Circumcision: my experience

[virgone]

Originally Posted by IamGood

I asked both pulse and dtap, both say circumcision no medisave or insurance claimable.

That's because both are not Day Surgery.
It's chicken & egg.

If you want to have medical claim and opt for Day surgery, in the end you pay more as well. Cos for Day Surgery, the centre charges about $2k+ more, and it doesn't mean that your insurance can cover full claim.

Insurance coverage depends on the Surgical code.

[yqz7]

Originally Posted by virgone

That's because both are not Day Surgery.
It's chicken & egg.

If you want to have medical claim and opt for Day surgery, in the end you pay more as well. Cos for Day Surgery, the centre charges about $2k+ more, and it doesn't mean that your insurance can cover full claim.

Insurance coverage depends on the Surgical code.

Actually what does it mean by pay more?
You mean the actual costs of the procedure is higher? But if you can claim most of it via insurance and medisave the out of pocket (cash or credit card) should be lower for a patient who chooses not to claim - overall cost is lower but then you will pay it all yourself?

[IamGood]

Originally Posted by yqz7

Actually what does it mean by pay more?
You mean the actual costs of the procedure is higher? But if you can claim most of it via insurance and medisave the out of pocket (cash or credit card) should be lower for a patient who chooses not to claim - overall cost is lower but then you will pay it all yourself?

I think he meant this
If u have a deductible, u may end up paying more even if u claim. Bcos the cost of a day surgery incl GA is much higher than u go to a clinic and done in 15min.
Troublesome to go hospital and all. Just pay 2k with immediate appt and done with. 2k will not make me rich or poor.

[virgone]

Originally Posted by yqz7

Actually what does it mean by pay more?
You mean the actual costs of the procedure is higher? But if you can claim most of it via insurance and medisave the out of pocket (cash or credit card) should be lower for a patient who chooses not to claim - overall cost is lower but then you will pay it all yourself?

Yes, IamGood has explain it.

For clinic like pulse and dtap, they can do it at the clinic itself which cost ~$2.2k.

For urology clinics, you can claim insurance but then they will need to use day surgery centre which cost more, say additional $2.5k more.

So if your insurance can only claim $1.5k (depending on surgery code), then it makes no sense to go urology clinics cos you end up paying $3k (this is after claim).. instead of the usual $2.2k.

[DoctorTan]

Please let me provide some more info on this.

Administratively there are several ways to go about paying for a circumcision:

1. In-Clinic Procedure (cash)

As pointed out in the posts above, most clinics charge between $2,200 and $3,000. For this you pay cash. You cannot use Medisave or claim insurance. This also has to be done under local anesthesia (i.e. awake with numbing). Some clinics offer installment plans like GRAB Pay-Later.

2. Using Insurance

For this, the surgery has to be done in an operating theater or a day surgery center. The total cost for this is higher because of the facility fees.

Depending on the details of your policy you may be able to claim 100% of the bill or less. The worst case scenario I have seen is you can claim 70% of the bill with a 5% co-pay.

Example:
Total bill $5,000
Insurance pay 70% = $3500
Your co-pay (5% of $3500) = $175
Your total payment = $1675 ($1500 + $175)
Your Medisave can pay $650
Your total cash out = $1025

For some insurances (like AIA) you can apply for a Guarantee of Payment. Just log into your e-benefits app then click on the LOG button. Once that is approved, you do not need to pay anything after the surgery. The operating theater will settle directly with the insurance.

For others (like NTUC), you need to pay the full bill upfront first then the operating theater will "e-file" the claim. Then when they get the money they will reimburse you. This can take 2 to 3 months.

Also, if you want to do the surgery under general anesthesia (asleep), then you have to do it in an operating theater. The total fees will be higher because you also need to pay for the anesthetist and the facility fee will be higher. So in the worst case scenario this is the math:

Example:
Total bill $7,000
Insurance pay 70% = $4900
Your co-pay (5% of $4900) = $245
Your total payment = $2345 ($2100 + $245)
Your Medisave can pay $650
Your total cash out = $1695

So my recommendation is this:
Check with your insurance agent. If your policy can cover 100% of the bill then fantastic. Even 90% is super good
Your agent would most likely ask you 2 questions:
1. Is the Circumcision medically necessary?
The answer is always "yes". Your doctor will know what diagnosis to put to make it so.
2. Can the hospital or operating theater efile?
This one you need to check with the doctor. The operating theater that I work with can e-file for all insurance companies so makes it easy.
Even if your policy is pro-rated to 70% with a co-pay, you will most of the time end up paying less than what you would pay in an in-clinic procedure.
Unless you cannot be bothered with all the admin and just want to get it done quickly then an in-clinic procedure paid in cash makes most sense.

The last caveat is when using insurance, there is always a small risk that the insurance finds a reason not to cover your procedure. Even with a letter of guarantee they can still do a 180 and decide not to pay for whatever reason they can think of. So far I have not come across such a scenario (knock on wood) but this is always a risk.

Hope this helps

[virgone]

Originally Posted by DoctorTan

Please let me provide some more info on this.

Administratively there are several ways to go about paying for a circumcision:

1. In-Clinic Procedure (cash)

As pointed out in the posts above, most clinics charge between $2,200 and $3,000. For this you pay cash. You cannot use Medisave or claim insurance. This also has to be done under local anesthesia (i.e. awake with numbing). Some clinics offer installment plans like GRAB Pay-Later.

2. Using Insurance

For this, the surgery has to be done in an operating theater or a day surgery center. The total cost for this is higher because of the facility fees.

Depending on the details of your policy you may be able to claim 100% of the bill or less. The worst case scenario I have seen is you can claim 70% of the bill with a 5% co-pay.

Example:
Total bill $5,000
Insurance pay 70% = $3500
Your co-pay (5% of $3500) = $175
Your total payment = $1675 ($1500 + $175)
Your Medisave can pay $650
Your total cash out = $1025

For some insurances (like AIA) you can apply for a Guarantee of Payment. Just log into your e-benefits app then click on the LOG button. Once that is approved, you do not need to pay anything after the surgery. The operating theater will settle directly with the insurance.

For others (like NTUC), you need to pay the full bill upfront first then the operating theater will "e-file" the claim. Then when they get the money they will reimburse you. This can take 2 to 3 months.

Also, if you want to do the surgery under general anesthesia (asleep), then you have to do it in an operating theater. The total fees will be higher because you also need to pay for the anesthetist and the facility fee will be higher. So in the worst case scenario this is the math:

Example:
Total bill $7,000
Insurance pay 70% = $4900
Your co-pay (5% of $4900) = $245
Your total payment = $2345 ($2100 + $245)
Your Medisave can pay $650
Your total cash out = $1695

So my recommendation is this:
Check with your insurance agent. If your policy can cover 100% of the bill then fantastic. Even 90% is super good
Your agent would most likely ask you 2 questions:
1. Is the Circumcision medically necessary?
The answer is always "yes". Your doctor will know what diagnosis to put to make it so.
2. Can the hospital or operating theater efile?
This one you need to check with the doctor. The operating theater that I work with can e-file for all insurance companies so makes it easy.
Even if your policy is pro-rated to 70% with a co-pay, you will most of the time end up paying less than what you would pay in an in-clinic procedure.
Unless you cannot be bothered with all the admin and just want to get it done quickly then an in-clinic procedure paid in cash makes most sense.

The last caveat is when using insurance, there is always a small risk that the insurance finds a reason not to cover your procedure. Even with a letter of guarantee they can still do a 180 and decide not to pay for whatever reason they can think of. So far I have not come across such a scenario (knock on wood) but this is always a risk.

Hope this helps

Thanks for your detailed explanation, Dr. Tan.

Yes, For my case, I've check with my insurance and by providing them the surgery code.

My max claim is only $1500, and that's providing doing at day surgery centre.

This is why I find the best option is to do in clinic.

For the other bros, best is to check with your insurance company.

[IamGood]

Ok thanks…

[lonelyfish]

I did it a few years ago at a heavily subsidised rate + CPF at NTFGH after getting referred by polyclinic as medical condition. How much I forgot, but it is some fees like just about $100+.

It took quite some time from first reporting to the surgery date. They attempt treatment before the advise of surgery. For the day surgery, reported in the morning, GA + surgery, recover + wake in the ward for awhile, out in the evening.

Laser circumcision, cut very clean, took 2 weeks or so I think for it to recover + 1x follow up where the doctor check clear. Whole process not painful except when showering and peeing for the 1st few times.

You can try this route for lower cost.

[virgone]

Originally Posted by IamGood

Did shang ring an hr ago. Cut…tsk…pain sial

Cut sure will be a bit pain lah.
But it's worth it, especially when it's a lot more comfortable for your other half.

[IamGood]

Ok thanks…

[virgone]

Originally Posted by IamGood

Do u keep the penis with ring in the 12 or 6 o’clock position?

No fix position. Always keep in most comfortable position.

[IamGood]

Noted thanks…

[virgone]

Originally Posted by IamGood

Why would the shang ring fall out on its own? Whats the magic behind it?

If the surroundings skin becomes dead, it will slowly come off.

Some don't experience pain, but I did experience extreme discomfort and pain. Which is why I went back to the doc to remove the ring.

The removal process is also painful, btw.

[POTAT0]

Thanks for this thread. Went for circumcision via polyclinic referral to SGH urology. Did the day surgery, general anaesthesia in early Aug and am recovering from it.

Was able to obtain LOG from insurance (AIA) but still in the process of claiming. Bill / payment was directly settled between Hospital and Insurer.

Before obtaining referral from polyclinic, I visited doctor Enoch Gan in his private practice too. Choose the polyclinic route due to the huge difference in price.

[want0nmee]

Originally Posted by virgone

Thanks for your detailed explanation, Dr. Tan.

Yes, For my case, I've check with my insurance and by providing them the surgery code.

My max claim is only $1500, and that's providing doing at day surgery centre.

This is why I find the best option is to do in clinic.

For the other bros, best is to check with your insurance company.

what's the surgery code bro, do you mind sharing so that i can check too? will this be the same for all clinic?