Central Provident Fund (Medisave Account Withdrawals) Regulations

Central Provident Fund Act

(Chapter 36, Section 77(1)(j))

Rg 17

G.N. No. S 570/2001

REVISED EDITION 2007

(15th May 2007)

[1st November 2001]

Citation

1. These Regulations may be cited as the Central Provident Fund (Medisave Account Withdrawals) Regulations.

Definitions

2.—(1) In these Regulations, unless the context otherwise requires —

“approved centre” means any centre in a hospital or clinic approved by the Minister for Health for renal dialysis treatment;

“approved chronic illness treatment” means any medical treatment in respect of any illness specified in the first column of the Second Schedule;

“approved CIT medical institution” means any centre, clinic, hospital or other premises which offers medical treatment and which the Minister for Health has approved for the purposes of approved chronic illness treatments under these Regulations;

“approved clinic” means any medical clinic approved by the Minister for Health for the purposes of these Regulations;

“approved community hospital” means any premises which, in the opinion of the Minister for Health, provides an intermediate level of care for out-patients and in-patients who have simple ailments which do not require specialist medical and nursing care and is approved by that Minister for the purposes of these Regulations;

“approved convalescent hospital” means any premises which provides in-patient medical care for the recovery or rehabilitation of patients and is approved by the Minister for Health for the purposes of these Regulations;

“approved day hospital” means any premises which provides for day rehabilitative assessment and treatment of patients and is approved by the Minister for Health for the purposes of these Regulations;

“approved day surgery centre” means any centre which provides day surgical treatment to a member or his dependant and is approved by the Minister for Health for the purposes of these Regulations;

“approved hospice” means any premises which provides for the medical treatment and care of terminally ill patients and is approved by the Minister for Health for the purposes of these Regulations;

“approved hospital” means any hospital approved by the Minister for Health for the purposes of these Regulations;

“approved medical institution” means any of the following:

(a)	approved centre;
(b)	approved CIT medical institution;
(c)	approved clinic;
(d)	approved community hospital;
(e)	approved convalescent hospital;
(f)	approved day hospital;
(g)	approved day surgery centre;
(h)	approved hospice;
(i)	approved hospital;
(j)	School Health Service;
(k)	Senior Citizens Health Care Centre;
(l)	Singapore Gamma Knife Centre;

“approved medical practitioner” means any medical practitioner who is approved by the Minister for Health or such other person as he may appoint for the purposes of these Regulations;

“approved medical treatment” means such medical treatment as is specified under the first column in the First Schedule;

“approved treatment” means any form of treatment which is provided by a Senior Citizens Health Care Centre and is approved by the Minister for Health for the purposes of these Regulations;

“co-payment amount”, in relation to a member or his dependant, means the amount which the member or his dependant (as the case may be) is responsible for paying in respect of any approved chronic illness treatment or treatment package, as specified in the third column of the Second Schedule;

“co-payment percentage”, in relation to a member or his dependant, means the percentage of the charge for any approved chronic illness treatment or treatment package which the member or his dependant (as the case may be) is responsible for paying, as specified in the third column of the Second Schedule;

“day surgical treatment” means any surgical treatment received by a person who is admitted and discharged on the same day;

“dependant” means —

(a)	a member’s spouse, child or parent; and
(b)	a member’s grandparent who is a citizen or permanent resident of Singapore;

“in-patient” means —

(a)	a patient who has been hospitalised for one day or more for medical treatment;
(b)	a patient who has been hospitalised for a period of not less than 8 hours; or
(c)	a patient who has died within 8 hours of being hospitalised,

but does not include a patient who has been hospitalised for day surgical treatment;

“last medical bill”, in relation to a member who has died on or after 1st July 2006 in an approved medical institution before his discharge therefrom, means the bill for charges incurred in respect of the medical or psychiatric treatments which the member received in the approved medical institution;

“medical clinic” means any premises used by one or more approved medical practitioners for the diagnosis or treatment of persons but does not include any such premises which forms part of the premises of an approved hospital;

“medical practitioner” means any medical practitioner registered under the Medical Registration Act (Cap. 174) or any dentist registered under the Dentists Act (Cap. 76);

“medical treatment” means any medical treatment, treatment of neoplasms by chemotherapy, radiotherapy, radiosurgery treatment, renal dialysis treatment, or surgical treatment and includes investigations, medicines, curative materials and devices and, where such treatment has been received by a person as an in-patient, includes the maintenance of that person in any approved medical institution, except a Senior Citizens Health Care Centre;

“medical treatment for conception” means assisted conception procedures, for example, Invitro Fertilisation (IVF), Gamete Intra-fallopian Transfer (GIFT), etc.;

“member” includes a member who is an undischarged bankrupt;

“out-patient” means a patient other than an in-patient or a patient receiving day surgical treatment;

“pre-delivery medical treatment” means any medical treatment prescribed by a medical practitioner that is received by a pregnant woman in relation to her pregnancy before the delivery of a child or the termination of her pregnancy;

“prescribed person”, in relation to a member, means a person —

(a)

who has attained the age of 21 years and is of sound mind; and

(b)

who is —

(i)	a committee of the person or of the estate of the member, appointed under the provision of the Mental Disorders and Treatment Act (Cap. 178); or
(ii)	the spouse, a parent or a child of the member, or such other person related to the member as the Minister for Health may approve for the purposes of regulation 3;

“psychiatric treatment” includes any therapeutic procedure given to control and relieve any psychiatric symptom or to prevent its recurrence;

“radiosurgery treatment” means the gamma knife treatment or the Novalis shaped beam treatment of neurosurgical or neurological disorders;

“radiotherapy treatment” means the treatment of any malignant disease or certain benign condition with ionising radiation delivered externally or internally by sealed or unsealed radionuclides and irradiating apparatus as specified in the First Schedule;

“renal dialysis treatment” means treatment received by a member with renal failure for the purpose of purifying his blood of waste metabolites accumulated as a result of failure and includes haemodialysis and continuous ambulatory peritoneal dialysis received at any approved centre or at the member’s home;

“Singapore Gamma Knife Centre” means any premises which provides gamma knife treatment for the care of in-patients and is approved by the Minister for Health for the purposes of these Regulations;

“surgical treatment” means any surgical treatment approved by the Minister for Health for the purposes of these Regulations;

“treatment for sexual sterilization” has the same meaning as in the Voluntary Sterilization Act (Cap. 347);

“treatment of neoplasms by chemotherapy” means the administration of tested and approved chemotherapeutic agents by the usual and known routes in the treatment of malignant and benign neoplasms, and neoplasms of uncertain behaviour;

“treatment package” means a course of approved chronic illness treatments that complies with such terms and conditions as the Minister for Health may impose.

(2) For the purposes of these Regulations, a reference to a person receiving medical treatment on or after a certain date shall, in relation to any medical treatment comprising a course of such treatment, include treatment received on or after such date if and only if the person received the first treatment of the course on or after that date.

Application for withdrawal

3.—(1) Subject to the Act and these Regulations, where a member or his dependant has received any medical, psychiatric or approved treatment from an approved medical practitioner in any approved medical institution, the Board may, on an application by the member within the period of 12 months commencing immediately after the relevant date or within such further period as may be specified by the Board, authorise the whole or part of the amount standing to the member’s credit in his medisave account to be withdrawn and used for the payment of the medical, psychiatric or approved treatment received by the member or his dependant, subject to such terms and conditions as the Board may impose.

(2) Where a member has received treatment in any of the situations specified in paragraph (3), the Board may, on an application by a prescribed person within the period of 12 months commencing immediately after the relevant date or within such further period as may be specified by the Board, authorise the whole or part of the amount standing to the member’s credit in his medisave account to be withdrawn and used for the payment of the treatment received by the member, subject to such terms and conditions as the Board may impose.

(3) The situations mentioned in paragraph (2) are as follows:

(a)

where the member —

(i)

has received any medical, psychiatric or approved treatment in

(A)	any approved hospital;
(B)	any approved community hospital;
(C)	any approved convalescent hospital;
(D)	any approved hospice;
(E)	any approved day hospital;
(F)	any approved day surgery centre;
(G)	the Singapore Gamma Knife Centre; or
(H)	a Senior Citizens Health Care Centre;

(ii)

is unconscious or otherwise mentally incapacitated; and

(iii)

is unable to make an application under paragraph (1) himself;

(b)

where the member —

(i)

has received any medical or psychiatric treatment as an in-patient from an approved medical practitioner in —

(A)	any approved hospital;
(B)	any approved community hospital;
(C)	any approved convalescent hospital;
(D)	any approved hospice; or
(E)	any approved day hospital;

(ii)

has not made an application under paragraph (1) himself; and

(iii)

dies, on or after 1st July 2006, before he is discharged from the approved hospital or hospice referred to in sub-paragraph (i); and

(c)

where the member has received, before his death, any treatment under such other circumstances as the Minister for Health may approve for the purposes of these Regulations, on such terms and conditions as the Minister for Health may impose.

(4) Every application for the withdrawal of moneys from a member’s medisave account under these Regulations shall be made in such form, and supported by such information and documents, as the Board may require.

(5) An application for the withdrawal of moneys from a member’s medisave account made by a prescribed person under paragraph (2) in relation to a situation specified in paragraph (3)(a) shall be signed by the prescribed person in the presence of an approved medical practitioner who shall confirm in writing that the member is unable to make the application due to his medical condition.

(6) In this regulation, unless the context otherwise requires, “relevant date” means —

(a)	in a case where the member or his dependant received any medical, psychiatric or approved treatment as an in-patient or received day surgical treatment in an approved medical institution, the date of discharge of the member or his dependant (as the case may be) from the approved medical institution;
(b)	in a case where the member received any medical or psychiatric treatment as an in-patient in an approved medical institution and the member dies in the approved medical institution before his discharge therefrom, the date of his death;
(c)	in a case where the member or his dependant received as an out-patient any approved medical treatment comprising a course of such treatment, the date on which the member or his dependant (as the case may be) received the first treatment of the course; or
(d)	in any other case, the date on which the member or his dependant received any medical or approved treatment as an out-patient.

Limits on withdrawal

4.—(1) Where moneys are withdrawn from one or more medisave accounts under regulation 3 for the payment of any medical, psychiatric or approved treatment, the total amount withdrawn for the payment of the treatment shall be subject to the limits prescribed in regulation 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 18, 19, 20 or 21, as applicable.

(2) Subject to paragraph (1), where the withdrawal is made from the medisave accounts of —

(a)	a deceased member; and
(b)	the spouse, a parent or a child of the deceased member, or any other person related to the deceased member and whom the Minister for Health has approved for the purposes of regulation 3,

the whole or part of the amount standing to the credit of the deceased member in the medisave account shall be withdrawn first for payment of the deceased member’s last medical bill before the moneys standing to the credit of the person referred to in sub-paragraph (b) in the medisave account are used to pay the balance of the deceased member’s last medical bill.

(3) Notwithstanding paragraph (1), where moneys are withdrawn from a deceased member’s medisave account under regulation 3 for the payment of his last medical bill, the limits prescribed in regulations 5, 6, 7, 8, 9, 16 and 20 shall not apply.

(4) Notwithstanding the limits on the withdrawal of moneys from medisave accounts prescribed in these Regulations, the Minister may, in a particular case, approve the withdrawal of the whole or part of the amount standing to the credit of a deceased member in the medisave account in excess of the prescribed limits for the payment of the charges incurred in respect of any treatment received by the member in an approved medical institution before his death, subject to such terms and conditions as the Minister may impose.

(5) For the avoidance of doubt, in relation to the payment of a deceased member’s last medical bill, any further limits on the withdrawal of moneys from the deceased member’s medisave account that may be specified by the member before his death shall be disregarded.

In-patient medical treatment in approved hospitals

5.—(1) Subject to paragraph (3) and regulation 4, where a member or his dependant has received medical treatment as an in-patient from an approved medical practitioner in an approved hospital, the amount that may be withdrawn by the member for payment of the treatment shall not exceed —

(a)

(i)

in a case not involving any surgical operation, the relevant sum multiplied by the number of days he was hospitalised;

(ii)

in a case involving one or more surgical operations —

(A)	the relevant sum multiplied by the number of days he was hospitalised or the actual total hospital charges, whichever is the lower; and
(B)	the amount of operation fees, which shall not exceed the amount as determined by the Minister for Health for such operation or operations, or a total of $5,000, whichever is the lower, and subject to a maximum of 3 surgical procedures involving not more than 2 anatomical systems and not more than 2 procedures within each system; or

(iii)

in a case involving radiotherapy treatment comprising stereotactic radiotherapy for cancer, a sum of $2,800 per treatment; or

(b)

the total expenditure for the medical treatment; or

(c)

the total credit balance in the member’s medisave account,

whichever is the lowest.

(2) For the purposes of paragraph (1)(a), the relevant sum is —

(a)	$300 if the member or dependant was admitted to the approved hospital before 1st April 2006;
(b)	$400 if the member or dependant was admitted to the approved hospital on or after 1st April 2006 but before 1st May 2007; and
(c)	$450 if the member or dependant is admitted to the approved hospital on or after 1st May 2007.

(3) The total amount that may be withdrawn by a member for the payment of attendance fees of all approved medical practitioners under this regulation shall not exceed $50 for each day the member or his dependant is hospitalised.

In-patient medical treatment in approved community hospitals

6.—(1) Subject to regulation 4, where a member or his dependant has received medical treatment as an in-patient from an approved medical practitioner in an approved community hospital, the amount that may be withdrawn by the member for payment of the treatment shall not exceed —

(a)

(i)

in a case not involving any surgical operation, a sum of $150 per day, subject to a maximum of $3,500 per year, with effect from 1st January 2002; or

(ii)

in a case involving one or more surgical operations —

(A)	a sum of $150 per day multiplied by the number of days he was hospitalised or the actual total hospital charges, whichever is the lower; and
(B)	the amount withdrawn for the payment of operation fees, which shall not exceed the amount as determined by the Minister for Health for such operation or operations, or a total of $5,000, whichever is the lower, and subject to a maximum of 3 surgical procedures involving not more than 2 anatomical systems and not more than 2 procedures within each system; or

(b)

the total expenditure for the medical treatment; or

(c)

the total credit balance in the member’s medisave account,

whichever is the lowest.

(2) Paragraph (1) shall not apply to any form of medical treatment unless it has been approved by the Minister for Health for the purposes of these Regulations.

(3) Notwithstanding paragraph (1), no withdrawal of any amount in excess of $30 for each day a member or his dependant is hospitalised shall be permitted under this regulation for the payment of any attendance fee of any approved medical practitioner or practitioners.

In-patient medical treatment in approved day hospitals

7.—(1) Subject to regulation 4, where a member or his dependant has received medical treatment as an in-patient from an approved medical practitioner in an approved day hospital, the amount that may be withdrawn by the member for —

(a)

the payment of attendance fees of the approved medical practitioner or practitioners shall not exceed $30 per day;

(b)

the payment of medical treatment, including attendance fees, shall not exceed $150 per day; and

(c)

the payment of all such medical treatments, including attendance fees —

(i)	shall not exceed $3,000 per year; and
(ii)	shall not exceed the total credit balance in the member’s medisave account.

(2) Paragraph (1) shall not apply to any form of medical treatment unless it has been approved by the Minister for Health for the purposes of these Regulations.

In-patient medical treatment in approved convalescent hospitals

8.—(1) Subject to regulation 4, where a member or his dependant has received medical treatment as an in-patient from an approved medical practitioner in an approved convalescent hospital, the amount that may be withdrawn by the member for —

(a)

the payment of attendance fees of the approved medical practitioner or practitioners shall not exceed $30 per day;

(b)

the payment of medical treatment, including attendance fees, shall not exceed $50 per day; and

(c)

the payment of all such medical treatments, including attendance fees —

(i)	shall not exceed $3,000 per year; and
(ii)	shall not exceed the total credit balance in the member’s medisave account.

(2) Paragraph (1) shall not apply to any form of medical treatment unless it has been approved by the Minister for Health for the purposes of these Regulations.

In-patient medical treatment in approved hospices

9.—(1) Subject to regulation 4, where a member or his dependant who is suffering from terminal illness has received medical treatment as an in-patient from an approved medical practitioner in an approved hospice, the amount that may be withdrawn by the member for —

(a)	the payment of attendance fees of the approved medical practitioner or practitioners shall not exceed $30 per day;
(b)	the payment of medical treatment, including attendance fees, shall not exceed $160 per day; and
(c)	the payment of all such medical treatments shall not exceed the total credit balance in the member’s medisave account.

(2) Paragraph (1) shall not apply to any form of medical treatment unless it has been approved by the Minister for Health for the purposes of these Regulations.

Senior Citizens Health Care Centres

10. Notwithstanding anything in these Regulations, where a member or his dependant has received any approved treatment as a day-care patient in any Senior Citizens Health Care Centre, the amount that may be withdrawn by the member for the payment of such treatment, including the payment of attendance fees, shall not exceed $20 per day, subject to a maximum of $1,500 per year, and shall not exceed the total credit balance in the member’s medisave account.

Hepatitis B vaccinations received as in-patient in approved hospitals

11.—(1) Where a member or his dependant has received any vaccination against Hepatitis B as an in-patient from an approved medical practitioner of an approved hospital or of an approved community hospital, the amount that may be withdrawn by the member for the payment of the vaccination shall not exceed —

(a)

the total charges in respect of the vaccination, subject to the following withdrawal limits:

Age of patient

Withdrawal limits (per course of treatment)

(i) below 12 years

$25

(ii) 12 to 19 years

$35

(iii) 20 years or above

$50;

(b)

in the case of an individual booster vaccination that is approved by the Minister for Health, the total charges in respect of the individual booster vaccination, subject to the following withdrawal limits:

Age of patient

Withdrawal limits

(i) below 12 years

$10

(ii) 12 to 19 years

$15

(iii) 20 years or above

$20; or

(c)

the total credit balance in the member’s medisave account,

whichever is the lowest.

(2) Any amount permitted to be withdrawn from a member’s medisave account under paragraph (1) shall be in addition to whatever amount that may be withdrawn under regulation 5, 6 or 16 unless the amount that may be withdrawn under that regulation is the total credit balance in the member’s medisave account.

Surgical treatment to reverse any sexual sterilization and for plastic surgery

12. Notwithstanding regulations 5, 6 and 21, no withdrawal shall be permitted under these Regulations for the payment of any charges incurred in respect of —

(a)

any surgical treatment to reverse any treatment for sexual sterilization on or after 8th June 1987 where —

(i)	the dependant is not the member’s spouse; or
(ii)	at the time such treatment was received, the female member or the spouse of a male member has more than 2 natural children who are alive; or

(b)

any plastic surgery which in the opinion of the Minister for Health is for cosmetic purposes.

Approved out-patient medical treatment

13.—(1) Except as provided in paragraphs (2), (3), (4), (5) and (6) and regulation 14, and subject to regulation 24, no withdrawal shall be permitted under these Regulations for the payment of any charges incurred in respect of any medical treatment afforded to a member or his dependant as an out-patient.

(2) Where a member or his dependant has received treatment of neoplasms by chemotherapy as an out-patient from an approved medical practitioner in an approved clinic, the amount that may be withdrawn by the member for the payment of such treatment shall not exceed such sum as is specified in the third column of the in relation to that approved medical treatment.

(3) Where a member or his dependant has received any approved medical treatment as an out-patient from an approved medical practitioner in an approved hospital, approved centre or approved clinic, the amount that may be withdrawn by the member for the payment of such treatment shall not exceed such sum as is specified in the third column of the First Schedule in relation to that approved medical treatment.

(4) No withdrawal shall be permitted under these Regulations for the payment of any charges in respect of any anti-retroviral drug or any drug for the purposes of treating opportunistic infection registered in Singapore for the medical treatment of human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS), except where such treatment —

(a)	is for the member himself or his child aged 18 years or below; and
(b)	is received from an approved medical practitioner in an approved hospital.

(5) Where a member or his dependant has received any vaccination against Hepatitis B —

(a)

from an approved medical practitioner as an out-patient in an approved clinic or at an approved community hospital, the amount that may be withdrawn by the member for the payment of the total charges in respect of the vaccination shall not exceed the withdrawal limits specified in regulation 11(1) or the total credit balance in the member’s medisave account, whichever is the lower; or

(b)

at the School Health Service or any approved clinic designated by the Minister for Health for the purposes of the School Health Service’s Hepatitis B Screening and Immunisation Programme, the amount that may be withdrawn by the member for the payment of the total charges in respect of the vaccination shall not exceed $25 or the total credit balance in the member’s medisave account, whichever is the lower.

(6) Notwithstanding anything in these Regulations, where a member or his dependant has received radiosurgery treatment from an approved medical practitioner at an approved medical institution, the amount that may be withdrawn by the member for the payment of such treatment shall not exceed —

(a)	the relevant sum per day for hospital charges; and
(b)	$7,500 per treatment or the total credit balance in the member’s medisave account, whichever is the lower.

(7) For the purposes of paragraph (6), the relevant sum is —

(a)	$150 if the member or dependant received the treatment before 1st December 2006;
(b)	$200 if the member or dependant received the treatment on or after 1st December 2006 but before 1st May 2007; and
(c)	$300 if the member or dependant received the treatment on or after 1st May 2007.

Approved chronic illness treatment

14.—(1) Where a member or his dependant has received any approved chronic illness treatment as an out-patient from an approved medical practitioner in an approved CIT medical institution —

(a)

the amount that may be withdrawn by the member in respect of such treatment (whether as part of a treatment package or otherwise) shall not exceed the lower of —

(i)

the total credit balance in the member’s medisave account; or

(ii)

an amount ascertained in accordance with the formula

(A — B) x (100% — C),

where A

is the charge imposed by the approved CIT medical institution for such treatment or for the treatment package, as the case may be;

is the applicable co-payment amount; and

is the applicable co-payment percentage; and

(b)

the amount that may be withdrawn by the member for the payment of all such treatments shall not exceed —

(i)	the sum of $300 per year; and
(ii)	the total credit balance in the member’s medisave account.

(2) Notwithstanding paragraph (1), if the charge imposed by the approved CIT medical institution for any approved chronic illness treatment or treatment package, as the case may be, is less than or equal to the applicable co-payment amount, no amount may be withdrawn by the member under paragraph (1) for the payment of such treatment or treatment package.

(3) Any withdrawal by a member under this regulation shall be subject to such terms and conditions as the Minister for Health may impose.

Delivery charges

15.—(1) Where a female member, or a female dependant of a member, has received medical treatment as an in-patient from an approved medical practitioner in an approved hospital in respect of her confinement for the delivery of a child, no withdrawal shall be made under regulation 5 for the payment of any charges relating to the medical treatment, except with the approval of the Minister for Health, if —

(a)

the child is delivered before 1st August 2004 and, at the time of such delivery, the female member or female dependant had 3 or more living children; or

(b)

the child is delivered on or after 1st August 2004 and, at the time of such delivery —

(i)	the female member or female dependant has 4 or more living children; and
(ii)	the total of the amounts standing to the credit of the parents of the child in their respective medisave accounts is less than $15,000.

(2) Notwithstanding paragraph (1)(b)(ii), where the total of the amounts standing to the credit of the parents of the child in their respective medisave accounts is less than $15,000, but will be increased to $15,000 within such period after the date of the delivery of the child as the Board may determine, the Board may, on the application of a member, in its discretion and subject to such terms and conditions as it may impose, allow the member to make the withdrawal without the approval of the Minister for Health under paragraph (1).

(3) For the purposes of this regulation and regulation 16, “living children” includes any living children who have been adopted by the female member or female dependant in accordance with any written law relating to the adoption of children, but excludes any living children of the female member or female dependant who have been adopted by a person other than the female member or female dependant or the spouse of the female member or female dependant, in accordance with any written law relating to the adoption of children.

Pre-delivery medical treatment

16.—(1) Except as provided in this regulation and regulation 4, no withdrawal shall be made for the payment of any charges incurred by a female member, or a female dependant of a member, in respect of any pre-delivery medical treatment received by her.

(2) Subject to paragraphs (4) and (5), where a female member, or a female dependant of a member, who has received pre-delivery medical treatment undergoes on or after 1st August 2004 the delivery of a child or the termination of her pregnancy as an in-patient, the total amount that may be withdrawn by the member for the payment of the pre-delivery medical treatment and the medical treatment for the delivery of the child or the termination of the pregnancy shall not exceed the aggregate of —

(a)

the lower of —

(i)

the total of all charges actually incurred in respect of the pre-delivery medical treatment and the medical treatment for the delivery of the child or the termination of the pregnancy; or

(ii)

the total of —

(A)	the relevant sum multiplied by the number of days the female member or female dependant was hospitalised; and
(B)	the fees or part thereof for the pre-delivery medical treatment and the medical treatment for the delivery of the child or the termination of the pregnancy, not in excess of the amounts determined by the Minister for Health for such treatments; and

(b)

in a case involving one or more additional operations, the amount of operation fees for a maximum of 3 surgical procedures involving not more than 2 anatomical systems and not more than 2 procedures within each system, which shall not exceed —

(i)	the amount as determined by the Minister for Health for such operation or operations; or
(ii)	a total of $5,000 ,

whichever is the lower.

(3) For the purposes of paragraph (2)(a)(ii) (A), the relevant sum is —

(a)	$300 if the female member or female dependant was admitted to the approved hospital before 1st April 2006;
(b)	$400 if the female member or female dependant was admitted to the approved hospital on or after 1st April 2006 but before 1st May 2007; or
(c)	$450 if the female member or female dependant is admitted to the approved hospital on or after 1st May 2007.

(4) The total amount that may be withdrawn by a member under paragraph (2) for the payment of attendance fees of all approved medical practitioners who treated the member or dependant, as the case may be, shall not exceed $50 per day.

(5) No withdrawal shall be made under paragraph (2) for the payment of any charges relating to pre-delivery medical treatment received by a female member, or a female dependant of a member —

(a)

if the charges are not claimed as part of the charges for the delivery of a child or the termination of her pregnancy, as the case may be; or

(b)

if she undergoes the delivery of a child and at the time of her delivery —

(i)	she has 4 or more living children; and
(ii)	the total of the amounts standing to the credit of the parents of the child in their respective medisave accounts is less than $15,000,

and the Minister for Health does not approve the payment of the charges.

(6) Subject to paragraphs (8) and (9), where a female member, or a female dependant of a member, who has received pre-delivery medical treatment undergoes on or after 1st August 2004 any day surgical treatment to terminate her pregnancy, the total amount that may be withdrawn by the member for the payment of the pre-delivery medical treatment and the day surgical treatment shall not exceed the aggregate of —

(a)

the lower of —

(i)

the total of all charges actually incurred in respect of the pre-delivery medical treatment and the day surgical treatment; or

(ii)

the total of —

(A)	the relevant sum for hospital charges for the day the female member or female dependant undergoes the day surgical treatment; and
(B)	the fees or part thereof for the pre-delivery medical treatment and the day surgical treatment, not in excess of the amounts determined by the Minister for Health for such treatments; and

(b)

(i)	the amount as determined by the Minister for Health for such operation or operations; or
(ii)	a total of $5,000 ,

whichever is the lower.

(7) For the purposes of paragraph (6)(a)(ii) (A), the relevant sum is —

(a)	$150 if the female member or female dependant received the day surgical treatment before 1st December 2006;
(b)	$200 if the female member or female dependant received the day surgical treatment on or after 1st December 2006 but before 1st May 2007; and
(c)	$300 if the female member or female dependant received the day surgical treatment on or after 1st May 2007.

(8) The total amount that may be withdrawn by a member under paragraph (6) for the payment of attendance fees of all approved medical practitioners who treated the female member or female dependant, as the case may be, on the day she underwent the day surgical treatment shall not exceed $30.

(9) No withdrawal shall be made under paragraph (6) for the payment of any charges relating to pre-delivery medical treatment received by a female member, or a female dependant of a member, unless the charges are claimed as part of the charges for the termination of her pregnancy.

(10) Notwithstanding paragraph (2), the Minister for Health may, on the application of a member, in the Minister’s discretion and subject to such terms and conditions as the Minister may impose, authorise the member to make a withdrawal under paragraph (2) in respect of the delivery of a child if —

(a)	the child was delivered before 1st August 2004; and
(b)	all other requirements for a withdrawal under paragraph (2) have been satisfied.

(11) Notwithstanding paragraph (5)(b)(ii), the Board may, on the application of a member, in its discretion and subject to such terms and conditions as it may impose, allow the member to make a withdrawal under paragraph (2) without the approval of the Minister for Health under paragraph (5)(b)(ii) in respect of the delivery of a child if —

(a)	the total of the amounts standing to the credit of the parents of the child in their respective medisave accounts will be increased to $15,000 within such period after the date of the delivery of the child as the Board may determine; and
(b)	all other requirements for a withdrawal under paragraph (2) are satisfied.

(12) Nothing in this regulation authorises any member to withdraw any sum under this regulation in excess of the total credit balance in the member’s medisave account.

Overseas treatment

17. Where a member or his dependant has received medical treatment in a hospital outside Singapore, the Minister for Health may, in his discretion, approve the withdrawal of such amount as the Minister may determine for payment of charges incurred in respect of such treatment and subject to such conditions as he may impose.

Treatment for infertility

18.—(1) Notwithstanding anything in these Regulations but subject to this regulation, where a female member or spouse of a male member has received medical treatment for conception from an approved medical practitioner as an in-patient or out-patient from an approved hospital or an approved clinic designated by the Minister for Health, the amount that may be withdrawn by the member to pay for such treatment shall not exceed —

(a)

where the medical treatment for conception was received before 1st August 2004 —

(i)	a sum of $4,000 per treatment cycle; or
(ii)	the total credit balance in the member’s medisave account,

whichever is the lower; or

(b)

where the medical treatment for conception was received on or after 1st August 2004 —

(i)

in the case of the first withdrawal for a treatment cycle —

(A)	a sum of $6,000; or
(B)	the total credit balance in the member’s medisave account,

whichever is the lower;

(ii)

in the case of the second withdrawal for a treatment cycle —

(A)	a sum of $5,000; or
(B)	the total credit balance in the member’s medisave account,

whichever is the lower; or

(iii)

in the case of the third withdrawal for a treatment cycle —

(A)	a sum of $4,000; or
(B)	the total credit balance in the member’s medisave account,

whichever is the lower.

(2) Notwithstanding paragraph (1), where a female member or spouse of a male member has received medical treatment for conception before 1st August 2004, the Minister for Health may, on the application of the member, in the Minister’s discretion and subject to such terms and conditions as the Minister may impose, authorise the member to make a withdrawal in accordance with paragraph (1)(b).

(3) Medical investigations on the cause of infertility shall not be considered as part of a treatment cycle for the purpose of this regulation.

(4) No withdrawal shall be made under this regulation for the payment of charges incurred for more than 3 cycles of medical treatment for conception in respect of each patient.

(5) Where a cycle of medical treatment for conception has been discontinued and there is a refund of charges to a member, there shall become due and payable to the medisave account of the member, on the date the refund is received by the member, the total amount withdrawn from the member’s medisave account under this regulation or the total amount of refund received, whichever is the lower.

(6) Where a cycle of medical treatment for conception has been discontinued and the sum withdrawn from the member’s medisave account for the treatment has been repaid to the account in full, the discontinued treatment shall not be counted as a cycle of medical treatment for conception for the purpose of paragraph (4).

Renal dialysis treatment

19.—(1) Notwithstanding regulation 3, no withdrawal shall be made from a member’s medisave account for the payment of charges incurred for any renal dialysis treatment received on or after 1st December 2004 by any of the following dependants of the member, except with the approval of the Minister for Health or any person designated by the Minister for Health:

(a)	a parent;
(b)	a grandparent who is a citizen or permanent resident of Singapore;
(c)	the spouse; or
(d)	a child above the age of 18 years.

(2) Notwithstanding anything in these Regulations , where a member or his dependant has received renal dialysis treatment, the amount that may be withdrawn by him from his medisave account for the payment of such treatment shall not exceed —

(a)	in the case of haemodialysis at any approved centre, a sum of $450 per month per patient;
(b)	in the case of continuous ambulatory peritoneal dialysis, a sum of $450 per month per patient for payment of the purchase of any approved consumables ;
(c)	in the case of haemodialysis received at the member’s home, a sum of $450 per month per patient for payment of the purchase of any approved consumables;
(d)	in the case of renal dialysis treatment received by the member as an in-patient in an approved centre or approved hospital, the sum permitted to be withdrawn under regulation 5;
(e)	the total expenditure for the renal dialysis treatment or for payment of the purchase of any approved consumables; or
(f)	the total credit balance in the member’s medisave account,

whichever is the lowest.

(3) Where any dependant of a member referred to in paragraph (1) has received renal dialysis treatment on or after 1st December 2004, the withdrawal from the member’s medisave account shall, in addition, be subject to such terms and conditions as the Minister for Health may impose.

(4) Notwithstanding paragraph (2), no withdrawal of any amount shall be permitted under this regulation for the payment of any of the following:

(a)	any consultation fee incurred by the member;
(b)	the purchase of an ultra violet machine for sterilization;
(c)	the purchase of a dialysis machine; or
(d)	the purchase of any other related equipment.

(5) In this regulation, “approved consumables” means any of the following:

(a)	continuous ambulatory peritoneal dialysis bag;
(b)	connecting bag;
(c)	dialyser;
(d)	arterio venous blood line;
(e)	arterio venous fistula needle;
(f)	dialysate;
(g)	intervenous infusion set;
(h)	normal saline or bicarbonate solution or biofiltrate; and
(i)	any other item approved by the Minister for Health for the purpose of this regulation.

(6) All moneys authorised to be withdrawn by the Board under this regulation shall be paid by the Board direct to the approved centre or approved hospital from which the claim for payment is made.

Psychiatric treatment

20.—(1) Notwithstanding anything in these Regulations (other than regulation 4), where a member or his dependant has received any psychiatric treatment as an in-patient from an approved medical practitioner in an approved hospital, the amount that may be withdrawn by the member from his medisave account for the payment of such treatment for himself or his dependant shall not exceed $150 per day and shall also not exceed the relevant sum per year.

(2) For the purposes of paragraph (1), the relevant sum is —

(a)	$3,500 if the member or dependant was admitted to the approved hospital before 1st January 2007; and
(b)	$5,000 if the member or dependant was admitted to the approved hospital on or after 1st January 2007.

Day surgical treatment

21.—(1) Notwithstanding anything in these Regulations, where a member or his dependant has received medical treatment and undergone any day surgical treatment from an approved medical practitioner in an approved hospital or an approved day surgery centre, the amount that may be withdrawn by the member for —

(a)

the payment of attendance fees of the approved medical practitioner or practitioners shall not exceed $30 per day;

(b)

the payment of hospital charges, including attendance fees, shall not exceed the relevant sum per day;

(c)

the payment of operation fees shall not exceed the amount determined by the Minister for Health for the operation or operations, or a total of $5,000, whichever is the lower, and subject to a maximum of 3 surgical procedures involving not more than 2 anatomical systems and not more than 2 procedures within each system;

(d)

the payment of radiotherapy treatment comprising stereotactic radiotherapy for cancer shall not exceed $2,800 per treatment; and

(e)

the payment of medical treatment —

(i)	shall not exceed the total expenditure for the medical treatment; and
(ii)	shall not exceed the total credit balance in the member’s medisave account.

(2) For the purposes of paragraph (1)(b), the relevant sum is —

(a)	$150 if the member or dependant received the day surgical treatment before 1st December 2006;
(b)	$200 if the member or dependant received the day surgical treatment on or after 1st December 2006 but before 1st May 2007; and
(c)	$300 if the member or dependant received the day surgical treatment on or after 1st May 2007.

Authorisation of withdrawal from future contributions

22.—(1) Where a member or his dependant has received —

(a)	any medical or psychiatric treatment as an in-patient in a Class C or B2 ward of an approved hospital, or in a ward of an approved community hospital, an approved convalescent hospital or an approved hospice which is equivalent to a Class C or B2 ward of an approved hospital and in respect of which the Government makes an annual grant in aid of recurrent expenditure incurred or to be incurred in operating or maintaining the ward;
(b)	any day surgical treatment at subsidised rates at an approved day surgery centre; or
(c)	any radiosurgery treatment at subsidised rates at an approved medical institution,

and the amount standing to the credit of the member in his medisave account is insufficient to pay for the charges incurred in respect of the treatment referred to in sub-paragraph (a), (b) or (c), the Board may, with the approval of the Minister for Health and subject to such terms and conditions as the Board may impose, authorise the member to withdraw his future contributions to his medisave account to pay the outstanding balance.

(2) Paragraph (1) shall not apply to any surgical treatment to reverse any treatment for sexual sterilization or any medical treatment for conception.

Obligation by other person to pay or reimburse member

23. Where another person is under an obligation, contractual or otherwise, to pay or reimburse a member for charges incurred in respect of medical, psychiatric or approved treatment afforded to the member or his dependant, there shall become due and payable to the Fund on the date the member receives such payment or reimbursement from that person, the total sum withdrawn from the member’s medisave account under these Regulations for the payment of charges so incurred or the balance sum ascertained by the formula

A + B — C,

whichever is the lower,

where A

is the total sum received by the member from that other person as payment or reimbursement;

is the total amount withdrawn from the member’s medisave account under these Regulations for the payment of the charges incurred in respect of the medical, psychiatric or approved treatment;

is the total sum of the charges incurred in respect of the medical, psychiatric or approved treatment.

Medical treatment provided to person other than dependant

24.—(1) The Minister for Health may, in his discretion and subject to such terms and conditions as he may impose, authorise a member to withdraw the whole or part of the amount standing to his credit in his medisave account for the payment of charges incurred in respect of —

(a)	any medical treatment provided by an approved medical practitioner in a Class C or B2 ward of an approved hospital, or in a ward of an approved community hospital, an approved convalescent hospital or an approved hospice which is equivalent to a Class C or B2 ward of an approved hospital and in respect of which the Government makes an annual grant in aid of recurrent expenditure incurred or to be incurred in operating or maintaining the ward;
(b)	any day surgical treatment at subsidised rates provided by an approved medical practitioner in an approved day surgery centre;
(c)	any approved treatment as a day-care patient in any Senior Citizens Health Care Centre;
(d)	any radiosurgery treatment at subsidised rates at an approved medical institution;
(e)	any approved medical treatment provided on an out-patient basis at subsidised rates; or
(f)	any approved chronic illness treatment provided on an out-patient basis by an approved medical practitioner at an approved CIT medical institution ,

to a person other than a member’s dependant as if the person were the member’s dependant.

(2) Where the Minister authorises a withdrawal under paragraph (1) , the person referred to in that paragraph shall for the purposes of these Regulations be deemed to be the dependant of such member.

(3) In paragraph (1)(e), “approved medical treatment” means any of the following medical treatments:

(a)	radiotherapy treatment from an approved medical practitioner in an approved hospital;
(b)	treatment of neoplasms by chemotherapy from an approved medical practitioner in an approved hospital;
(c)	blood transfusions and desferrioxamine for the medical treatment of thalassaemia from an approved medical practitioner in an approved hospital;
(d)	intravenous antibiotic infusion from an approved medical practitioner in an approved hospital as designated by the Minister for Health;
(e)	rental of devices for long term oxygen therapy and infant continuous positive airway pressure therapy from an approved medical practitioner in an approved hospital;
(f)	immunosuppressants for organ transplant from an approved medical practitioner in an approved hospital.

Direct payment to hospitals, etc.

25. All moneys authorised to be withdrawn by the Board under these Regulations shall be paid by the Board direct to the approved medical institutions from which the member or his dependant received medical, psychiatric or approved treatment.

Revocation of approval of medical practitioner

26. Notwithstanding anything in these Regulations, where the approval of a medical practitioner is revoked at such time when a member or his dependant is receiving medical treatment from the practitioner —

(a)	as an in-patient in an approved hospital; or
(b)	as an out-patient in an approved clinic or approved centre,

the member or his dependant may continue to withdraw from the medisave account for payment of any treatment authorised under these Regulations by the medical practitioner for the period of such hospitalisation or approved out-patient treatment as if the approval had not been revoked.

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