The Employees Provident Fund (EPF) is supposed to be one of the world’s oldest provident funds. It was established in 1951.
Its website explains that the EPF helps the Malaysian workforce to save for their retirement in accordance with the Employees Provident Fund Act 1991.
A type of early withdrawal from the EPF is the medical withdrawal. The EPF website description on medical withdrawals states that medical advancements have extended lifespans and improved the quality of life for many.
However, health care costs remain a major financial burden. To help members facing medical challenges, the EPF allows for withdrawals, which can be used to cover the costs of approved illnesses, health care equipment, and fertility treatments.
The documents required, as mentioned on the website for individual withdrawals for medical costs which have been paid, are bills, receipts, a critical illness medical report (LPP1), and a copy of the applicant’s identity card.
A recent encounter with the Teluk Intan EPF branch for a patient who is also an EPF contributor with spinal cord stenosis and degenerative spine disease turned out to be a painful ordeal.
The patient was seen at a government hospital and required scans at another government hospital. However, the scans could only be done after six months at the earliest, or even later, according to the attending doctor.
The patient was already unwell, in poorly controlled pain, and was not able to go to work because of the condition. The patient is also the care provider for two other elderly parents who are unwell themselves.
As popularly known, public hospital doctors have no issues about patients getting scans at private centres and showing them the scan findings to expedite the treatment process at government hospitals.
So, the patient did the required scans using his own money. For those who do not know, scans at private hospitals using the government hospital scan request form does not require re-consultation at the private hospitals. Just the scan order form is enough to get the scan done, so the patient need only to pay for the scans.
The patient, having exhausted all savings for scans and supportive management, had to get reimbursement from the EPF for the scans and supportive management done at private hospitals.
The relevant documents, as mentioned on the EPF website, and after confirmation with the relevant EPF officer, were then submitted. Clarification was also given that the scans did not require any private hospital consultation, and the reimbursements were expected only for the scans and supportive treatment.
The EPF critical illness form was filled out by the public hospital doctor, which was the way it should be, as that was the primary consultation doctor for the patient.
A few days later, the EPF rejected the application. It was stated through an unofficial WhatsApp message that a medical report is required from the private hospital where the scans and supportive measures were done.
Attempts to get a letter from the EPF stating the reason for rejection was not responded to objectively. A second application was asked to be submitted after getting the non-existential documents from the private hospital.
Some of the patient’s reimbursement receipts will be reaching the deadline soon, as the duration to claim is one year from treatment. The patient could not apply earlier, as there was nobody to help him then.
I was told by the EPF officer that this is the norm. Others have also been rejected for similar scenarios.
However, I beg to differ. I am not one of the others. Something which is deemed the norm need not be necessarily right. There is no clause anywhere in any EPF document or on the website which says that reimbursement for health care management can only be done involving a single health care centre for the same condition.
As an observer, I am shocked and disappointed by the lackadaisical attitude shown by the EPF towards understanding and keeping up with current health care trends among the general public. Many have opted to get certain procedures done at a private hospital and other treatments at public hospitals.
Most people do this juggling act as private health care is too expensive and public health care is too slow when it comes to certain processes. The patients do what is best for their health, since no one else cares enough to make significant revolutionary changes. The public is slowly but surely adopting this pattern of seeking treatment.
Why is there so much apprehension to return the investments of EPF contributors, especially when it is genuinely supported by documents and receipts from the relevant health care institutions, both private and public? Whose money is it anyway? Who is dependent on whom?
Recently, the government announced a proposal to introduce EPF contributions for new civil service hires, instead of putting them on the pension scheme. However, going by this particular experience with the EPF, it may be worth considering the pension scheme for new civil servants, as the contribution amount can instead be saved and used during medical emergencies, instead of investing in the EPF, where there is a possibility of difficulty in getting reimbursements, especially for health reasons.
The EPF was also stated to be among the investors of the Rakan KKM programme that seeks to set up “premium economy” wings in public hospitals. On the same note, it would be wonderful if the EPF could reanalyse its idea of medical reimbursements and cater to current health care trends.
There is a need for EPF to redraft its forms and website to be crystal clear about the specific documents required in various medical scenarios. It is also best to inform application statuses with formal rejection reasons, instead of using informal channels like WhatsApp.
Those manning the counters can save a lot of time by being constructive bridges between contributors and reimbursement approvers.
As for this unwell contributor’s scenario, if the Teluk Intan EPF office cannot reimburse the medical expenses, would it be unlawful to ask for the return all the contributor’s money, since it has failed to be of use to the patient, when he needed it the most?
This is important, especially when the website does not spell out clearly the rigid rules which govern medical reimbursements requested by contributors. The contributor is not going to have money for even next week’ meal’s necessities, having used up all his savings paying for his health care needs.
As for the public health care sector, kindly improve your efficiency at investigation and managing patients before everyone ends up wanting to withdraw money from their second EPF accounts, with the risk of being rejected.
You can put an end to this vicious cycle and may well help the EPF reduce the number of contributors removing money from their second accounts for medical reasons.
“If you do not do what you cannot do, it is all right. But if you do not do what you can do, your life is a tragedy.” — An Extremely Wise Teacher.
CodeBlue is providing the author anonymity as civil servants are prohibited from writing to the press.
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