SHAH ALAM, Oct 19 — The introduction of the MediAsas Plan in January next year could ease treatment costs and shorten patients’ waiting times, but four key challenges must be addressed to ensure its effectiveness.
Universiti Putra Malaysia (UPM) public health medicine specialist Assoc Prof Dr Aidalina Mahmud said the plan could help participants cover eligible medical bills as medical insurance costs continue to rise.
“However, being able to afford insurance premiums does not necessarily mean someone can afford to receive treatment. Nevertheless, this plan could help reduce treatment delays and ease patients’ financial burdens,” she told Media Selangor.
Patients undergoing surgery at private hospitals will also free up operating theatre slots, beds, and staff time at government hospitals for other patients, thereby speeding up access to treatment for lower-income groups.
However, the Faculty of Medicine and Health Sciences' Community Health Department senior lecturer emphasised four challenges that require attention: affordability, access to services, consumer understanding, and governance and coordination.
“First, people must be able to maintain their policies and pay for treatment, as premiums may change with age. Second, access to services is important because insurance coverage is only useful if patients can reach a suitable hospital, with travel distances and incidental costs varying.
“Third, consumers need to understand what is covered, what is excluded, and how much they must pay out of pocket. Finally, hospitals and insurance companies must establish clear and timely processes for approvals, payments, and appeals,” Dr Aidalina said.
MediAsas will also use a digital system in which codes will be assigned to the conditions treated before insurers determine the charges payable.
She added that coding and claims audits will be necessary to ensure payments correspond to the cases treated. Patients’ conditions after discharge should also be monitored, including complication rates, recovery outcomes, and patient experiences.
This approach is important to ensure the plan not only helps participants maintain coverage during temporary financial difficulties, but also provides access to quality treatment over the long term.
Prime Minister Datuk Seri Anwar Ibrahim announced during the tabling of Budget 2027 on October 9 that MediAsas would be introduced from January 2027 at affordable rates, with hospital charges based on diagnoses and treatments to help control medical costs.
Employees Provident Fund (EPF) members under 55 may use their Account Sejahtera savings to pay the plan’s premiums. Meanwhile, the government will provide a RM200 subsidy for the first year for 50 employees at each small and medium-sized enterprise with fewer than 75 employees, benefiting up to 200,000 workers.
