KUALA LUMPUR (Jan 27): Copayments and deductibles under the proposed base medical and health insurance and takaful plan could limit uptake among lower-income groups, an analyst flagged.
The required deductibles and copayments, particularly for out-of-network care, could deter B40 policyholders from subscribing, even though the plan is positioned as a more affordable alternative, said Kenanga Investment Bank.
“Our concern is [that] the required copayment or deductible structure may deter B40 policyholders from subscribing since the annual coverage limit could prove insufficient for complex or prolonged chronic illnesses,” the research house said.
Malaysia is set to launch a pilot programme for the base plan in the second half of 2026, with the full rollout in early 2027.
The initiative, designed to provide lower-cost coverage for essential medical care, targets middle-income households and policyholders who exited private medical plans following repricing in 2024 and 2025, with participation remaining voluntary.
While the base plan is a step towards widening healthcare access, structural features of the plan may constrain its effectiveness, Kenanga said.
Kenanga’s comment mirrors that of Galen Centre for Health and Social Policy who viewed the government’s proposed plan as worse than existing health insurance products on the market. The think tank also said that the plan may also fail to attract those who are currently uninsured.
While the annual coverage of RM100,000 or RM150,000 could cover many routine procedures and admissions, “we believe this could prove insufficient for complex or prolonged conditions” like cancer or if policyholders require multi-disciplinary rehabilitation, Kenanga said.
Hospitals, meanwhile, may also need to adjust service offerings towards more standardised and cost-efficient packages, as benefits under the base plan are benchmarked against lower- and mid-tier private hospital costs, the research house cautioned.