Many HR managers assume a Group Hospitalisation & Surgical (GHS) plan is enough to tick the “employee benefits” box. It’s not.
Here’s what gets overlooked:
No Outpatient Rider = Daily Pain for Staff
Hospital plans sound impressive on paper. But what about day-to-day GP visits? Most GHS plans exclude outpatient treatment unless you’ve added a rider. That means employees still pay out-of-pocket for flu, minor injuries, and follow-ups — defeating the purpose of offering health benefits.
💡 Tip: Always consider bundling GHS with a Group Outpatient Insurance plan that covers GP, specialist, and TCM visits.
Pre- and Post-Hospitalisation Limits Are Tricky
Many plans cover 90 days before and after a hospital stay. But “coverage” doesn’t always mean “full reimbursement.” Some insurers cap the pre/post benefits or require panel referrals.
🧾 According to MOH Guidelines, pre- and post-hospitalisation are crucial parts of a patient’s recovery journey. Leaving them underinsured can cause dissatisfaction and unexpected claims disputes.
Panel Problems: Staff Confused, Claims Rejected
Employees often assume they can visit any doctor or hospital. But if the plan restricts them to a panel, out-of-panel claims may be rejected — or reimbursed at a much lower rate.
✅ HRs must clearly communicate panel limitations during onboarding and provide accessible claim guides.
What HR Should Do Differently
Don’t just look at premium costs — assess real employee usage. Flu visits, blood tests, follow-ups, mental health consults — these aren’t hospital admissions, but they add up.
Want to be seen as a thoughtful employer? Offer comprehensive care beyond ward coverage.
See how to structure a smarter employee benefits plan at your-insurance-guy.com
(Speak to us and we can help audit your current coverage gaps).