This study explored the effects of insurance literacy, perceived usefulness, attitude toward health insurance, subjective norm, and perceived behavioral control on the intention to purchase and the actual purchase of health insurance among working adults in Malaysia. This quantitative study adopted the cross-sectional design with data gathered from 1,308 working adults through a Google form link shared in social media. Upon analysis, the outcomes revealed that insurance literacy, perceived usefulness, attitude toward health insurance, subjective norm, and perceived behavioral control exerted a significantly positive effect on the intention to purchase health insurance. Intention to purchase health insurance exhibited a significantly positive impact on actual purchase of health insurance. Empirically, intention to purchase health insurance yielded a significantly positive mediating effect. Based on the multi-group analysis (MGA), the perceived behavioral control was significantly stronger among rural respondents than urban respondents, as well as among respondents with a bachelor degree than those with secondary school certificate. Referring to the retrieved empirical outputs, financial and health management policymakers, as well as insurance companies in Malaysia should concentrate more on the positive attributes of health insurance in order to improve the attitude of Malaysian working adults toward insurance and insurance literacy.