KUALA LUMPUR, Jan 29 — Finance Minister II Amir Hamzah Azizan defended today the copayments and deductibles in the government’s Base Medical and Health Insurance/Takaful (MHIT) product.
During Question Time in Parliament, Khoo Poay Tiong (PH-Kota Melaka) raised concerns by analysts about the deductibles and copayments in the Base MHIT Plan designed by the government.
“In our product, we put in the concept of copayments as a way to control costs. For these copayments, we aren’t asking for high payments,” Amir Hamzah told the Dewan Rakyat.
“We want transparency in terms of prices; whoever buys insurance is responsible to control the cost of health care services provided. Things will be better when there are controls from the side of the giver and the recipient.”
Galen Centre for Health and Social Policy chief executive Azrul Mohd Khalib previously said the government’s Base MHIT Plan shifted costs back to patients without addressing the root causes of medical inflation.
Under the Base MHIT, the Standard Plan has an annual policy limit of RM100,000 (RM150,000 for those above the age of 60) and comes with a deductible of RM500 per disability (RM1,000 at age 61 onwards).
If treatment is sought at out-of-network hospitals, an additional 20 per cent copayment, capped at RM3,000 per disability, is imposed.
The Standard-Plus Plan has an annual policy limit of RM300,000 and comes with a hefty deductible of RM10,000 to RM15,000, albeit with lower premiums than the Standard Plan.
Azrul warned that repeated health episodes could be financially catastrophic with no yearly cap to deductibles and copayments. Deductibles are the initial amount a policyholder must pay upfront before coverage begins, whereas copayments are a percentage of the bill paid by the policyholder when health care services are used.
Insurance analyst Dr Mohamed Rafick Khan similarly wrote in an op-ed for CodeBlue that patients may delay treatment as a result of copayments and deductibles, while insurers still face large payouts. Large copayments, he said, would make insurance coverage resemble self-funding.
Amir Hamzah also told parliamentarians today that the government was in discussions with the Employees’ Provident Fund (EPF) to allow contributors to use their retirement savings in Account 2 Sejahtera to pay for the Base MHIT.
He noted that Account 2 already permits use of i-Lindung, a critical illness product that was launched by EPF in 2022.
“We’re still discussing with EPF on whether our concept of the base product can be accepted as part of products that can be allowed for EPF withdrawals.”
The second finance minister claimed that the government received a positive response from focus groups, without specifying who its target group is for the Base MHIT Plan, ahead of a planned trial in June.
“In our efforts to introduce the MHIT, we worked together with the industry to create a system for which we expect good support from people and insurance providers and ITOs (insurance and takaful operators),” he said.
He explained that all ITOs are welcomed to participate in selling the Base MHIT Plan, but only companies that fulfil certain conditions will be allowed to underwrite the product. The product price will be the same across participating ITOs.
“We want the premium process to be clear to everyone and for the risk to be shared among all existing ITOs.”
In response to Roslan Hashim (PN-Kulim Bandar Baharu), who asked whether pre-existing conditions would be covered under the Base MHIT Plan, Amir Hamzah said a currently insured person can switch from their own health insurance to the portable government-designed product without a requirement for new underwriting.
“So there’s no issue for pre-existing conditions,” he said.
“New policyholders will be subject to assessments, but with looser requirements, so that we can cover more people.”
According to Bank Negara Malaysia’s (BNM) White Paper, the Base MHIT Plan will be risk-rated based on an individual’s age, gender, and health status, not community rated, but “limits” will be applied to premium loading based on health status.
