KUALA LUMPUR, Jan 29 — The government’s Base Medical and Health Insurance/Takaful (MHIT) Plan aims to serve as a “baseline” to existing market offerings, says Bank Negara Malaysia’s (BNM) White Paper.
However, a CodeBlue search found at least five comparably priced or even cheaper health insurance products that simultaneously provide 10 to 50 times more coverage than the so-called “base” MHIT product designed by Putrajaya.
Five and three existing medical plans in the market for the 31-35 and 61-65 age groups respectively offer better value and protection than the Base MHIT Plan.
Three (Great Eastern Life, Prudential, and AIA) are medical riders to investment-linked products, while two (Kaotim and RHB Insurance) are standalone plans. The government’s Base MHIT is a standalone medical plan. Riders are typically attached to life insurance; hence if one likes a particular medical rider, they can purchase a small life policy to attach the rider to.
In its White Paper, BNM asserted that the Base MHIT Plan’s annual limits of RM100,000 (for those aged 60 and under) and RM150,000 (for older adults) were adequate to cover 99 per cent of treatment episodes across a range of common medical conditions.
Yet, many commercial medical plans offer annual limits of RM1 million or more — at similar or lower cost than the government-designed product.
For Early 30s: RM62-RM116 Monthly Premiums, RM5m-RM1m Annual Limits
For the 31-35 age group, monthly premiums or takaful contributions for medical plans by Great Eastern Life (GREAT MediValue: Plan 200), Prudential (PRUMillion Med 2.0: Plan 200), AIA (A-Plus Health 2: Plan 200), Takaful Malaysia (Kaotim Medikad: Max with MediBooster), and RHB Insurance (MediSure Supreme Insurance: Plan 7) range from about RM62 to RM116, compared to the government’s Base MHIT: Standard Plan’s proposed RM80 to RM120.
For Great Eastern, Prudential, and AIA, these premiums are based on RM500 deductibles, similar to the government’s Base MHIT Plan, whereas deductibles are optional for RHB and Kaotim. Deductibles are the initial amount a policyholder must pay upfront before coverage begins.
Great Eastern, Prudential, AIA, Kaotim, and RHB offer substantially higher coverage with annual limits ranging from RM5 million to RM1 million, compared to the government’s RM100,000 annual limit under the Standard Plan of its base MHIT product.
The Base MHIT’s Standard-Plus Plan with RM300,000 annual cover proposes lower monthly premiums of RM50 to RM70, but with large deductibles of RM10,000 to RM15,000. These deductibles exceed the upper limit of deductibles of other plans in the market, like Prudential (RM10,000) or Kaotim (RM3,000).
In contrast, Great Eastern’s GREAT MediValue plan has a whopping RM5 million annual cover, with just an RM500 deductible and RM62 or RM63 monthly premiums that are still lower than the maximum RM70 in the government’s Standard-Plus Plan.
If policyholders opt for an RM5,000 deductible (twice or three times cheaper than the RM10,000-RM15,000 deductible under the government’s Standard-Plus Plan), monthly premiums for Great Eastern’s plan drop to RM45 or RM46.
Great Eastern and AIA charge 20 per cent copayments only if policyholders seek treatment outside designated medical pathways that require referrals from general practitioner (GP) clinics for hospital admission. Copayments are a percentage of the bill paid by the policyholder when health care services are used.
The government’s Base MHIT plan charges 20 per cent copayment for seeking treatment at out-of-network hospitals, but without making GPs the gatekeepers of care.
The five alternative medical plans identified by CodeBlue provide additional benefits beyond standard hospital and surgical – especially Great Eastern, Prudential, and AIA – that aren’t available in the government’s Base MHIT plan.
Kidney dialysis and cancer treatment as charged are common outpatient benefits offered by health insurance/takaful products in the market. Yet the government’s Base MHIT doesn’t provide outpatient kidney dialysis benefit; its outpatient cancer treatment benefit is restricted to select high-cost medications listed by the Ministry of Health.
Comprehensive benefits, which aren’t available in the government’s Base MHIT Plan, include AIA’s specified maternity complication and emergency medical evacuation and repatriation; Great Eastern’s outpatient imaging (MRI/PET) and genomic testing for cancer; or Prudential’s emergency treatment for accidental injury and expert medical opinion.
Both Kaotim and RHB provide RM100 and RM150 daily cash allowance at government hospitals respectively.
For Early 60s: RM190-RM642 Monthly Premiums, RM5m-RM1.1m Annual Limits
For adults aged 61 to 65, the range of available options in the private market narrows considerably. While several plans offer substantially higher annual limits than the Base MHIT Plan, most come with noticeably higher premiums, particularly for those at the upper end of the age band.
Among the plans examined by CodeBlue, Great Eastern’s GREAT MediValue stands out as the only product that is both cheaper than the government’s Base MHIT Plan and provides multi-million ringgit annual coverage for seniors in this age group.
Other medical plans for seniors, such as AIA’s A-Plus Health 2, also offer significantly higher annual limits than the Base MHIT Plan, but at monthly premiums that either fall within or slightly exceed the range in the government-designed product.
These products may appeal to individuals who are willing and able to pay more in exchange for broader coverage and additional benefits, but they are not cheaper alternatives to the Base MHIT Plan.
Takaful Malaysia’s Kaotim Medikad Max, a standalone takaful plan, similarly provides annual coverage exceeding RM1 million, but monthly contributions increase substantially for those in the 65-69 age band. While contribution discounts are available for policyholders who opt for higher deductibles, premiums for many seniors remain well above the Base MHIT’s flat rate.
In terms of pricing and coverage, Great Eastern Life’s GREAT MediValue: Plan 200 offers RM5 million annual limit with an RM500 deductible, with monthly premiums of about RM190 for women and RM229 for men aged 61 to 65. Premiums are uniform across this age band.
By comparison, the government’s Base MHIT Plan: Standard Plan provides an annual limit of RM150,000 for seniors and an RM1,000 deductible, with monthly premiums proposed at RM280 to RM350.
AIA’s A-Plus Health 2: Plan 200 provides RM1.5 million in annual coverage, with monthly premiums ranging from about RM332 to RM345 for women and RM367 to RM377 for men in this age group, depending on age. Like Great Eastern, AIA applies a 20 per cent copayment only if policyholders seek treatment outside its designated medical pathway.
Kaotim Medikad: Max (with MediBooster) offers annual limits of up to RM1.1 million, with monthly takaful contributions ranging from about RM361 to RM642 for adults aged 60 to 69, depending on age and gender. Lower contributions are available if policyholders choose RM2,000 or RM3,000 deductible.
As with plans targeted at younger adults, the market alternatives for seniors generally include benefits beyond standard hospital and surgical coverage that are not available under the Base MHIT Plan.
These include outpatient kidney dialysis and cancer treatment as charged, home nursing care, intraocular lens benefits, and, in some cases, mobility and hearing support.
Bank Negara’s Advice: ABC Of Buying MHIT Products
Last January 20, the central bank posted on X its advice to the public about the ABC of buying MHIT products: Assess your needs and ask the right questions, Browse options available, and Choose wisely from options provided.
Under “Choose wisely”, BNM urged people to look at “key features such as coverage, claims process, limitations” in deciding whether a particular MHIT product was right for them.
Considering that the Base MHIT Plan will be paid solely by policyholders, including retirees who wish to use their Employees’ Provident Fund (EPF) savings – without a single sen of subsidy from the government – it’s all the more prudent for Malaysians to decide whether to purchase the product.
At least five competitively priced medical plans in the market have been found to provide vastly superior coverage and benefits compared to the government’s Base MHIT.
BNM’s White Paper explicitly states that premiums in the Base MHIT Plan will be subject to periodic review based on the claims experience, medical inflation, and any revision to the benefits covered.
However, the central bank also noted that with more than 70 per cent of MHIT plans sold as riders to investment-linked products, a policyholder’s MHIT coverage may be affected by the performance of their investment accounts.
CodeBlue’s October 2025 survey among over 850 specialists in private hospitals in Malaysia revealed “Deny, Delay, Revoke” health insurance tactics by insurance and takaful operators (ITOs) and third-party administrators (TPAs) in Malaysia.
But there is no way for anyone to know – whether from product brochures or insurance agents – what the claims process in a particular ITO is like or if claims denials are common, except via word of mouth.
Since the Base MHIT Plan isn’t underwritten by the government and is open to participation by ITOs, policyholders may still be subject to claims denials. Like other health insurance products in the market, the Base MHIT Plan is individually risk-rated based on one’s age, gender, and health status.
BNM’s White Paper said the central bank was considering a “no look-back” provision for the Base MHIT Plan that is targeted for launch next year. This means that insurers won’t investigate a policyholder’s past medical history after a certain point or “look back” to find reasons to deny claims based on pre-existing conditions.
However, this begs the question as to why the regulator can’t impose a “no look-back” policy on the entire market, rather than mandating it only for one product that the government designed but isn’t paying for, whether in premiums or claims.
Government participation doesn’t necessarily guarantee a high claims approval rate either. mySalam’s 2024 annual report showed that payouts were made for only 54 per cent of claims from 2019 to 2024 for critical illness and hospitalisation income replacement benefits. The health protection scheme is administered by Great Eastern Takaful Berhad, with premiums paid by the government.
Correction note: The tables and a paragraph in this article were amended to state that deductibles are optional for Kaotim, not that surgical expenses are subject to RM2,000 or RM3,000 deductible as reported earlier.
