Medi Shield Life Scheme (Private Medical Insurance Scheme) Regulations 2015

if the day of the month on which a person was born cannot be ascertained, the person is taken to be born on the first day of the month in which the person was born; and

if the month in which the person was born cannot be ascertained, the person is taken to be born in January.

a medisave-approved plan;

a MediShield Life cover.

any approval given by the Board for any withdrawal from any CPF member’s medisave account, for the payment of premiums for any earlier plan of the insured person, is taken to be cancelled in respect of the payment of such premiums for any period on or after the commencement of the later plan (called in this paragraph the affected premiums); and

withdrawals for the payment of the affected premiums are to cease on the commencement of the later plan.

any approval given by the Board for any withdrawal from any CPF member’s medisave account, for the payment of premiums for any earlier plan of the insured person, is taken to be cancelled in respect of the payment of such premiums for any period on or after the commencement of the later plan (called in this paragraph the affected premiums); and

withdrawals for the payment of the affected premiums are to cease on the commencement of the later plan.

the withdrawal from the CPF member’s account was made in breach of these Regulations or the MediShield Life Scheme Regulations 2015; or

the CPF member had made a false representation to the Board or the insurer, or furnished the Board or the insurer with any false information, in connection with the purchase of the medisave-approved plan.

the insurer of that plan must, if required by the Board, transfer to the Board any money paid as such premium for that plan from the CPF member’s medisave account, which could not have been withdrawn if the cancelled approval had not been given; and

the Board must refund to the CPF member’s medisave account the moneys so transferred by the insurer.

are not limited by regulation 12(1) to (4); and

apply to any permission granted by the Board under regulation 4(1) of the revoked PMIS Regulations, as those powers apply to any approval granted by the Board under paragraph (1).

for the additional private insurance coverage under an integrated shield plan, is the medisave withdrawal limit specified in the First Schedule; and

for a non-integrated shield plan, is the medisave withdrawal limit specified in the Second Schedule.

the insurer must transfer to the Board from that payment, in such manner as the Board may require, the premium for the MediShield Life Component of that insured person’s integrated shield plan; and

the Board must pay into the Fund the amount transferred.

the earlier plan is terminated; and

the insurance cover under the earlier plan ceases.

that person’s insurance cover under the earlier plan continues as if it had not ceased under paragraph (1), on such terms and conditions as the insurer may require; and

the later plan is terminated on the date that person’s insurance cover under the earlier plan is reinstated.

in the case of an integrated shield plan, the amount of all the premiums paid for the additional private insurance coverage under that plan; or

in the case of a non-integrated shield plan, the amount of all the premiums paid for that plan.

after the free-look period applicable to that plan; or

within the free-look period applicable to that plan, and a claim was paid under that plan,the insurer of that plan must refund an amount not less than the amount specified in paragraph (1)(a) or (b), as the case may be, pro‑rated for the unexpired period of the person’s insurance plan at the time the insured person ceases to be insured under that plan.

the amount specified in paragraph (1)(a) or (b), as the case may be; or

if a claim has been made under a person’s insurance plan before the date the plan is cancelled, an amount not less than the amount specified in paragraph (1)(a) or (b), as the case may be, pro-rated for the insurance periods of that plan falling after the insurance period in which the last claim was made under that plan.

to the person from whom, and in the mode of payment by which, the premium was received by the insurer; or

in any other manner as the Board may determine,and the insurer must pay the premium refunded as directed by the Board.

an insured person’s claim under a medisave-approved plan, in respect of any medical treatment or services received by the insured person, has been paid from the Fund or by an insurer, or both, as the case may be; and

another person, who is under an obligation (contractual or otherwise) to pay or reimburse the insured person for charges incurred in respect of that medical treatment or service, has made the payment or reimbursement,an amount computed in accordance with the following formula becomes due and payable to the Fund or the insurer, or both (as the case may be) by the insured person on the date such payment or reimbursement is made by that other person:X + Y – Z,where Xis the total amount of the payment or reimbursement made by that other person;Yis the total amount of the claim paid from the Fund or by the insurer, or both, under the medisave-approved plan; andZis the total amount of the charges incurred by the insured person.

may retain the amount paid by the insurer under the plan in respect of that medical treatment or service, excluding the amount paid from the Fund; and

must transfer to the Board, in the manner directed by the Board, the lower of the following:

any remaining balance;

the amount paid from the Fund in respect of that medical treatment or service.

an insured person had in force, immediately before 1 November 2015, an integrated medical insurance plan with a MediShield Component; and

the last day of the policy year of that plan is on or after 1 November 2015,then, on 1 November 2015, the integrated medical insurance plan continues as an integrated shield plan with a MediShield Life Component for the unexpired period of the integrated medical insurance plan.

an insured person had in force, immediately before 1 November 2015, an integrated medical insurance plan with a MediShield Component;

the last day of the policy year of that plan is on 31 October 2015; and

the insured person —

was a citizen or permanent resident of Singapore immediately before 1 November 2015 (whether or not the insured person is a citizen or permanent resident of Singapore on that date); or

was not a citizen or permanent resident of Singapore immediately before 1 November 2015, but becomes a citizen or permanent resident of Singapore on that date,then, the integrated medical insurance plan (if renewed) is replaced by an integrated shield plan with an insurance period of 12 months commencing on 1 November 2015, and the insured person’s MediShield Life cover which commences on that date forms the MediShield Life Component of the insured person’s integrated shield plan.

an insured person had in force, immediately before 1 November 2015, an integrated medical insurance plan without a MediShield Component; and

the last day of the policy year of that plan is on or after 1 November 2015,then —

if the insured person’s MediShield Life cover commences on 1 November 2015 —

the insured person may replace the integrated medical insurance plan with an integrated shield plan with an insurance period of 12 months commencing on 1 November 2015; and

the insured person’s MediShield Life cover forms the MediShield Life Component of the insured person’s integrated shield plan; or

if the insured person has no MediShield Life cover on 1 November 2015, the integrated medical insurance plan continues as a non-integrated shield plan for the unexpired period of the integrated medical insurance plan.

an insured person had in force, immediately before 1 November 2015, an integrated medical insurance plan without a MediShield Component; and

the last day of the policy year of that plan is on 31 October 2015,then —

if the insured person’s MediShield Life cover commences on 1 November 2015 —

the integrated medical insurance plan (if renewed) is replaced by an integrated shield plan with an insurance period of 12 months commencing on 1 November 2015; and

the insured person’s MediShield Life cover forms the MediShield Life Component of the insured person’s integrated shield plan; or

if the insured person has no MediShield Life cover on 1 November 2015, the integrated medical insurance plan is replaced by a non-integrated shield plan with an insurance period of 12 months commencing on 1 November 2015.

shorter periods apply under these Regulations or the MediShield Life Scheme Regulations 2015; or

the integrated shield plan or non-integrated shield plan, as the case may be, is earlier terminated or cancelled.

any reference in regulation 4(11) or (12) or 9 to a person’s medisave-approved plan, integrated shield plan or non‑integrated shield plan, as the case may be, is taken to include a reference to the insured person’s replaced plan; and

in relation to a replaced plan, regulation 4(11)(a) refers to a breach of the revoked PMIS Regulations or revoked MediShield Regulations, as the case may be.

the revocation of the Central Provident Fund (Private Medical Insurance Scheme) Regulations (Cap. 36, Rg 26) does not affect anything done under any provision of those revoked Regulations before 1 November 2015;

the revoked PMIS Regulations continue to apply in relation to every integrated medical insurance plan which was in force before 1 November 2015 as if those Regulations had not been revoked; and

moneys may continue to be withdrawn from the CPF member’s medisave account, in accordance with the Board’s grant of permission under regulation 4(1) of the revoked PMIS Regulations (where such permission has not been cancelled), for payments due before, on or after 1 November 2015, as if those Regulations had not been revoked.