Set 3 Flashcards
Q20: The type of Health Maintenance Organization (HMO) that employs the healthcare providers who usually work together in a centre is the…
(A) Staff Model HMO.
(B) Group Model HMO.
(C) Network Model HMO.
(D) Independent Practitioners Association HMO.
(A) Staff Model HMO.
Q21: Suzie is a policyholder making a claim under a Managed Health Care policy. Suzie is likely to be asked by her insurer to provide the original itemised medical bill and…
(A) death certificate.
(B) relevant wage slips.
(C) the claimant’s statement.
(D) disability income statement.
(C) the claimant’s statement.
Q22: All preliminary calculations shld be correct to 2 d.p(with rounding) and the final answer correct to the nearest unit (with rounding).
Jane purchased an ElderShield 400 policy from one of the approved insurers. She subsequently needed long-term care, but recovered after 75 months. Calculate the total payout that Jane received from her ElderShield 400 policy.
(A) S$3,200
(B) S$4,800
(C) S$28,800
(D) S$30,000
(C) S$28,800
ElderShield 400 = S$400 for maximum of 72 months. Total Payout = S$400 X 72 = S$28,800
Q23: Mr Law and Mrs Law are a young Singaporean married couple. They have been experiencing difficulties in conceiving their first baby and wish to explore the possibility of using their Medisave to pay for the Assisted Conception Procedure (ACP) treatments. They consulted a specialist who will perform the procedure locally, and the expected cost of such ACP treatment is S$25,000.
Which of the following statements about Medisave account usage on ACP is correct?
(A) Only the patient is able to use the Medisave account.
(B) Both the patient’s and her spouse’s Medisave accounts may be used.
(C) Only inpatient treatment expenses can be used for Medisave account.
(D) Only outpatient treatment expenses can be used for Medisave account.
(B) Both the patient’s and her spouse’s Medisave accounts may be used.
Q29: There are several types of hospitalization and day surgery expenses that can be paid with MediSave. The inpatient daily hospital limit applies if the patient is admitted to the hospital for at least ____ hours.
(A) 4
(B) 6
(C) 8
(D) 12
(C) 8
Q30: Janet is a needy Singaporean facing financial difficulties with her healthcare bills despite receiving Government subsidies and drawing on other means of payment like MediShield Life. The endowment fund set-up by the Government which is likely to assist Janet is called…
(A) Medifund.
(B) MediShield Life Fund.
(C) Community Health Assist Scheme.
(D) Pioneer Generation Disability Assistance Scheme.
(A) Medifund.
Q31: The Singapore Government worked with Integrated Shield Plan(IP) insurers to develop a Standard IP which is targeted at covering large hospital bills for Class _____ ward.
(A) A
(B) B1
(C) B2
(D) C
(B) B1
Q32: Gloria is a Singapore Citizen with a household monthly income of S$1,500 and lives in a HDB flat with an annual value of S$15,000. She does not have sufficient Medisave savings to pay for her MediShield Life premiums in full. Assuming that she is eligible to receive premium subsidies under the MediShield Life Scheme, what is the % of the premium which can be subsidized under the Premium Subsidies for the lower to middle income?
(A) 80%
(B) 50%
(C) 60%
(D) 75%
(B) 50%
Q33: Simon wishes to claim under his MediSave account for the following Inpatient Psychiatric Treatment costs incurred as follows:
21 January 2020: S$100
13 February 2020: S$140
11 March 2020: S$210
16 April 2020: S$260
How much can Simon recover from his MediSave account?
(A) S$540
(B) S$640
(C) S$700
(D) S$710
(A) S$540
The withdrawal limit for inpatient psychiatric treatment is S$150 per day, subject to a maximum of S$5,000 per year.
S$100 + S$140 + S$150 + S$150 = S$540
Q34: CareShield Life will pay a monthly benefit of at least S$600 for as long as the insured is severely disabled. It pays the benefits if the insured is unabled to perform at least ______ of the six Activities of Daily Living as defined.
(A) two
(B) three
(C) four
(D) five
(B) three
Mr Ong is a 65-year-old Singaporean earning S$2,0000 per month. He is concerned about paying his medical expenses in the event of suffering from any severe disability and he is, therefore, interested in seeking Careshield Life coverage. However, Mr Ong is interested in exploring the subsidy options offered by the Careshield Life scheme. The subsidy which is most likely to assist Mr Ong is…
(A) Means-tested premium.
(B) Deferred claim payment.
(C) Critical Illness protection.
(D) Accident and Health benefit.
(A) Means-tested premium.
Q36: To ensure that CareShield Life premiums remain affordable, the Government helps Singapore Citizens with their CareShield Life premiums by means-tested premium subsidies for the…
(A) higher income group.
(B) lower and middle income group.
(C) married couples with no children.
(D) group with pre-existing conditions
(B) lower and middle income group.
Q37: Danielle works for a health insurer in the underwriting department. Danielle issues policies to policyholders. Danielle notices that health insurance policies contain a `Mis-statement Of Age Or Gender’ provision which states that, in the case of an insured person mis-stating his age or gender, the insurer will…
(A) terminate the policy and keep the premium.
(B) terminate the policy and refund the premium.
(C) adjust the premium based on his correct age and gender.
(D) ignore the correct age and gender during the policy period and rectify the error at renewal.
(C) adjust the premium based on his correct age and gender.
Q38: Alex has purchased a medical expenses policy and notes that this contains a waiting period. Alex reads that the waiting period is the period of time…
(A) starting from the date that a claim occurs, where the insured person’s medical expenses are not covered by the policy.
(B) starting from the date that a claim is made, where the insured person’s medical expenses are covered by the policy.
(C) starting from the date that the premium is paid, where the insured person’s medical expenses are not covered by the policy.
(D) starting from the date of policy issue or reinstatement date, where the insured person’s medical expenses are not covered by the policy.
(D) starting from the date of policy issue or reinstatement date, where the insured person’s medical expenses are not covered by the policy.
Q39: The type of Health Insurance policy that gives the insurer the right to refuse to renew on certain dates as specified in the policy is known as: …
(A) non-renewable.
(B) annually renewable.
(C) optionally renewable.
(D) guaranteed renewable.
(C) optionally renewable.
