Here’s why Malaysians will have the option to pay partially for hospital bills in exchange for cheaper insurance

KUALA LUMPUR, July 8 — Malaysians will soon have the chance to choose between two types of medical insurance: new cheaper insurance products where you still have to co-pay or pay part of the hospital bills, or existing insurance products where you don’t have to share medical costs but may have to pay higher insurance premiums.

Here’s a quick summary of how you will be impacted and what we know so far, based on insurance industry regulator Bank Negara Malaysia’s (BNM) documents including its February 29, 2024 “Policy Document on Medical and Health Insurance/Takaful Business” and press statements this month:



1. What is happening?

From September 1, 2024, when you buy a medical insurance policy, the insurance company or takaful company must offer you the choice of an insurance policy with a “co-payment” feature. That means it must show you at least one insurance product where both you and the insurance company will share the cost of medical bills in the future.

Also from September 1, 2024, the insurance company must offer a range of other co-payment amounts as options when selling insurance policies, and the range offered should match the different financial needs of customers.

What if insurance companies don’t already have an insurance product with a co-payment feature? They must design one that matches the minimum co-payment amount set by BNM.

What is co-payment? It can either look like a co-insurance (percentage) or deductible (amount) that you have to pay for the medical bill, before the insurance company pays the balance.

2. How much is the minimum you have to co-pay or share for costs?

BNM says the minimum co-payment amount (or the minimum you will have to pay) shall be at least:

i. Five per cent of the total hospital bills you can claim for (after deductibles, if there are any) but subject to a maximum co-payment limit to be set by the insurance company; and/or

ii. RM500 deductible

How did BNM decide on 5 per cent or RM500 as the minimum cost-sharing amount?

BNM’s decision is based on existing co-payment products in Malaysia and Malaysians’ income levels; balanced against current economic conditions and the objective for the co-payment requirement. Another factor is the experiences of other countries which have implemented the co-payment requirement.

4. Who decides the maximum co-payment limit?

It will be up to the insurance company to decide the maximum limit that customers must pay, and what the maximum limit is based on.

Screenshot from BNM’s 2023 annual report

5. Do you have to co-pay for everything? What if you can’t afford the co-payment amount?

The co-payment feature will not apply for the following situations:

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