In recent years, Malaysia has seen growing utilisation of private healthcare services, leading to higher claims for insurers and takaful operators (ITOs). Bank Negara Malaysia (BNM), together with key stakeholders, are pursuing healthcare reforms under the RESET Strategy to address private healthcare costs and ensure that medical and health insurance/takaful (MHIT) products remains affordable and accessible for Malaysians.
Read the BNM Annual Report 2024 Feature Article entitled Securing Sustainable Access to Medical and Health Insurance/Takaful Protection to learn more about the key drivers leading to rising hospital bills and MHIT premiums.
Introducing MediAsas
The Base MHIT Plan, now known as MediAsas, is a key component of the RESET Strategy, a collaborative effort by the Ministry of Health, Ministry of Finance, Bank Negara Malaysia and key stakeholders. It is a voluntary medical insurance and takaful protection plan with standardised features. It is designed to provide more Malaysians with access to affordable health protection. The plan aims to improve access to private healthcare while supporting better healthcare.
MediAsas is intended to enable more Malaysians to obtain a basic level of health protection, particularly individuals who are currently uninsured as well as those seeking a more affordable alternative due to repricing or changes in their financial circumstances.
The design of MediAsas was developed following insights gathered from over 60 stakeholder engagements, consumer focus groups and extensive analysis, ensuring that the product meets consumers’ needs while supporting broader healthcare reform objectives.
The MediAsas Pilot Programme will commence at the end of July 2026 to test and refine operational processes, customer experience and implementation readiness. Insights from the pilot will help inform further enhancements ahead of the nationwide rollout slated for early 2027.
About MediAsas
Voluntary and standalone plan
- A voluntary medical and health insurance/ takaful plan introduced under a national healthcare initiative. It is not a social insurance/ takaful scheme.
- Provides access to essential coverage for medical treatments at private hospitals, with annual limits that cover up to 99% of common treatments.
- A yearly renewable standalone medical and health protection plan that is not linked to any investment products.
Designed differently
- Enables more people to access essential medical treatment at private hospitals through broader eligibility and more affordable coverage.
- Built-in cost control and cost-sharing features to help keep premiums stable, affordable and sustainable over time.
- Ability to choose from panel hospitals for cashless admission, with greater certainty over eligible hospital bills, and lower out-of-pocket costs.
- A standarardised medical insurance plan with clearer benefits and policy terms.
Healthcare protection at every stage
- MediAsas is designed to provide coverage across different stages of healthcare, including with coverage for pre- hospitalisation, hospitalisation, post hospitalisation and outpatient treatments.
- The MediAsas premiums will be determined based on the plan’s benefits and the latest medical claims experience and healthcare cost inflation trends.
- Indicative premiums are within the target monthly range of RM60 to RM550 for individuals within the entry age of up to 70 years.
- Final product features and pricing will be published during its nationwide launch in January 2027.
About the Pilot Programme
- The pilot programme will test the end-to-end system and consumer journey in a controlled environment (staff of selected statutory bodies, GLCs and SMEs), ITOs and hospitals in Klang Valley to assess implementation readiness ahead of the January 2027 launch.
- This will involve participation of 6 insurers and takaful operators and 10 hospitals in the Klang Valley from end July to October 2026.
- The pilot should not be viewed as the final version of MediAsas as the findings from the Pilot will help identify areas for improvement and support operational readiness ahead of the planned January 2027 national rollout.
What does it mean for the public
- Most Malaysians will not be affected during this phase as the current pilot involves selected participants and healthcare providers.
- Participants in the pilot will gain early access to MediAsas to facilitate feedback collection for improvements before its national launch. They will benefit from earlier access to coverage without being disadvantaged compared to those who join in the wider rollout.
- Once MediAsas is launched in 2027, the public can contact their respective insurer, takaful operater or healthcare providers for further information.
For more information about the Pilot Programe and MediAsas, please refer to the Frequently Asked Questions (FAQs)
Interim Measures to Promote Continued Access to MHIT Products
In December 2024, BNM announced interim measures to assist policyholders who are experiencing premium revisions for their MHIT products. The interim measures were introduced to help alleviate the immediate financial impact to policyholders and preserve MHIT coverage.
This includes any changes in premiums arising from medical claims inflation effected in 2024 until 2026, that will be spread out over a minimum of three years. The vast majority of policyholders experience yearly premium adjustments due to medical claims inflation of less than 10%.
Read the announcement for the full list of measures.For further information and to avail yourselves to the interim measures, contact your insurer or takaful operator.
MHIT Made Simple
Need guidance through the journey of purchasing MHIT product and making a claim?
Promoting fair, transparent and prompt MHIT claims management
Consumers are expected to be fairly treated throughout all stages of the claim processes. As part of claims management, insurance and takaful operators (ITO) or their appointed TPAs, will assess submitted claims to confirm that the treatments fall within the policy’s coverage. This is based on accepted treatment protocols and clinical practice guidelines.
Consumers who are dissatisfied with the resolution may escalate their complaint to the Financial Markets Ombudsman Service (FMOS). For matters outside FMOS’s scope, consumers may seek assistance from BNMLINK.
Healthcare Partners Protocol and Solutions Committee (HPPSC)
(previously known as Grievance Mechanism Committee)
Together with the Malaysian Medical Association (MMA), the Association of Private Hospitals of Malaysia (APHM), the Life Insurance Association of Malaysia (LIAM), Persatuan Insurans Am Malaysia (PIAM), and the Malaysian Takaful Association (MTA), as well as the Ministry of Health and Bank Negara Malaysia as observers, the HPPSC has been established to strengthen collaboration, transparency and fairness in medical claims management.
The HPPSC reviews cases related to claims procedures, such as guarantee letter issuance, disputes over hospital charges, and matters involving claims management. It also serves as an avenue for providers and medical practitioners to resolve issues that they may encounter in obtaining approval or payment for legitimate claims from ITOs.
