Is Company Medical Insurance Enough? Answer These 5 Questions to Find Out

It’s one of the basic things we expect our employers to provide although we don’t really check it until we need to claim for it. 

But even so, corporate health insurance in Singapore varies quite differently from company to company. 

You don’t want to end up in a situation where you pay for a medical treatment and realise your company insurance, or personal one, doesn’t cover it. 

How do you determine it’s enough for your needs though? 

We present the 5 essential questions to ask yourself to decide if your company insurance is enough.

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What your company medical insurance covers 

Corporate medical insurance usually has 2 main parts—coverage for hospitalisation and coverage for regular GP visits. 

Hospitalisation coverage, usually called Group Health and Surgical insurance, applies when something serious happens and you have to be admitted and if there are any surgeries needed. 

The other component is coverage for GP visits, which will be the most common use for many people. We all know who to go to when we want to take an MC. Completely for legit reasons of course!

Most corporate insurance policies have what’s called a list of panel clinics, which means if you visit the clinics on this panel, you usually don’t have to pay for the visit. 

Let’s say you’re having really bad diarrhoea and the nearest clinic to your home is not on the panel, you can still go, but you will have to pay for the full sum. Depending on your policy’s coverage, you may be able to claim a partial amount of the fee back. 

Some companies may include coverage for dental and/or maternity, depending on how good your company’s benefits are.

The important thing to remember is that there’s no standard package for corporate health insurance in Singapore. Your employer’s plan could cover only basic hospitalisation and outpatient treatment, while another company’s plan may offer wider hospital coverage or additional benefits.

So before deciding whether your company insurance is enough, you need to know exactly what your policy covers, its limits, and what you may have to pay out of pocket.

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Is your company medical insurance enough? 5 questions to answer

Is it? What’s considered “enough”? You may be young and healthy but illness can come up at any time. It really depends on your own personal needs. We’ve got these 5 questions to help you determine.

Q1: Does it cover your spouse, kids, or parents—or just you?

If you’re single with no dependents, your company insurance might seem sufficient. But what happens if you get married and have kids?

Does company insurance cover family members in Singapore? The answer depends on your employer’s policy. Some companies offer employee-only coverage, while others allow you to add your spouse or children, sometimes at an additional cost.

Parents are another consideration. If you’re supporting elderly parents, you’ll want to check whether they have their own medical insurance, such as MediShield Life or an Integrated Shield Plan, and where else they may lack coverage.

If you’re a parent, you may also check on what are the annual limits, exclusions and co-payment requirements for your dependents.

Q2: What happens to your coverage the day you leave your job?

This is basically one of the main downsides of relying only on corporate insurance. Your company medical insurance is tied to your employment. When you leave your job, you are simply no longer covered. 

This means if you resign, get retrenched, or switch to a company with less comprehensive benefits, you could suddenly find yourself without the same level of medical protection. 

If you’re undergoing treatment that extends over a few months and you change jobs, the coverage of your previous employer no longer holds. Your new company could be under a different insurer with a completely different set of panel clinics, or have lower amounts that you can claim for. 

Or if you’re 45 and have been relying on your company’s medical insurance for the past 15 years. You switch jobs, but your new employer offers only basic hospitalisation coverage. If you have no personal health insurance, you may find yourself having to pay for medical treatment out of pocket, or apply for a new policy at an older age.

And the older you get, the more important it becomes to think about whether you can still get the coverage you want.

Q3: Does it cover pre-existing conditions, or would a gap in employment expose you later?

This is a particularly important question if you’ve already been diagnosed with a medical condition.

Corporate insurance may cover certain pre-existing conditions, depending on the company’s group policy. But not every policy does, and the scope of coverage can differ.

For example, your company plan may cover a medical condition you developed while working there. However, if you leave your job and try to buy a new personal insurance policy, the insurer may assess your medical history and exclude your condition from being covered or charge an extra fee for coverage.

That’s why relying on corporate insurance alone can be risky if you already have health concerns. If you somehow get retrenched unexpectedly, you’d also be left in the lurch. 

What’s more, if you switch jobs, your new employer’s insurance may have different benefits, exclusions and limits.

Q4: What's your ward-class limit, and would it actually cover a real private hospital stay?

This is where your company's medical insurance can make a huge difference. Most basic plans only cover public hospitals and you’d have to check if your coverage extends to private as well. 

If your company insurance covers only public hospital B2 or C wards, you may have to pay more if you choose to stay in a higher ward class or private hospital.

For example, imagine you need surgery and decide to go to a private hospital.

Your company insurance may cover part of the bill, but you could still be left with a significant amount to pay, depending on the policy’s coverage limits, deductibles, co-insurance and exclusions. 

Q5: Does it stack with MediShield Life / an Integrated Shield Plan, or does it stand alone?

In Singapore, MediShield Life provides basic protection against large hospital bills, with coverage based on subsidised bills in B2/C wards in public hospitals. An Integrated Shield Plan adds private insurance coverage on top of MediShield Life, potentially covering higher ward classes in public hospitals or private hospitals.

Your company insurance is a separate layer of protection.

If you have both, it doesn’t necessarily mean you’re paying for the same thing twice. They may cover different aspects of your medical expenses.

For example, your company plan might cover hospitalisation and surgery, while your personal Integrated Shield Plan provides additional coverage for higher ward classes or private hospitals.

But you need to understand how the policies work together.

If you have both corporate insurance and a personal Integrated Shield Plan, you can generally pay for your treatment using corporate insurance. Any balance payment that exceeds the corporate insurance coverage, you can use your Integrated Shield Plan to pay for it. 

This means having two insurance policies doesn’t mean you can claim the full amount twice. That would be insurance fraud! 

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If you answered "no" to any of those, should you buy your own?

If you answered “no” to any of the questions above, it doesn’t necessarily mean you need to buy a personal insurance plan immediately.

But it does mean you should take a closer look at your coverage.

For example, if your company insurance only covers you and not your family, you may want to consider personal health insurance for your spouse or children.

If you’re planning to leave your job and only have been relying on corporate insurance, you may consider getting your own policy so that you’re not tied to the limits of your company’s policy. 

If your company insurance only covers basic public hospital wards, you may want to explore an Integrated Shield Plan if access to higher ward classes or private hospitals is important to you.

Check where you’re not covered based on your personal needs, whether it’s for basic GP coverage or higher hospital coverage, or whether you have dependents to look after or are changing jobs. 

You should also consider whether you can afford the premiums over the long term. 

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How company insurance and personal insurance work together

So, should you have both company insurance and personal insurance? The answer depends on your needs and lifestyle presently and in the future, as premiums go up as you age. 

They both serve different purposes. 

Company insurance is an employment benefit. It can help cover medical expenses while you’re working, depending on the plan’s benefits and limits.

Personal health insurance, on the other hand, provides coverage that continues independently of your employer, and is more comprehensive and catered to your condition and needs that general company insurance may not cover. 

Having both isn't overkill. The goal isn't more insurance, it's knowing where your actual coverage ends. 

Know someone who relies solely on their corporate insurance? Share this article with them!