Personal Health Insurance Vs Group Health Insurance

Coverage provided by health insurance companies in Singapore is among the world’s best, but it is also more expensive than most other countries in the region. If you are a Singaporean or a Permanent Resident (PR), you will be eligible for a subsidised medical insurance plan provided by the government known as MediShield. If you are a foreign national, it is essential to get a basic individual or personal health insurance coverage from a private insurance company.

Many Singapore nationals also opt for additional coverage if they are not satisfied with what they get with MediShield. Such policies begin with a copayment or deductible scheme, where you either pay a part of the medical bills while your insurance company pays the rest or you pay a small amount before making any claims.

The government’s Medisave programme mandates employers to contribute part of PR and Singaporean salaries to a medical savings account. Employees working in certain companies may get partial coverage with employer plans or a group health insurance policy too. Here we will discuss in detail both individual health insurance and group health insurance.

Personal Health Insurance

There are five different types of personal health insurance:

  1. Long Term Care Insurance
  2. This will pay for the care that you will need when you are disabled severely or too fragile to look after yourself. Most people opt for this insurance for their old age.

  3. Disability Income Insurance
  4. This policy will provide you with an income when you suffer from a disability due to an illness or accident that leaves you in no condition to earn, while you are still young.

  5. Critical Illness Insurance
  6. With this policy, you will obtain a lump sum amount to help you with your expenses when you get diagnosed with a major illness such as cancer.

  7. Hospital cash Insurance
  8. This policy will provide you with a fixed quantity of cash when you get hospitalised due to accidents or illnesses. There are some private insurers that limit the health coverage to a few clinics.

  9. Medical Expenses Insurance
  10. This policy will provide coverage only for your hospital and surgical (medical) expenses.

What to look out for when purchasing Health Insurance?

Most personal health insurance policies will normally have exclusions for expenditures for which there is no coverage. When you are thinking of purchasing a health insurance policy, read through all the terms and conditions carefully that state the situations that are not part of the insurance cover. Most importantly, never assume anything. For example, if you are diabetic, your health insurance may cover basic charges. However, it may not cover the treatment of any complications arising out of diabetes, such as kidney failure that may eventually lead to dialysis. These and many other services will be available through additional insurance coverage.

You should ideally purchase basic coverage as early as possible because premiums for extra coverage will grow fast with age.

How do I sign up for Health Insurance?

There are insurance agents representing the insurers or independent financial advisors who are responsible for selling policies in Singapore. However, before looking for an agent or signing up, it is prudent to do your own study. All the relevant information on premiums and several health insurance policies are present on company websites, which will help you make an informed decision without having to listen to a sales pitch.

How do I file a Health Insurance Claim?

Insurers have claims team with expertise of risks, business practices, legal and regulatory issues. They have experts for handling each claim, based on the complexity of the disability or illness. The process of filing a claim is different for different types of personal health insurance. However, certain aspects like submitting all the relevant hospital and medical bills are common for all.

Group Health Insurance

A Group health insurance is a policy that most large and medium-sized employers provide their employees under a single contract. It normally covers hospitalisation and surgical procedures, in the event of injury or illness. In Singapore, it is compulsory for employers to provide all foreign nationals and employees having work permit with group health insurance. A group health insurance or employer plan is part of employee benefit and is mainly provided to attract and retain employees.

Why is a Group Health Insurance Important?

A group health insurance is important because you will be protected from expensive surgical procedures in the event of an injury or illness. You will not have to worry about filing for claims as your employer will take care of reimbursement of medical expenses in the event of your hospitalisation due to accident or illness.

Make changes to your policy when enrolment comes around

Group health insurance policies normally have guidelines about when and what aspects of your policy you can modify during enrolment. During enrolment, you are free to make modifications to your coverage if options are available on the policy. You can also update your policy based on the healthcare needs of you and your family.

In addition, your company may alter these policy options, or even select a new insurer completely. During the enrolment period, if you wish to choose the best options available, you must participate in the process. Give your honest opinion and raise any concerns that you may have with the current policy in the previous year and encourage your colleagues covered under a similar policy to do the same. By doing so, people who are responsible for changing, renewing and managing your organisation’s group health insurance policy can have a better understanding of employee expectations.

How are your Dependents Covered Under Group Health Insurance?

Most personal health insurance policies do not provide coverage to your dependents. However, it is not the same with group health insurance. So, never disregard the fact that your group health insurance policy may provide coverage to your spouse and possibly your children and their needs are likely to vary from yours. You must consider this when picking your options.

Also, even if your group insurance plan covers your dependents, the insurer can refuse coverage for them if they currently have a policy of their own. For instance, if your spouse has health insurance through his/her employer, your policy may not cover them.

You must not judge a group health insurance policy based on its price tag, because any limitations of a poor plan can lead to you losing much more than you might save.

Despite covering all the above points, if you still think that your group health insurance does not address every area, you may want to consider buying private insurance that provides wider coverage than what your employer-provided plan does.

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