Start with the employee’s status

Three questions settle most of the health-cover picture in Singapore. Is the employee a citizen or permanent resident (PR)? If not, which work pass do they hold: an Employment Pass, an S Pass or a Work Permit? And who is the legal employer? The answers show whether a national scheme already applies, whether the Ministry of Manpower (MOM) requires medical insurance, and whether an international plan becomes the main cover or an extra layer.

For a US company the third question carries a twist, because MOM limits what an employer of record can do for a foreigner working for an overseas business. That rule gets its own section below.

MediShield Life for citizens and PRs

MediShield Life is Singapore’s basic national health insurance. The Ministry of Health says it covers every citizen and PR for life, whatever their age or health, pre-existing conditions included. Nobody applies: cover is automatic, and the Central Provident Fund (CPF) Board administers it.

It is built for large hospital bills and selected costly outpatient treatment such as dialysis and chemotherapy. Benefits are sized for subsidised Class B2 and C public wards, so a stay in an A or B1 ward or a private hospital is covered for a smaller share. Premiums come out of the member’s MediSave account within their CPF savings, and relatives such as a spouse or parents can pay them from their own MediSave.

An employer of a citizen or PR makes CPF contributions, and part of each one flows into MediSave. Foreigners on work passes cannot contribute to CPF and stay outside it until they become PRs.

Medical insurance by work pass

For an Employment Pass holder, MOM does not require the employer to buy medical insurance. The employer can write it into the employment contract or encourage the employee to buy a plan.

For an S Pass holder, the employer must buy and maintain medical insurance that meets MOM’s minimum before the pass is issued or renewed, with no exemption. For a Work Permit holder, the policy must cover inpatient care and day surgery, including conditions unrelated to work, up to at least a minimum annual claim limit. The employer pays, cannot pass the cost to the worker, and submits the details before the permit is issued. The exception MOM lists is a worker on a Dependant’s Pass who already holds a plan meeting the minimum.

MOM has reworked these rules in two stages. From 1 July 2023 the insurer pays 75% and the employer 25% of claims above a set threshold. From 1 July 2025 exclusions were standardised, premiums were set by age band, and insurers began paying hospitals directly.

Why an employer of record mostly suits citizens and PRs

MOM states that an employer of record in Singapore may not apply for a work pass for a foreigner who would be based in Singapore while working for an overseas company. Work passes are meant for foreigners working for Singapore-based companies.

Hiring guides read that to mean a US company can use an EOR in Singapore mainly for a citizen or PR, who is already covered by MediShield Life through CPF. To employ a foreigner on a work pass, the company generally needs its own Singapore entity, which then carries the pass-holder rules above. The structure has legal and tax consequences, so check with a local adviser before settling on one.

A self-employed contractor who is a citizen or PR contributes to their own MediSave account rather than the full CPF.

Group medical and the IRAS rules

Local benefits guides describe group medical insurance, usually hospital and surgical cover and sometimes outpatient care, as a common Singapore benefit. The Inland Revenue Authority of Singapore (IRAS) sets out how it is taxed. Group medical cover for the employee, spouse and children, offered to all staff, is not taxable to the employee. A personal policy the employee holds is taxable when the employer pays for it.

Since the 2013 year of assessment, an IRAS concession lets an employer choose not to claim a tax deduction for group insurance premiums, and the premiums are then not taxed in employees’ hands. The election must apply to every covered employee. Business-travel insurance and work injury compensation premiums paid by the employer are not taxable to the employee either.

International plans: the main layer or a second one

For a citizen or PR, MediShield Life is already in place, so an international plan only tops it up. For an Employment Pass holder there is no statutory medical-insurance mandate, and a private or international plan can be the main cover. For S Pass and Work Permit holders, any plan used has to meet MOM’s minimum, and whether a particular international plan qualifies is for the insurer to answer.

Singapore also restricts who can sell. Section 3 of the Insurance Act 1966 bars anyone from carrying on insurance business in Singapore without a Monetary Authority of Singapore (MAS) licence for that class, and MAS has said unlicensed insurers may not solicit business there, including the overseas head office or branches of a licensed insurer. Only the insurer can confirm whether it may offer a given plan to someone living in Singapore.

Getting an introduction for a Singapore hire

Use the quote form on this page to tell us how many people you have in Singapore and, for each one, whether they are a citizen, a PR or on a work pass, and who employs them on paper. Add any family members who need cover. With those answers, we can introduce you to a benefits partner that works on health coverage for teams spread across several countries. Eligibility, plan design and pricing rest with that partner and the insurer.

A few useful answers

Common questions

Does MediShield Life cover a foreign employee on an Employment Pass?

No. MediShield Life covers Singapore citizens and PRs only, so any health cover for an Employment Pass holder comes from a private or employer-arranged plan.

Must an employer buy medical insurance for an Employment Pass holder?

MOM does not require it. An employer can still write medical cover into the contract or encourage the employee to buy a plan.

Can an employer of record sponsor a work pass for someone working for a US company?

MOM says an employer of record in Singapore may not apply for a work pass for a foreigner based in Singapore who works for an overseas company. For a foreign hire, a US company generally needs its own Singapore entity.

Is group medical insurance taxable to employees in Singapore?

IRAS treats group medical cover offered to all staff, for the employee, spouse and children, as not taxable to the employee. An employer-paid personal policy is taxable.

Who pays for Work Permit medical insurance?

The employer buys and maintains it and cannot pass the cost to the worker. Above a set threshold, the insurer pays 75% of a claim and the employer 25%.

International Health Insurance for Remote Employees in Singapore