Eighty-five percent of people in Singapore eligible for coronavirus vaccines are fully vaccinated, and 18% have received booster shots.

But the Singaporean government said Monday that it will no longer cover the medical costs of people “unvaccinated by choice,” who make up the bulk of remaining new COVID-19 cases and hospitalizations in the city-state.

“Currently, unvaccinated persons make up a sizable majority of those who require intensive inpatient care, and disproportionately contribute to the strain on our health care resources,” the Ministry of Health said in a statement Monday.

“COVID-19 patients who are unvaccinated by choice may still tap on regular health care financing arrangements to pay for their bills where applicable,” the ministry added.

The government now foots the bill for any Singaporean citizen, permanent resident and holder of a long-term work pass who is sick with COVID-19, unless they tested positive shortly after returning from overseas.

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“This was to avoid financial considerations adding to public uncertainty and concern when covid-19 was an emergent and unfamiliar disease,” the Health Ministry said in its statement.

Singapore is considered to have one of the world’s the best health care systems. A 2017 study in the leading medical journal the Lancet found that Singapore ranked first among 188 countries in efforts to meet health-related sustainable development goals set by the United Nations for 2030.

The Singaporean model, however, depends heavily on privatized medical services, meaning that the unvaccinated may already have coverage if they become sick with COVID-19. In the United States, for example, about one-third of health care spending is private, while in Singapore it’s the opposite, according to an analysis by The New York Times.

Moreover, workers in Singapore are mandated to put a portion of their salaries away in health savings accounts, which employees are also required to contribute to based on varying criteria.

Under this system, bills for the unvaccinated will still be “highly supported and highly subsidized,” Health Minister Ong Ye Kung told a news conference Monday, Yahoo News reported.

“Hospitals really much prefer not to have to bill these patients at all,” Ong said. “But we have to send this important signal to urge everyone to get vaccinated if you are eligible.”

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Singapore recorded some 91,000 new coronavirus infections over the last 28 days, 98.7% of which were asymptomatic or mild cases, according to the Health Ministry.

As of Nov. 7, 1,725 people were hospitalized with the virus. Of those, according to the Health Ministry, 301 have required oxygen, 62 are under close monitoring in the intensive care unit, and 67 are critically ill and intubated. That has put Singapore’s current ICU use rate at 68.5%.

“While this is still manageable by stretching our health care manpower, we must not let down our guard and must avoid a resurgence of cases that could once again threaten to overwhelm our health care system,” the Health Ministry said Monday.

Early in the pandemic, Singapore relied on extensive surveillance, contact tracing and strict movement restrictions to keep virus cases low. The heavily surveilled city-state has since begun easing some virus-related restrictions.