Most group insurance schemes in Singapore start with GHS. GMM is the add-on employers hear about and aren’t sure they need. The short version: GHS covers the usual hospital stay, and GMM is there for the unusual one.
What GHS pays for
Group hospital and surgical (GHS) cover pays for an employee’s stay in hospital and for surgery, including day surgery. Each plan sets limits: a daily room and board limit or a ward class, a limit on surgical fees, and limits on items such as intensive care, in-hospital doctor visits and hospital services like medicines, tests and implants.
Most plans also pay for specialist consultations and tests before an admission, and follow-up visits after discharge. These are the pre- and post-hospitalisation benefits, and the number of days covered varies by plan.
Plans come in levels. Among the plans in our calculator, the entry plans pay for a 4-bed ward in a public hospital, and the top plans pay for a single room in a private hospital. The higher the level, the higher the limits and the premium.
Where GHS runs out
Every GHS limit is a ceiling. For a routine stay, such as a few nights in a public hospital after an appendix operation, a mid-level plan usually covers most or all of the bill. For a long admission, a complex operation or a stay in a private hospital, one or two items can go past their limits even when the rest of the bill is covered.
That gap is what group major medical is for.
What GMM adds
Group major medical (GMM) sits on top of GHS. When a bill goes past the GHS limits, GMM pays part of the remaining eligible costs, up to its own overall limit. Most GMM plans have two features that keep their price down:
- A deductible: a fixed amount of the excess that the employee pays before GMM starts paying.
- Co-insurance: a share of the rest that the employee pays, commonly 20%, with GMM paying the other 80%.
Say a hospital bill goes S$6,000 past an employee’s GHS limits, and the GMM plan has a S$1,000 deductible and 20% co-insurance. The employee pays the first S$1,000 and 20% of the remaining S$5,000, which is another S$1,000. GMM pays S$4,000. Without GMM, the employee would pay the whole S$6,000 or claim it from personal insurance.
The details differ between insurers. Some build major medical into their hospital plans, and some require the GHS and GMM plan levels to match. GMM is always bought together with GHS, never on its own.
Do you need both?
Not always. GHS on its own covers the stays most employees are likely to have. GMM earns its keep on the rare, expensive admission, and because it only pays after GHS does, it costs much less than GHS.
It’s worth considering if:
- Your team includes foreign employees, who aren’t covered by MediShield Life and may rely on the group plan for a large bill.
- You’ve chosen a lower GHS plan to keep premiums down and want a safety net above it.
- Your team is older on average, or you want cover that holds up if someone becomes seriously ill.
- You want your benefits to compare well when you hire.
It matters less if you’ve chosen a top GHS plan with as-charged benefits and a high overall limit, where little is left above the limits to cover.
GHS covers the usual hospital stay. GMM is there for the unusual one.
How to compare them
Two GHS plans with similar names can have quite different limits, so compare the numbers item by item rather than the plan names. Look at the ward class or daily room and board limit, the surgical limit, the pre- and post-hospitalisation days and the overall yearly limit. For GMM, check the deductible, the co-insurance and the overall limit.
Our calculator gives a ballpark yearly price for hospital cover at three levels, and the standard level includes major medical. When you’re ready for exact figures, we’ll set out quotes from insurers on our panel side by side, within the next working day.
