CMFAS HI Medical Expense & Group H&S Insurance question: INSURER pay in total

CMFAS HIMedical Expense & Group H&S Insurance

A Work Permit holder's covered, work-related hospital bill is S$35,000, within the S$60,000 annual claim limit. Under the enhanced migrant-worker medical insurance (effective 1 July 2023), the insurer pays 100% up to S$15,000 and, for the amount above S$15,000, the insurer co-pays 75% and the employer 25%. How much does the INSURER pay in total?

A S$35,000
B S$26,250
C S$15,000
D S$30,000

Show the answer and explanation

Answer: D. S$30,000

First S$15,000: insurer pays 100% = S$15,000. Amount above S$15,000 = S$35,000 − S$15,000 = S$20,000, split 75% insurer / 25% employer → insurer S$15,000, employer S$5,000. Insurer total = S$15,000 + S$15,000 = S$30,000 (employer bears S$5,000).

Common mistake

The 75/25 split applies only to the portion ABOVE S$15,000, not the whole bill — 75% of S$35,000 (S$26,250) is wrong.

Practise more HI Medical Expense & Group H&S Insurance questions

Exam-style questions with worked answers, then full timed mocks. Free to start.

Start practising →

Study note: Medical Expense & Group H&S Insurance CMFAS HIpractice questions & mock exams

Related CMFAS HI questions

Mr Rahman's policy carries a per-disability (per-claim) deductible of S$1,000 and 10% co-insurance. During the same policy year he made three separate, unrelated claims of S$3,000 each. What is the insurer's total payout for the year?Under the Transferable Medical Insurance Scheme (TMIS), the 'continuation of coverage' feature allows an employee whose employment ends to continue enjoying hospitalisation cover for up to Mr Faisal's policy carries a per-disability (per-claim) deductible of S$800 and 10% co-insurance. In the same policy year he made two separate, unrelated claims of S$5,000 and S$2,500. What is the insurer's total payout for the year?

Build a daily practice habit — a few exam-style questions a day, with worked answers. Free to start.

Start practising →

Original study material mapped to the public CMFAS HI syllabus. Unofficial, not endorsed by MAS or SCI. Verify figures and rules against current guidance before relying on them.