How To Choose A Group Medical Insurance Plan That Works For You (And Everyone Else)

Due to the overwhelming number of enquiries we've received on this topic, I thought I'd pen down my thoughts on the Group Medical plans available. We have covered this topic before, but this is the updated version as of August 2024.

First, Group medical plans refer specifically to employee health plans and typically require at least a 4-6 person headcount to get started. If you don't meet the minimum requirement, you'll need to consider using a standalone medical card first until you attain the minimum number. There are a ton of them available out there. 

What is Group Medical Insurance?

Group medical insurance refers to a single policy that covers a group of people, typically company employees, under one plan. This type of insurance is designed to provide health coverage to employees and, in some cases, their dependents.

In simpler terms, it's also known as the following;

1. Group Health & Surgical Program (GHS).

2. Group Medical Insurance.

3. Group Insurance.

4. Employee Benefits.

It all generally means the same thing except for number 4, which can extend beyond what we discuss in this blog article. 

Benefits of Group Insurance

- Typically cashless admission. So that works well for your staff and employees.

- Can be extended to cover outpatient/clinical visits (also known as GP).

- Most have a wide network of panel hospitals from which to choose.

- Relatively cheap considering the facilities provided to your team.

- Technology/app-driven for added convenience.

But let's focus on the key elements here.

In a broad sense, most group employee insurance plans are modular and will typically consist of the following benefits and options;

Death Benefit

It is sometimes also known as a Life Insured Amount (because nobody likes to use the word 'Death').

Critical Illness

A lumpsum payout in the event a critical illness occurs.

Hospitalisation

This portion usually includes the daily Room and board (R&B) amount, which can sometimes be as low as RM100/night to RM500. 

It also details the annual surgical benefit amount, which can range from RM20,000 to RM200,000.

Personal Accident (PA)

This benefit typically provides a payout by percentage of the insured value.

Hospitalization Income

Provides a daily payout to the insured. It can range anywhere from RM50 to RM100 a day, and it's usually used as a buffer to help you cover any expenses your insurance program may not cover.

Additional Benefits

The list here is endless. Some programs may provide outpatient Cancer Treatment, while some don't. You'll need to speak with your insurance provider about this.

Some outpatient benefits include dental benefits and traditional Chinese medicine (TCM) access.

Some programs can be tailored to extend coverage towards family members (spouse & children).

Outpatient / Clinical / GP Visits

Some programs provide cashless admission facilities for clinical visits, which can be extremely helpful. These are sometimes done through a Third-Party Administrator (TPA). Conversely, some insurers offer an outpatient program with an annual premium rate attached to it.

Needless to say, each insurance provider will offer its unique program. Most programs can be tailored (to a certain degree), and we've not even got to the details of which insurer offers what. The best way is to work backwards to identify your requirements and then source for a provider that offers that.

The good news is that Cover Buddies loves working on group medical insurance plans. For more info, drop us a line or schedule a call with us, and our professional consultants will be happy to assist you (usually within the same day).

Or if you need quick answers, WhatsApp Us instead. We love questions on Group Insurance, GHS, and Employee Insurance. Call it whatever you want.