KUALA LUMPUR, August 7 — While the government continues to tinker with MediAsas, new health insurance products that offer much better value at competitive prices have emerged in the market.
An example is AIA’s new A-Plus Health360 medical plan that was launched last June, a comprehensive medical insurance rider, attached to a regular premium investment-linked insurance plan (ILP), that is designed not only to cover hospitalisation and medical expenses, but also reward a policyholder for staying healthy, according to its website.
AIA’s new medical plan has an annual limit of a whopping RM3 million (no lifetime limit), 30 times higher than MediAsas’ RM100,000 annual coverage. For those aged 60 years and older, MediAsas’ annual limit automatically increases to RM150,000. MediAsas’ Standard Plus option has an annual limit of RM300,000.
Despite its much higher annual limit, A-Plus Health360 isn’t significantly more expensive, but is actually comparably priced with the so-called “affordable” MediAsas that’s touted as a “base” MHIT product.
Malaysiakini reported last Monday that indicative monthly premiums for MediAsas would start from RM60 to RM550, depending on age and plan type, with eligibility enrolment up to age 70, and coverage continuing until age 85. It’s not known which age bracket the cheapest RM60 monthly premium applies to.
AIA’s A-Plus Health360 plan is cheapest for 15-year-old females, with RM821 annual cost of insurance (COI) if an RM500 deductible is chosen (RM68.42 a month). If an RM1,000 deductible is chosen, the annual COI drops to RM785 (RM65.42 a month). With an RM3,000 deductible, annual COI further decrease to RM661 (RM55.08 a month), cheaper than MediAsas.
As A-Plus Health360 is a rider attached to an ILP with death and total and permanent disability (TPD) cover, the total amount payable by a customer will depend on the full policy structure and selected benefits. MediAsas is a standalone medical plan.
Health Minister Dzulkefly Ahmad said last August that the National Heart Institute (IJN) received the country’s youngest heart attack case at age 19.
A-Plus Health360 deductibles of RM500, RM1,000, or RM3,000 are per rider year and do not discriminate based on age (a policyholder of any age can choose whichever deductible), better than MediAsas’ deductibles per disability that aren’t up for choice and twice as high for senior citizens (RM500 for those aged 60 years and below, and RM1,000 from age 61).
Deductibles are the amount that a policyholder must pay upfront before their plan takes care of the balance of eligible expenses.
For 30-year-old men, A-Plus Health360 annual COI ranges from RM1,264 to RM1,017 (RM105.58 to RM84.75 a month), depending on the deductible chosen. If MediAsas is priced at RM60 a month for 30-year-old men, this is only RM45.58 to RM24.75 cheaper than AIA.
For 70-year-old women, A-Plus Health360 annual COI range from either RM7,607, RM7,176, or RM6,028 (RM633.92/ RM598/ RM502.33 a month) for RM500, RM1,000, or RM3,000 deductible respectively. Hence, A-Plus Health360 is just RM48 more expensive than MediAsas’ RM550 monthly premium if an RM1,000 deductible is chosen, or even cheaper than the government-designed product if an RM3,000 deductible is chosen.
Eligibility enrolment for both A-Plus Health360 and MediAsas is up to 70 years old, but AIA coverage extends up to age 100 or 25 years, unlike MediAsas that only covers one until age 85.
The government hasn’t announced the age when MediAsas can be enrolled. AIA’s A-Plus Health360 offers coverage for eligible newborns and even pre-born children.
AIA’s cost-sharing features are also better for consumers than MediAsas. A-Plus Health360 only charges deductibles for inpatient care. A 5 per cent copayment capped at RM500 per rider year is only applicable to outpatient illness treatment and outpatient physiotherapy treatment benefits (which offsets the deductible amount in a rider year and vice versa).
MediAsas, on the other hand, charges a 20 per cent copayment, capped at RM3,000 per disability, for treatment in non-panel hospitals, on top of deductibles.
Besides comparable prices with MediAsas for the elderly, A-Plus Health360 provides what it touts as a “first in market” Healthy Retirement Bonus that allows policyholders to transfer their Health Wallet amount into their policy from age 60 or rider year 10.
A Health Wallet is a special savings pocket, automatically filled by the plan when one meets certain criteria, that can be used for a prevention benefit like health screening and vaccination, among other benefits (special care, recovery and support, and mental health [psychiatrist consultation fees]).
A No-Claim Bonus of RM2,500 every rider year is credited to one’s Health Wallet that also grows over time as a reward for staying healthy.
Although Bank Negara Malaysia’s (BNM) White Paper states that the average cost of individual medical claims paid in 2024 was RM5,695 – as justification for MediAsas’ RM100,000/RM150,000 annual limits – Great Eastern Life Malaysia CEO Koh Yaw Hui told the Public Accounts Committee (PAC) last year that he has seen many cancer claims of more than RM1 million per admission.
“In order for them to get good treatment, if you have only RM300,000, RM200,000, it is insufficient, YB.”
GP Visits Covered, RM1,000 Reward For Hospital Admission, No Gatekeeping Of Care
A-Plus Health360 claims to be the first in the market to cover preventive and primary care, at up to RM50 per visit for consultation and medication, available up to three visits per rider year to AIA panel clinics, including for flu or cough.
AIA’s limit of RM50 per general practitioner (GP) visit is probably insufficient for full coverage, since the ceiling for GP consultation fees is RM80 (with a floor of RM10). However, no such benefit has been announced for MediAsas, despite the Madani government repeatedly touting the importance of primary care to reduce health care costs.
A-Plus Health360’s prevention benefit (health screening and vaccination) and primary care benefit (visits to AIA panel clinics or telemedicine access via the AIA+ app with 24/7 online doctor consultations) are subject to a combined limit of RM1,000 every two rider years, subject to the total amount in one’s Health Wallet.
Malay Mail reported last Wednesday that MediAsas policyholders will get discounts for health screenings and vaccinations, but they have to pay out of pocket for these preventive services, unlike AIA’s plan that allows policyholders to utilise their Health Wallet for this benefit (albeit capped at a low RM1,000 every two years, a fraction of one’s annual RM2,500 No-Claim Bonus).
A-Plus Health360’s unique hospitalisation care benefit pays a policyholder up to RM1,000 once per rider year upon admission to AIA’s SMART panel hospitals, or up to RM500 at other hospitals, depending on one’s healthy lifestyle. This cash payment deposited into a policyholder’s bank account is described as a “recovery bonus”.
“Masuk hospital? AIA bagi duit!” says an insurance agent’s poster promoting the product on social media [Translation: “Admitted to the hospital? AIA gives you money!”]. AIA Malaysia’s Facebook page also highlights the RM1,000 benefit when admitted to a SMART panel hospital, besides the plan’s RM3 million annual limit.
AIA literally paying policyholders to get admitted to the hospital goes against the insurance industry’s carping to a PAC inquiry last year about “overtreatment” and people supposedly seeking hospitalisation simply to claim from insurance.
A-Plus Health360 also credits an RM1,000 Preferred Panel Bonus per rider year into a policyholder’s Health Wallet when they receive treatment or are admitted to a SMART panel provider.
These features show that AIA seeks to incentivise treatment at its panel hospitals or providers, as opposed to MediAsas that punishes policyholders with copayments for going to non-panel hospitals.
Crucially, AIA’s A-Plus Health360 doesn’t gatekeep care, allowing self-referrals to panel specialists or hospitals, unlike products by other insurance companies that charge 20 per cent copayments if policyholders do not follow their GP referral pathway for non-emergency treatment.
Both MediAsas and A-Plus Health360 cover outpatient treatment for dengue, bronchitis, influenza, and pneumonia. Under the AIA plan, this outpatient illness treatment benefit for the four conditions applies to both clinics and the outpatient department of a hospital.
Other outpatient illness treatment benefits in hospitals under A-Plus Health360 include gastrointestinal conditions, spine-related back pain, closed fractures, and ligamental and meniscal injury like sprains and strains.
Maternity Complication Benefit, Outpatient Kidney Dialysis And Cancer Treatment Benefits, Pre- And Post-Hospitalisation Benefits
MediAsas covers “selected high-cost” outpatient medications for serious illnesses like cancer. A-Plus Health360 covers outpatient kidney dialysis treatment and outpatient cancer treatment as charged, subject to annual limit.
Other benefits related to serious conditions that are covered by the AIA plan – as charged, subject to the total amount in one’s Health Wallet – include a special care benefit for congenital conditions and elective/ plastic/ cosmetic surgery due to accident or cancer. A-Plus Health360 also offers a recovery and support benefit: mobility and hearing support (artificial limb and hearing aid) and recovery care for cancer, stroke, and heart attack.
Besides conventional hospitalisation benefits (room and board, intensive care, in-hospital related fees) that are also covered by MediAsas, insurance agents have highlighted A-Plus Health360’s specified maternity complication benefit (up to RM10,000 per lifetime).
Room and board with A-Plus Health360 is RM300, with possible upgrades to RM450 or RM600.
A-Plus Health360 offers a pre-hospitalisation outpatient benefit within 90 days before hospitalisation, covering diagnostic tests, consultation, and medication and treatment. The plan also has a post-hospitalisation outpatient benefit (up to 180 days or 365 days after discharge from hospitalisation for non-serious and serious conditions respectively), comprising diagnostic tests, consultation, and medication and treatment (inclusive of physiotherapy, chiropractic, and acupuncture treatment).
These pre- and post-hospitalisation benefits are as charged. Day care procedures and surgery are also covered as charged, subject to annual limit.
Other outpatient benefits include home nursing care (up to RM6,000 per confinement and up to 180 days per lifetime), outpatient physiotherapy treatment (maximum eight sessions), emergency accidental outpatient treatment (inclusive of dental), optical support (intraocular lenses), and emergency medical evacuation and repatriation (up to US$1 million per event).
The new medical product provides customers other value-added services in the AIA Healthcare Ecosystem of 150 AIA panel providers, including over 70 SMART panel hospitals nationwide, such as priority lane, waiver of admission deposit and administrative fees, complimentary admission kits or fruit basket, exclusive discount on health screening packages, and complimentary or flat-rate car park fee.
Like conventional medical plans, A-Plus Health360 doesn’t cover pre-existing illnesses. Malay Mail reported that MediAsas will have a “no-look back” clause that prohibits claims denials based on historical medical records, but did not say how many years of continuous coverage is required before that clause kicks in to protect policyholders, such as 10 years.
There’s also a takaful version of AIA’s new medical plan: A-Plus Health360-i.
Malaysiakini claimed that MediAsas was “designed differently” but didn’t explain how the product would provide “affordable and sustainable protection over time”. The central bank hasn’t publicly committed to instituting legally binding premium rates for MediAsas across one’s lifespan in a policy contract, for example, to protect consumers from regular repricing exercises.
MediAsas – which is voluntary and will be offered by six private insurance and takaful operators (ITOs), including AIA – was “piloted” last week for internal operational work before a planned launch for the public in January 2027.
In conclusion, unless MediAsas covers pre-existing illnesses or congenital conditions, or allows claims to be submitted on Day One of coverage (insurers usually deny claims submitted within two years of a policy), MediAsas is inferior to new medical insurance products designed by the private sector.
MediAsas isn’t dirt cheap for a “base” product with basic benefits, compared to AIA’s similarly priced A-Plus Health360 with bells and whistles.
To put it in ringgit and sen by simply comparing annual limits (excluding other benefits) and based on RM500 deductible, if AIA’s new medical plan with an RM3 million limit is cheapest at around RM68 monthly COI, then MediAsas with an RM100,000 limit should cost as low as RM2 a month, not RM60. Likewise, for 70-year-olds, MediAsas with an RM150,000 annual limit should only charge RM30 monthly premiums with RM1,000 deductible, not RM550.
Correction note: Certain paragraphs in this article were amended for attribution to Malaysiakini, instead of Bank Negara as erroneously reported earlier, after Malaysiakini said the disclaimer, “provided by Bank Negara Malaysia”, for its article titled “Making private healthcare protection more accessible and sustainable for Malaysians“ was an error.
Editor’s note: This article was amended to specify the “cost of insurance” for A-Plus Health360, a medical insurance rider, which doesn’t represent the total premium payable for the overall insurance solution to which the rider is attached. The headline and stand-first were also amended.
