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What’s the deal with individual vs group health insurance?

We get a lot of questions about health insurance. That’s to be expected; we’re a leading health insurance broker. People, by and large, don’t ever really need to consider the ins and outs of insurance unless they actually need to use it – or find that they should have bought some. Two of the key questions we get from clients are: “Is there a difference in individual vs group health insurance?”, and “Is group health insurance good?”

Well, how long is a piece of string? The truth is that buying insurance is just like buying a car or a house – it’s less about buying the best plan available, and more about buying the best plan for you. As employee benefits specialists, and one of the largest distributors of individual international private medical insurance in the world, let us simplify this insurance matter for you.

Does your company provide health benefits?

If it does, then you’ll be covered under a group health insurance plan. Group or employee benefits are plans that are designed to provide coverage to groups of generally 20 or more people, where insurers can spread the risks associated with members across the group. This can often mean some more attractive benefits or limits for cheaper premium prices than you might get with an individual plan.

If you need health insurance as your company doesn’t provide it as part of your employment package, then you’ll be looking for an individual health insurance plan. These are products that are offered to individuals looking for medical coverage. The downside is that premiums for individual plans can be more expensive when compared with group plans offering the same benefits. The upside is that individuals have greater control over what they can include and exclude to adjust their actual price.

What are the key differences between individual vs group health insurance?

We have a page on our website that outlines the differences, but here are the main pros and cons to be aware of:

Individual health insurance

Group health insurance

  • Great flexibility
  • Better control over co-pays, deductibles, and limits
  • Choice of insurer
  • Portable; meaning it’s not tied to your employment


  • Higher premiums
  • Either no coverage or extra fees for pre-existing conditions
  • Lower levels of customer support in some cases
  • Greater coverage for cheaper per member premium price
  • Easier to get pre-existing conditions covered
  • Extra support offered by some brokers and insurers


  • Coverage benefits and limits are standard across all members; not according to individual need
  • May lose coverage if you leave job
  • Company owns the plan, not you

What if my company’s employee benefits are not comprehensive enough?

The question of “Is group health insurance good?” actually comes down to “Does my employer-provided health insurance meet my needs?” Unfortunately for some, the answer might be that it doesn’t. In times like these, you might be interested in looking at top-up insurance plans. These plans do as the name says on the tin – it tops up your existing group health insurance plan with supplementary and complementary coverage that you can get for less than the cost of purchasing a whole new individual plan outright.

Individual vs group health insurance: need to know more?

Understanding what gaps exist between individual and group health insurance can be hard if you’re not familiar with insurance products. Luckily, Pacific Prime is your ideal partner for ensuring that your personal health and wellbeing is supported by a great medical coverage plan. For more information about individual vs group health insurance, or for a free quote, contact our team today!