WorksheetsPHI Sales Quiz
Total questions: 16
Worksheet time: 9mins
I've just become a permanent resident, can I purchase PHI without LHC?
Yes, as long as you purchase PHI within the first 12 months of being in Australia
Yes, as long as you purchase a hospital cover within 12 months of receiving Medicare
Yes, as long as you purchase a hospital cover within the first 6 months of arriving in Australia
No, you will be subject to LHC if you are over 31
If my taxable income is $125,000 as a single, my MLS would be...
$1,250
$1,562.50
$1,875
What is the main distinction between a Gold-tier private hospital cover and a Bronze-tier private hospital cover?
Gold-tier cover is only available for people over 60, while Bronze-tier cover is available for all ages.
Gold-tier cover includes unlimited psychiatric treatment, while Bronze-tier cover does not cover any mental health services.
Gold-tier cover includes cover for all 38 clinical categories, while Bronze-tier cover includes only the minimum categories like treatment of cancer and general surgery.
Gold-tier cover includes dental and optical services, while Bronze-tier cover does not.
What is not covered by PHI?
Ambulance
Specialists Appointments
GP Appointments
Outpatient Blood Tests, Ultrasounds & X-Rays
PBS Scripts
When does an Extras Benefit year reset?
Select all that apply
Calendar Year
Financial Year
Membership Year
Rolling Year
LHC will be applied when...
When someone turns 31 and doesn't hold Private Health Insurance
When someone turns 31 and doesn't hold Private Hospital Insurance
After the new Financial Year following someone turing 31 and not holding Private Health Insurance
After the new Financial Year following someone turing 31 and not holding Private Hospital Insurance
If someone believes purchasing a Hospital policy will reduce their Medicare Levy and their Taxable Income as a single is $87,000, what should you advise?
They will be able to save 1% extras Tax when purchasing a Hospital policy
Explain the difference between the Medicare levy and the Medicare levy Surcharge and that they will still pay 2% towards the MLS
Explain that each day they hold a Hospital policy they will no longer have to pay the Medicare Levy
There is nothing that needs to be said at all, this is a trick question
A customer has a pre-existing condition and is worried about waiting periods for hospital cover. How would you explain this?
Waiting periods are only 2 months for pre-existing conditions.
There is no waiting period for pre-existing conditions with private insurance.
There is a 12-month waiting period for pre-existing conditions, reassure the customer after which they’ll be covered.
Pre-existing conditions are never covered by private insurance.
What is included in Portability?
All waiting periods are transferred over to the new fund
Any upgrades will have a waiting period to serve
Any claims previously made will be carried over and deducted off the new limits
The transfer process can take up to 21 days
Mary and Bob both require a Gallbladder to be removed. Mary is on a Gold Hospital and Bob is on a Bronze Hospital. Who will be covered to a higher degree for this surgery?
Mary as she is on a Gold Hospital, she receives more cover towards the Gallbladder operation
Both Mary and Bob will receive the same cover and treatment
Mary as Bob's policy will not cover the Gallbladder operation
If a specialist charges more than the Medicare Benefits Schedule (MBS) fee and is not part of the Access Gap Cover scheme, what is likely to happen?
Medicare will cover 100% of the specialist’s fees
Private health insurance will cover the entire fee
The gap fee will be automatically waived
The patient will pay the full difference between the fee and the MBS schedule
If my CAE is 43 my LHC would be
0%
13%
26%
20%
Just by holding a Hospital cover, I will be given 100% Comprehensive Ambulance within which State/Territory?
QLD
NSW
ACT
VIC
South of the 26th Parallel in WA
A Pre-Existing condition needs to be diagnosed by a doctor prior to taking up PHI
True
False
What happens to an individual's hospital cover if they take advantage of the 1,094 'Days of Absence' allowed under Lifetime Health Cover (LHC)?
Their hospital cover is immediately cancelled, and they must reapply after 1,094 days.
The individual’s hospital cover continues, but their LHC loading will increase by 2% for each additional year after the permitted days are used.
The 1,094 days are only counted when the individual re-enrolls in hospital cover after the break, with no penalties.
Their LHC loading decreases by 2% per year after returning from the 1,094 days without cover.
A client asks whether they can claim certain treatments on their health insurance, but you’re unsure. What should you do?
Inform them that you will check with the insurer and provide accurate information once confirmed.
Tell them, “How would I know? Just submit it and see if it gets rejected.”
Dismiss their question with, “You should’ve read the policy before asking me this.”
Say, “It’s probably not covered, but go ahead and try if you want to waste time.”
