The hidden cost of retirement

The Hidden Cost Of Retirement: Healthcare

Many of us look forward to retirement. It is the time when we can finally enjoy our lives and the fruits of our labor. We envision that we can use the hard-earned money that we have save and invest in our wealth management journey to spend on the finer things in life.

The hidden cost of retirement

The hidden cost of retirement: I wonder why are retirement photos all at the beach.

However, as we grow older, there is this cost that keeps creeping up. If uncareful, may derail our retirement.

(This is a joint-post together with Life Finance. Do check them out. I think the quality of their article are great. They are certainly one of the better writers out there and I’m happy that there is someone like them writing on these important topics)

 

Healthcare costs in retirement

Healthcare costs will form a significant part of retirement spending. In Life Finance previous article, he documented that healthcare costs will shoot up from a bit less than 7% of household spending for a typical household before retirement to more than 12% after retirement. This is on top of health insurance spending. This 12% of overall spending is made up of the deductibles, co-payments and other outpatient expenses tat actually comes out of the retirees’ pockets (or Medisave account).

The hidden cost of retirement healthcare cost

The hidden cost of retirement healthcare cost

The higher percentage does not mean that a retired household spends less on everything else. In fact, once household size and inflation are accounted for, retired households actually spend the same amount after retirement as they do before. Hence planning for higher healthcare costs is crucial as part of retirement planning.

 

Why does healthcare costs go up in retirement?

It is no secret that while inflation has moderated for most goods and services in the past few years with slowing economic growth, healthcare inflation has continued unabated. But the rate at it is going up is not well known. Let’s look at some data.

From the data.gov website, we can see that healthcare inflation has outpaced general inflation, in the last few years.

The hidden cost of retirement healthcare inflation

The hidden cost of retirement healthcare: Inflation

But this chart gives a relatively benign view of healthcare cost inflation, showing that it is still manageable. This is however, not true at the patient level, especially for retirees. As life expectancy increases, Singaporeans are also seeing an increase in the number of years spent in ill health to more than 10 years out of a lifespan of 84 years. This means that the corresponding bills for healthcare will increase, as hospital stays becomes longer, and procedures become more complex.

To get a better sense of the increase in healthcare costs at the patient level, we can look at the Ministry of Health’s Fee Benchmarks Committee Report from 2018. While Class A public hospital bills grew by 4.9% per year between 2007 and 2017, private hospital bills grew by 9% a year in that same period!

The hidden cost of retirement healthcare bills

The hidden cost of retirement healthcare bills

Beyond that, healthcare costs have kept increasing. Mercer in 2019 indicated that in 2018, Singapore healthcare cost inflation was 10% and the same is projected for 2019 and 2020

In addition to hospital bills and healthcare costs going up, retirees are faced with the fact that the frequency of their hospital stays will also increase. The likelihood of hospitalization in any year will go up from between 20% – 27% for retirees in their late 60’s and early 70’s, to a staggering 70% – 80% when they reach their mid 80’s, or a three-fold increase at a minimum.

The hidden cost of retirement healthcare hospitalisation episodes

The hidden cost of retirement healthcare hospitalisation episodes

A three-fold increase over 20 years corresponds to a growth rate of hospitalization of 7% per year.

Hence, to get the true rate of healthcare cost increase in the retirement years, we need to consider both:
a) The higher frequency of hospitalization and healthcare needs
b) The growing rate of healthcare inflation

Putting both these figures together:

• Retiree patients in Class A wards in public hospitals will be faced with a 12% increase in healthcare costs per year (4.9% and 7%)
• Retiree patients using Private hospitals will be faced with a 18% rise in healthcare costs on a year-on-year basis

While it is true that with healthcare insurance, such as Medishield Life or an Integrated Shield plan, much of these rising costs can be transferred to the insurer, the retiree patient is still faced with the prospect of rising co-payments and other out of pocket costs. Furthermore, rising healthcare costs will ultimately be reflected in higher insurance premiums as well, which is what we discuss next.

 

Rising healthcare insurance premiums

As healthcare cost increase as explained above, premiums from medical insurance will go up due to the risk pooling nature of insurance policies. From 2015 to 2020, Singapore’s medical insurance premium began its steep incline. The Ministry of Health has stepped in on many initiatives such as co-payment, the use of preferred doctors and also pre-authorisation to help cope the medical inflation rates in Singapore.

The Medishield Life Committee gave their recommendation in 2014 with the proposal of the upgrade from Medishield to Medishield Life. In a nutshell, it means that the scope of coverage will increase and at the same time, the premiums will increase. There were a series of government subsidies over the last 5 years to help Singaporeans cope with the rising cost of medical insurance.

As the Integrated Shield (IP) plan is made up of Medishield (Now Life) and Additional Insurance Coverage from Insurance company, this directly increase the overall premiums that consumers have to pay.

The hidden cost of retirement healthcare medishield life

The hidden cost of retirement healthcare Medishield life

To the same time, insurance companies were making underwriting loses as net claims faced by the insurers outpaced premiums earned, particularly for plans covering private hospitals. Net claims are made up of the absolute cost of healthcare and the frequency of healthcare. The absolute cost of healthcare has gone up over the years as written above. At the same time, with medical advancement, it is more common for people now to seek medical treatment as compared to the past. These has made premiums unsustainable in the long run.

Between the years 2016 and 2019, the premiums of riders and the private insurance component of IP increase on average of 24% and 10% respectively each year. These trends are largely reflective of increases in private hospital insurance claims.

The raise in questionable claims also push up the claims experience of the insurance companies. (Quoted from source almost fully to retain the meaning of the article)

In one example, A 37-year-old woman stayed seven days in hospital for abdominal hernia repair. Of the $46,000 bill, the surgeon’s share was $31,900, or five times the norm. It transpired that while in hospital, she also had her breast augmented, and a tummy tuck with the fat transferred to her buttocks, but since these are not covered by insurance, none of this was stated in the bill.

A second example is for a woman was warded for 42 days for cervical sprain and strain (or pain in the neck) but received treatment only on seven days. She was given physiotherapy and painkillers for the other 35 days, something that could have been done as outpatient treatment. The bill was $84,000.

The combination of Medishield Life premiums increase, healthcare cost inflation, frequency of healthcare and the raise of questionable claims made the previous premiums charged unsustainable. This led to an inevitable increase in medical insurance inflation and also tightening of the claim procedures in the last 5 years.

 

Cost of Hidden Cost of Retirement

Medical insurance is one cost that people don’t usually take into account during retirement. We generally assume we will be well (why will we not) and plan for our living expenses with occasional holiday or two. However, we have to bring this to you to share with you the cost of medical insurance at your age of retirement.

The hidden cost of retirement healthcare great eastern shield

The hidden cost of retirement healthcare great eastern shield

The hidden cost of retirement healthcare great eastern totalcare

The hidden cost of retirement healthcare great eastern totalcare

Taking Great Eastern medical policy as an example (Disclaimer: We are not advocating any insurance policies from any company. We are using Great Eastern as an example for premium calculation. In my experience, the premiums for the other companies should be around the same).

At age of 65, we will need to annual cash premium of $2,226 ($967+$1259) for a private hospital coverage (with 5% co-payment). This comes out to be around $185/month.

In 5 years time, at the age of 70, we will need to pay an annual cash premium of $3,234 ($1695+$1539) which comes out to be around $269/month.

If this don’t scare you, at age of 75, we will need to pay an annual cash premium of $4,685 ($2650+$2035) which comes out to be around $390/month.

In Singapore, our life expantacy is around 85, I cannot imagine how one can afford those premiums when that time happens. All this is assuming that there is no future medical inflation which does not inflate the current premiums now.

PS: If you thinking that you can self-insure and not have any insurance, I hope that I have to burst your bubble.

 

Final Thoughts

The hard truth is that healthcare cost is going to continue to increase due to the factors explained above. The first thing I get my client to plan for is their paycheck. Remember that during retirement, there is a paycheck and a playcheck. The paycheck consist of items such as healthcare cost, phone bills, utilities, basic food and beverages and so on. Usually, we allocate money from “safer” asset class  to take care of those cost because it will have to be paid at whichever market conditions.

The playcheck is the one we are more familiar with. It consist of items such as exotic holidays, a roadtrip, etc.

Whichever the paycheck or playcheck, it is part of our retirement journey.

Thank you Life Finance for your contributions. If you like this article, do comment before and leave a message for me or Life Finance.

 

No one will care about your money as much as you do.

In Wealth Management, it is important to Pay yourself first. Beware of scams. Before you invest in any company or popular investment opportunity, be sure to do your own due diligence. If you wish to learn more about investment, I hope to nurture genuine relationships with all of my readers.

Check out my most popular blog post in 2020 so far: 5 mistakes people make using their CPF.

Please feel free to contact me on my Instagram (@chengkokoh) or Facebook Page or my Telegram Channel! Or subscribe to our newsletter now!

What Will Happen To My Insurance Policies If My Insurer Sells Away Their Business Phew

What Will Happen To My Insurance Policies If My Insurer Sells Away Their Business?

In Wealth management, one of the major expenditure is on insurance policies to protect your downside. In the recent case for AXA, they are considering to sell of their Singapore’s business unit, this lead to some people questioning what will happen to their insurance policies when they sell away their business.

What Will Happen To My Insurance Policies If My Insurer Sells Away Their Business Worries

What Will Happen To My Insurance Policies If My Insurer Sells Away Their Business: Worries

 

Why do they want to sell away their business?

Before we explore what will happen to our insurance policies after the companies sell that business away, we need to explore why would they even want to sell that business unit away if it is profitable.

It could be any of the following reasons:

  • Business strategy has changed
  • Raise funds to divest for peripheral operations (This is AXA’s cited reason)
  • Concentrate on other business lines
  • Focusing on other geographical markets
  • Being offered a good price / Cashing out on business

The list goes on. Insurance companies also acts like normal businesses and they will probably consider the sale of that business unit when an opportunity arises.

 

Is this the first time it happened?

It happened various times in the past and I believe this will happen again in the future.

In 2003, John Hancock was bought over by Manulife.

in 2007, TM Life Asia was acquired and now known as Tokio Marine Life Insurance Singapore Ltd.

In 2010, UOB Life sold away their life insurance unit to Prudential.

In 2018, Zurich Life was bought over by Singapore Life.

Under going discussion since 2019, AVIVA is considering to sell it’s Singapore/Vietnam business unit.

Under going discussion in 2020, AXA is considering to sell Singapore’s business unit. (Special note: AXA mentioned they will not be selling their Singapore’s business unit in 28 Dec 2017)

You can see that there is a fair amount of transaction that took place in Singapore shores as well.

 

What Will Happen To My Insurance Policies If My Insurer Sells Away Their Business?

I think that’s the key to the topic today. I have contacted the Life Insurance Association of Singapore (LIA) to confirm above. This is their response. I will bold the information that is relevant to consumers.

All insurers are licensed and are regulated by the Monetary Authority of Singapore via the Insurance Act, and its subsidiary legislation, and regulations. Due to the long term nature of life insurance policies, there are provisions* in the Insurance Act which the licensed insurer has to comply with, in an event of a voluntary transfer of business or re-structure of business or business failure, to safeguard the interests of policyholders. Refer to *Part IIIAA on Transfer of Business and Shares, Restructuring of Licensed Insurer and Winding Up.

Business Transfer (Buy-Over)

Depending on the deal agreed between the two parties, the buying insurer will generally become responsible for all policies of the selling insurer. For the individual policyholder, his policy’s terms and benefits will be unchanged, and will continue to be honored by the buying insurer.

In short, suppose you hold a policy issued by Insurer A. Insurer A is sold to Insurer B, Insurer B will become your insurance company. Your policy, now under B, will be untouched and will be made good by B.

What Will Happen To My Insurance Policies If My Insurer Sells Away Their Business Phew

What Will Happen To My Insurance Policies If My Insurer Sells Away Their Business: Phew

 

Conclusion

Your policy will still be in-force and be taken care of the new insurer. The next question will then be who will be taking care of your insurance policy from then on?

 

No one will care about your money as much as you do.

In Wealth Management, it is important to Pay yourself first. Beware of scams. Before you invest in any company or popular investment opportunity, be sure to do your own due diligence. If you wish to learn more about investment, I hope to nurture genuine relationships with all of my readers.

Check out my most popular blog post in 2020 so far: 5 mistakes people make using their CPF.

Please feel free to contact me on my  Facebook Page or my Telegram Channel! Or subscribe to our newsletter now!

3 Lessons I Learnt From Critical Illness Survivors and Family Members Being Strong

3 Lessons I Learnt From Critical Illness Survivors and Family Members

In July 2020, I had to honor to interview Critical Illness Survivors and their Family Members. I interviewed a Daughter whose mom suffered from a stroke, a 2-time breast Cancer Survivor and also a Father who’s son had Leukemia (Blood Cancer). After the 3rd interview, I noticed a consistent trend that all 3 exhibit and how they manage the whole journey in their family planning or wealth management.

I want to thank Angie, Grace and also Sean for their selfless sharing so that more people can learn what they went through. We also pray that you won’t need to use this lessons in future.

Thank you.

 

Lesson #1: It starts of with pain

In my interview, I realised that it starts from with some unexplained pain at a particular body part. Most of the time, it was brushed aside or just thought that it was harmless pain. Very commonly, the person will feel more tired than usual.

Pain is an message to your body that something is wrong. Please do not ignore it.

3 Lessons I Learnt From Critical Illness Survivors and Family Members Pain

3 Lessons I Learnt From Critical Illness Survivors and Family Members: Pain

 

Lesson #2: Seek Support

This was the most important when it comes to recovery. The journey of critical illness could be confusing, overwhelming and devastating. The right support could ease the journey where every single step is already well planned out. The Children Cancer Foundation and the Breast Cancer Foundation specifically named in my interview for being very meticulous. These societies impacted their lives so much that they continue to donate or give back till today.

“Please don’t stay in a private ward” 

Even though your hospital entitlement might be a single bedder, staying in hospital with no other people to communicate with and journey together might give the feeling of being alone and that’s the last thing we want. Talk to people, listen to their journey, know that you are not alone.

Seek out your friends, family and GOD.

3 Lessons I Learnt From Critical Illness Survivors and Family Members Support

3 Lessons I Learnt From Critical Illness Survivors and Family Members Support

 

Lesson 3: Be Financial Prepared

Whether you are a parent or a child, a critical illness will rob your time off work and saving. Fortunately, my interviewees bought insurance to protect their livelihood, money and especially time so that their loved one can spend time to journey together with the patient. Grace’s husband was able to step away from work for half a year so that he can accompany Grace during her treatment. Sean was able to spend time with his son during treatment times as well.

The hospital bills will be scary. “It is easily more than $500K a year”.

Be financially prepared even before it happens.

3 Lessons I Learnt From Critical Illness Survivors and Family Members Bills Shock

3 Lessons I Learnt From Critical Illness Survivors and Family Members Bills Shock

 

Bonus Lesson #4: Keep yourself in good condition

As a caretaker, parents or child, keep yourself in good condition. You need to be in the best condition physically and mentally to bring your family out of this. If you want to blame and punish yourself for what has happened, punish yourself by keeping yourself in a good condition and take responsibility to bring your family out of this.

You need to appear strong in front of your child, your spouse or your parents so that you can give them the confidence that everything will be alright.

3 Lessons I Learnt From Critical Illness Survivors and Family Members Being Strong

3 Lessons I Learnt From Critical Illness Survivors and Family Members Being Strong

 

Conclusion

Don’t ignore pain, seek support and be financially prepared.

Thank you Angie, Grace and Sean for the inspiration for me to write this article. You can view the replay below.


No one will care about your money as much as you do.

In Wealth Management, it is important to Pay yourself first. Beware of scams. Before you invest in any company or popular investment opportunity, be sure to do your own due diligence. If you wish to learn more about investment, I hope to nurture genuine relationships with all of my readers.

Please feel free to contact me on my Instagram (@chengkokoh) or Facebook Page or my Telegram Channel! Or subscribe to our newsletter now!

How to have better relationship with money stressed woman

How to have better relationship with money?

We talk about building better relationship, having good wealth management but have we thought of having a better relationship with money (self-care)?

In Singapore, one thing that fly under the radar of the recent politics campaign is the high stress level of working. Do you know almost 100% of Singaporeans are stressed at work? (Source: Human Resource Director).

 

“Almost 100% of Singaporeans are stressed at work”: Survey

How to have better relationship with money stressed woman

How to have better relationship with money: stressed woman

Welcome to the city where the cost of living is high, have expensive healthcare and unaffordable housing. Together with this economic situation after COVID-19, many young people struggle to find their first job after graduation. Though I agree we have our positive side, we must also recognized that these economic-social issues will affect our relationship with money.

 

Why are Singaporeans Stressed at work?

Top causes of stress for single, married and working mothers vary, but all mention personal finance, too much work and personal health.

According to a survey by Jobscentral, being overburdened with financial commitments (29%) is one of the biggest reasons Singaporeans don’t leave a job they hate. 25% cited fear of not being able to find a better job as their reason for not leaving a crappy job. (Source: 3 Big Reasons Why Singapore Employees Are Always Stressed Out!).

While money is not the only reason, it is a common reason for stress.

Relationship With Money Stressed Statistics

Relationship With Money Stressed Statistics

 

Where did this stress stems from?

In my previous article about Self-Care and Wealth Management, I’m grateful to be able to ponder in depth on why people might become narcissist on self-care. It has to do a lot with their beliefs about money and I’m going to summarize it in the chart below.

Your relationship with money will determine your money habits that you have and it will led to the financial circumstances that one will go through and finally happiness.

Relationship with money

Relationship with money

Example #1: You are undeserving of money / reward.

I had a classmate, Karen who scored straight As for her primary school examinations. One year, another classmate shared with us that he just came back from a trip to Australia because he had good results in the last year. Karen decided to tell her parents about it. Her parents told her that if she continued to score straight As, she will be able to go for the trip.

Eventually, Karen had the straight As. But, the trip didn’t happen.

As a child, Karen held a belief that no matter how much effort she puts in, she will not get a reward. Today, Karen is a hardworking individual and put in a lot of effort in her work. Despite her hard work, she was unable to climb the corporate ladder and have mediocre salary. Personally, I feel that she still believes that she’s undeserving (relationship with money), other people are luckier and so passed on several opportunities (habits). This lead to her living a miserable life (financial circumstances)

 

Example #2: Believe that People With Alot of Money is Evil / Money is the root of all evil.

When I was young, I asked my parents why my classmate could go to Europe to travel while we only went Genting. My Mom told me that my classmate’s father was a businessman and he have to spend a lot of time on entertainment. He have to do a lot of “funny/bad things” that as children, we won’t understand at that age. Lots of Taiwanese/Korean dramas also reinforce this belief that you have to ruthless to earn money.

When I grew up, there was a period of time I judged people for earning a lot of money instead of being happy for them. If I learnt that they were earning more money, I felt that they done a lot of “funny/bad” things to achieve their goals.

I felt that earning a lot of money is evil (relationship with money), I would try not to earn over a certain threshold (habit) and that led me to living a normal life (financial circumstances).

 

This is ridiculous.

Your relationship with your money is largely influenced by the money lessons you learned from your primary caregivers and mentors, as you were growing up. While it is on no fault of theirs, we need to identify and be aware of the beliefs you have on money so that we can break out of this trap.

I challenge you to write down a list of your money beliefs. It could be “Money is never enough”, “Investing is risky”, “I need to spend money to feel good” etc. Ask yourself, does this money belief serves you or hinder you. If it hinders you, spend sometime to process why has it been affecting you and make a decision to change the belief.

We wish you good luck and stay safe.

 

No one will care about your money as much as you do.

In Wealth Management, it is important to Pay yourself first. Beware of scams. Before you invest in any company or popular investment opportunity, be sure to do your own due diligence. If you wish to learn more about investment, I hope to nurture genuine relationships with all of my readers. Please feel free to contact me on my Instagram (@chengkokoh) or Facebook Page or my Telegram Channel! Or subscribe to our newsletter now!

Can You Afford Cancer Without Insurance Second Chance

Can You Afford Cancer Without Insurance?

The Cancer War destroyed many families wealth management and robbed people of their loved ones for centuries until now…

Because of medical advancement, we have a second chance. Let’s see if we can afford cancer without insurance.

Can You Afford Cancer Without Insurance Second Chance

Can You Afford Cancer Without Insurance Second Chance

 

Cancer Statistics

  • 39 People diagnosed with Cancer everyday
  • 15 people die of Cancer everyday
  • 1 out of 4 people may develop Cancer in their lifetime 

In other words, we have around 25% chance of developing cancer in our lifetime (Source: Common Types of Cancer, Singapore Cancer Society). Let’s put some fun facts as a probability comparison.

Enough said. So now I know the chances of developing cancer is high, what are the cost?

 

Treatment Cost

It really depends on what cancer we are talking about here. MOH now provide fee benchmarks and fee information for the treatments in public hospital and private hospitals. There are 3 main things that biopsy, surgery or treatment.

I have extracted the most common form of cancer in Singapore in a private hospital. (Data Extracted: 24 June 2020)

  • Breast Cancer treatment (conservation of breast, removal of cancerous growth with removal of underarm lymph nodes) will cost $23,423
  • Cervical cancer (female reproductive tract, scope of the cervix with removal of growth (<2am): $7,075 to $8,261
  • Colon cancer (lower abdomen, scope of large intestine for diagnosis with removal of growth (multiple or >1cm): $3,755
  • Prostate cancer (male reproductive tract, removal of entire prostate and surroundings): $53,326
  • Pancreatic cancer (upper abdomen, scope of bile duct and pancreatic duct with treatment): $1,412 to $2,984

You can find out more about MOH fee benchmark here.

The conclusion here is that the cost varies wildly and depends on the stage at which the cancer is discovered and the size of the tumor.

Outpatient Cost

The 3 common outpatient treatment for Cancer is Chemotherapy, Radiotherapy and Immunotherapy. Like treatment cost, outpatient cost also varies wildly.

In Singapore, the average cost of Chemotherapy is $1500 per cycle. It really depends on the stage of cancer to determine the number of cycle needed. Depend on the drugs used, an article from David mentioned an average of 2 chemotherapy session a month may cost up to $10,000 (Source: MOH New Highlights). Would you be prepared to pay $3000/month (average cost x 2 session) for chemotherapy?

The average cost of Radiotherapy ranges from $25,000 to $30,000. (Source: Precision cancer treatment expected by 2020). There is a new treatment called Proton Bean Therapy that is just being approve by MOH. The cost could go up to three times as much and require about the same number of sessions.

Immunotherapy is the most “expensive” method because it is one of the newer treatment available. It cost around $9000 per dose. If we assume that the dose is needed very 2 weeks, the total cost could be $234,000 per year. (Source: Immune System Unplugged: Releasing Cancer’s Grip on Immune Cells with Checkpoint Inhibitors)

 

Are you afford Cancer?

Given a typical medium income of $56,550, (Source: SingStat: Key Household Income Trend), the outpatient cost will easily wipe away a person’s annual salary or more. Most likely, they will be digging deep into their saving to afford cancer.

This also assumes that the person is able to continue working during cancer. There is a possibility that you might be asked to stop work to undergo treatment. This lost income not only impact the ability to afford cancer but also the ability to afford your current lifestyle to provide for your family.

 

What should you do?

The problem will still be there even if you don’t face it.

Firstly, check if you have adequate critical illness coverage and hospitalisation coverage. Follow up with your financial consultant or you can contact me if you don’t have one. Your coverage amount will be determined by your age, whether you have a family, number of dependents, etc.

Do it before 26 August 2020, After 26 August 2020, all critical illness policies in Singapore will have to follow the new definition as stated by the LIA.

Take Care and Stay Safe!

 

No one will care about your money as much as you do.

In Wealth Management, it is important to Pay yourself first. Beware of scams. Before you invest in any company or popular investment opportunity, be sure to do your own due diligence. If you wish to learn more about investment, I hope to nurture genuine relationships with all of my readers. Please feel free to contact me on my Instagram (@chengkokoh) or Facebook Page or my Telegram Channel! Or subscribe to our newsletter now!