days) that provides care while you are not able to do so. Sometimes, it could just be a break for a caregiver because caregiving can be very draining and stressful and we all need a break.
These are mainly the ones I find most applicable but there are actually many forms of assistance available, though not all are applicable due to difficulty in getting financial assistance for them. Best website for this is actually Silverpages.sg so do head over there for reference.
Important Resources: How do you access these assistance?
Now, all the information above involves a few main organisation and people. Firstly, you need to know that most financial assistance goes through MSW, who will apply to different organisations for you, so that’s easy.
Another part that you need to know is how Singapore’s medical and social assistance landscape work. We have mainly 2 ministries
working on their own while trying very hard to integrate their services to no avail because it’s still a maze to navigate the for assistance MSF and MOH. They do not carry out the help themselves but rather they provide the money and assistance to do so and the actual centers that deliver the services are actually private companies and VWOs (voluntary welfare organisations). For example, MOH plans to open a new nursing home. They will then open the site for bidding and VWOs and private companies then put in their bid to run the particular center to provide the services. Therefore, you will realise that there are many nursing homes and care providers around different neighbourhood, all with different names. How do you get their services? Do you walk in? How do you get referred in? Are they private? Can I get subsidy if I get their services?
The answer is: Agency for Integrated Care (AIC)
AIC is (surprisingly) a private organisation that helps MOH and MSF to consolidate their efforts by directing patients to relevant resources. AIC is basically a ‘directory’ or a ‘referral’ robot that can point you to the right organisations for help e.g. I live in Hougang, I need medical escort service in that area, so they refer me to Sunlove Home who is providing that service. Looking for nursing home? Go to AIC, tell them your needs, and they’ll refer based on each center’s availability as well as your location because all service centers actually have a service boundary to follow.
So, you’ll definitely need to pay a visit to AIC centers known as AICare Link. They are basically located in hospitals and if you are lost and not sure where to get help, just ask them. Here’s a list of their location. Be sure to be clear about the help that you’ll need.
Most centers have KPIs of X number of patients to assist, so they’ll welcome you with open arms, lol.
Because of the complex service roadmap in singapore, I highly recommend doing your own homework first before heading down to meet with MSW and AIC. This is because we may not always be blessed with competent workers, just like how not all insurance agents are knowledgeable, so we should do our own homework before we meet an agent to buy a policy. It’s exactly the same. Be clear about what you need, check online to get a rough idea which centers are available to you here and then get their advice. This way, they can’t smoke you and you won’t miss out on any assistance that you can get.
This is a sample screenshot of what your search result will return:
Here is a brochure showing most of the financial assistance schemes available for elderly
Here is a brochure showing all the care services center around Singapore. If you see the names, you’ll understand what I mean above when I said it’s actually run by VWOs and private operators.
I also highly recommend preparing some financial documents items before you meet a social worker, like:
- CPF contribution statement up to past 12 months (doesn’t hurt to have more) of ALL family members [yes, good luck helping your parents to log into their singpass if they don’t usually do it. You’ll need to run to the nearest CC to reset their password etc]
- Payslips of all working adults (CPF statements should suffice but just in case)
- Bank account statement (showing latest balance, i.e. you need date on the proof)
- Information of expenses and liabilities (HDB bill, Town Council bill, etc)
- Liabilities information (outstanding loans etc)
- Medical appointment card or any documentation e.g. letter proving inability to work due to illness (this is mainly for comcare)
- Any other document useful to justify your need for assistance
It probably seems very daunting (look how long and how many jargons and organisations are involved) to be seeking help in a jungle when we are already stressed out from having a sick parent to take care of. We have to stay logical, keep calm, and do one thing at a time. That’s the only way out. I hope the information above will at least give people in such situation a rough idea of what to do and what to expect. If it’s just too much, remember the 2 main point: MSW and AIC! They are the most important.
Last but not least, to my dearest GJH…
Please stay strong for your family! I’ll help you to take very good care of myself when you’re not around and I’m always here for you if you need help or advice. I’m really lucky and blessed to be with someone who is responsible and takes care of his parents. 🙂 So do what you need and do what you must! 日本から応援します！我們一起加油，度過這關。
And that’s all I have this time.