Firstly, many employees in Malaysia enjoy employee medical insurance provided by their employer as part of a benefits package. It’s a great perk and can help reduce your healthcare costs, particularly when you’re just starting out in your career. But does that mean you should only rely on it? Not necessarily — and here’s why.
Group or employee medical insurance can be valuable, but it’s fundamentally different from having your own personal medical insurance. Moreover, understanding these differences can help you make more informed decisions about your health protection and financial planning.
What is group medical insurance?
Group medical insurance is a type of insurance that gives coverage to employees or members of a company/organisation. It usually provides coverage at a lower cost as the risk to the insurer is spread across a group of policyholders.
Key features of group medical insurance:
- Group members can choose if they want to enrol in or decline coverage.
- Family members or dependents can be included in the group plans at additional cost
- Group medical insurances typically require a 70% participation rate.
- Premiums are shared normally between the company and employee.
*However, different companies have different ways to decide on their group medical insurances.
What is individual medical insurance?
Individual medical insurance is coverage to a person on an individual sum insured basis. You may customize the coverage as per your own health and not be shared with others (family members or dependents).
A comprehensive individual medical plan usually covers your hospitalization and surgical expenses due incurred to illnesses.
Key features of an individual medical insurance:
- Individual medical insurance only provides coverage for the insured individual.
- You get to customise your risk planning depending on your needs.
- Best suited for people with higher health risks.
Having employee medical insurance surely does have its perks as are a few added advantages that you can enjoy for being covered by a group policy plan. Among the benefits that we may conclude is that group insurance is some of the most affordable insurance covers that you can invest in. It is much lower than individual insurance plans because the risk is spread across a higher number of people.
The process for insurance claims is faster and easy; hence; saving you from the hassle. Most group plans waive the waiting period for hospitalisation, and they do not require you to undergo a medical check-up to assess pre-existing conditions.
Although there are benefits as mentioned above, relying entirely on your employer’s insurance plan to cover you can pose other problems too.
The range of coverage provided under group medical insurance may differ from organisation to organisation. Usually the coverage is vastly subjective and limited. They may not provide enough to cater to all your medical needs.
Should you solely depend on employee medical insurance?
Although your employee medical insurance helps you cover some of the costs of healthcare, you should not only solely rely on it. Here we list out several reasons why:
The range of coverage provided under group medical insurance may differ from organisation to organisation. Usually the coverage is vastly subjective and limited. They may not provide enough to cater to all your medical needs.
Limited coverage
Your company holds the right to determine your coverage along with other benefits featured under the group plan. Some employers may decide the amount of the coverage depending on the pay or seniority ranking.
Generally, medical insurance policies have low annual limits, and the amount is the maximum that an employee can claim for each year. For any medical expenses exceeding the given annual limits, the employee will have to foot the bills (remaining balance). You would have to check if your employee insurance is enough to cater your medical needs.
The annual spend limitations can range from RM20,000 to RM200,000.
Changes in terms and conditions
The company can change the terms and conditions at any time to reduce expenses.. Say if the company is experiencing hiccups, therefore it might reduce the insurance coverage. The company might ask the employees to co-pay some of the premium as they could not afford to pay for all.
You can lose your coverage upon resignation
This is a terrifying notion, since your medical coverage is tied to your employment
If your employer lays you off or you choose to leave the company, your employer will terminate your policy immediately. Keep in mind that this coverage only applies while you are part of the company.
Furthermore, if you were to land on another job after resigning from your previous job. The coverage may differ from your previous coverage or even worse the company itself may not provide medical insurance. Would you currently have the funds to cover for new coverage?
No future savings
Medical insurance is a critical component of personal financial management. But group insurance policy does not include continuous coverage for employees.
Once you retire, how are you going to cover your medical expenses after that (if you are in dire need)?
Your company does not longer cover for you after retirement. Therefore, this could be a big problem for you if you don’t have your own medical insurance. Other than that, An individual medical for yourself will be costly at the age of 50, considering your age and possible pre-existing illnesses.
Unlike an individual plan, you hold the power to plan how you want to spend on medical insurance on an annual basis.
Here we conclude the differences for you to do comparison.
| Individual Medicine Insurance | Group Medicine Insurance | |
| Policy Period | – The company has the power to cancel the policy plan – Policy plan of an employee may be terminated upon resignation from the company | It is up to the policyholder to continue/discontinue the policy plan |
| Premium | – Usually covered by – Policy does not get costlier with the age of the employee | Paid by the individual on a regular basis- Policy gets costlier as you age |
| Coverage | – The plans are neither flexible or customisable- Uniform coverage to all members in group – Coverage may vary to a certain amount of the employee’s pay | Policyholder gets to customise their risk planning depending on their needs |
| Medical Checkups | Medical check ups are required for buying individual medical plans | There is no need for prior medical check ups for a specified coverage |
Conclusion
Employee medical insurance is a valuable benefit, but it shouldn’t be your only source of healthcare protection. Its coverage limitations, potential for change, and lack of portability outside employment mean that combining it with your own personal medical insurance gives you more robust, long-term peace of mind — especially as medical costs continue to rise and healthcare needs evolve in 2026 and beyond.
Lastly, If you’d like help choosing the right personal medical card to complement your employee coverage, BJAK’s insurance experts can guide you based on your budget and long-term goals.
