MediAsas Explained: What Malaysia's New Medical Insurance Plan Means for You
MediAsas could make basic private medical cover more accessible from 2027. But it is voluntary, not free, and several important details are still being tested.
3 August 2026
5 min read-- reading now
MediAsas is set to give Malaysians a new option for private medical protection at a more manageable cost. But it is not free government insurance, and it is not yet available nationwide.
The plan is being tested through a Klang Valley pilot from late July to October 2026. Nationwide rollout is targeted for January 2027.
Because the pilot is still under way, final prices, the hospital network and some coverage terms may change. Here is what matters so far.
What Is MediAsas?
MediAsas is the official name for the base medical and health insurance and takaful plan being developed under the government's RESET strategy.
It will be sold by participating insurers and takaful operators. Its basic benefits will be standardised to make comparison easier, and it will be a standalone medical plan rather than an investment-linked policy.
Most importantly, MediAsas is:
voluntary, not compulsory;
paid for by individuals, not provided free;
designed to help pay for private hospital treatment; and
a complement to, not a replacement for, public hospitals.
It is aimed mainly at people who have no individual medical cover but can sustainably afford some private protection, and existing policyholders looking for a cheaper option after premium increases.
How Much Could It Cost and Cover?
The Ministry of Finance says indicative premiums are expected to be around RM60 to RM550 per month for people entering the plan up to age 70. This is a target range, not a final quotation. Actual prices will depend on factors such as age, gender and health status.
Two options are being developed:
Plan
Annual limit
How it works
MediAsas Teras
RM100,000
Basic protection with a lower upfront payment by the patient
MediAsas Fleksi
RM300,000
Higher limit, but the patient bears a much larger initial amount
Under the current design, the Teras limit increases to RM150,000 for people above 60. Bank Negara Malaysia says RM100,000 was sufficient for 99% of treatment episodes in its 2024 claims data. This does not mean it will cover 99% of one person's total annual medical expenses. Multiple admissions or a highly complex treatment could still exceed the limit.
For Fleksi, a deductible of RM10,000 to RM15,000 is still being considered. This means the patient may have to pay that amount before the plan starts paying. Fleksi is better understood as protection against a very large bill, rather than a full replacement for an ordinary medical card.
Would You Still Pay Part of the Bill?
Yes. MediAsas uses cost-sharing to help control claims costs.
The current Teras proposal applies a RM500 deductible per medical condition at an in-network hospital, rising to RM1,000 at age 61. No additional percentage co-payment would apply in-network.
At an out-of-network hospital, the same deductible would apply, followed by a 20% co-payment capped at RM3,000 per medical condition.
For example, on an eligible RM10,000 in-network bill, the patient would generally pay the first RM500 and the plan would pay the remaining eligible amount. The actual payment would still depend on the policy terms and covered charges.
The final hospital network has not been announced. Malaysians should therefore not assume that every private hospital will offer the same out-of-pocket cost.
What About Pre-existing Conditions and Existing Policies?
MediAsas aims to improve access for people whose prior medical conditions are stable and well managed. However, the final underwriting rules, waiting periods and exclusions have not been published.
Bank Negara is considering a “no look-back” provision after a period of continuous coverage. It remains under consideration and does not mean that every pre-existing condition will automatically be covered.
Existing policyholders will be able to switch to MediAsas with the same insurer or takaful operator without fresh underwriting or a new waiting period. More details will be provided closer to launch.
Do not cancel an existing medical card simply because MediAsas has been announced. A cheaper plan may have a lower limit, higher out-of-pocket costs or a smaller hospital network.
Can EPF Savings Be Used?
The current proposal allows EPF members to pay premiums voluntarily from Account Sejahtera. It is not compulsory.
This could ease today's cash flow, but it also reduces retirement savings. Before using it, consider whether the premium can be paid from regular income and how the cost could increase as you grow older.
What Should You Do Now?
MediAsas could give more Malaysians access to basic private protection. But it does not by itself make hospital treatment cheaper, and it will not meet everyone's needs.
For now:
Keep your existing policy until the final details are published.
Compare annual limits, deductibles, co-payments and network hospitals, not just premiums.
Check carefully how prior medical conditions will be treated.
Consider the retirement impact before using EPF savings.
MediAsas' real value can only be judged when its final prices, benefits, exclusions and participating hospitals are confirmed ahead of the nationwide rollout.
Information is based on official announcements available as of 3 August 2026. MediAsas is still in pilot implementation, and some features may change before its planned launch in 2027.
MediAsas bakal menjadi pilihan baharu bagi rakyat Malaysia yang mahukan perlindungan perubatan swasta pada kos yang lebih mampu ditanggung. Namun ia bukan insurans percuma daripada kerajaan, dan belum boleh dibeli di seluruh negara.
Pelan ini sedang diuji melalui program perintis di Lembah Klang dari hujung Julai hingga Oktober 2026. Pelaksanaan di seluruh negara disasarkan pada Januari 2027.
Oleh sebab program perintis masih berjalan, harga akhir, rangkaian hospital dan sebahagian syarat perlindungan masih boleh berubah. Berikut ialah perkara utama yang diketahui setakat ini.
MediAsas Itu Apa?
MediAsas ialah nama rasmi bagi pelan asas insurans dan takaful perubatan dan kesihatan yang dibangunkan di bawah strategi RESET kerajaan.
Ia akan dijual oleh syarikat insurans dan pengendali takaful yang mengambil bahagian. Manfaat asasnya akan diseragamkan supaya lebih mudah dibandingkan, dan ia merupakan pelan perubatan kendiri, bukan polisi berkaitan pelaburan.
Yang penting, MediAsas:
bersifat sukarela, bukan wajib;
dibayar oleh individu, bukan diberikan secara percuma;
membantu membayar rawatan di hospital swasta; dan
melengkapi, bukan menggantikan, hospital kerajaan.
Ia disasarkan terutamanya kepada mereka yang belum mempunyai perlindungan perubatan individu tetapi mampu membayar sedikit untuk rawatan swasta, serta pemegang polisi yang mencari pilihan lebih murah selepas premium mereka meningkat.
Berapa Kos dan Jumlah Perlindungannya?
Kementerian Kewangan menyatakan bahawa premium indikatif dijangka sekitar RM60 hingga RM550 sebulan bagi individu yang menyertai pelan sehingga umur 70 tahun. Ini ialah julat sasaran, bukan sebut harga akhir. Harga sebenar akan bergantung pada faktor seperti umur, jantina dan keadaan kesihatan.
Dua pilihan sedang dibangunkan:
Pelan
Had tahunan
Cara ia berfungsi
MediAsas Teras
RM100,000
Perlindungan asas dengan bayaran awal pesakit yang lebih rendah
MediAsas Fleksi
RM300,000
Had lebih tinggi, tetapi pesakit menanggung jumlah awal yang jauh lebih besar
Di bawah reka bentuk semasa, had Teras meningkat kepada RM150,000 bagi individu berumur lebih 60 tahun. Bank Negara Malaysia berkata had RM100,000 memadai untuk 99% episod rawatan berdasarkan data tuntutan 2024. Namun itu tidak bermakna ia akan menampung 99% daripada semua perbelanjaan perubatan tahunan seseorang. Beberapa kemasukan atau rawatan yang sangat kompleks masih boleh melebihi had.
Bagi Fleksi, deduktibel antara RM10,000 hingga RM15,000 masih dipertimbangkan. Ini bermakna pesakit mungkin perlu membayar jumlah tersebut dahulu sebelum pelan mula membayar. Fleksi lebih sesuai dilihat sebagai perlindungan daripada bil yang sangat besar, bukannya pengganti penuh kad perubatan biasa.
Adakah Pesakit Masih Perlu Membayar Bil?
Ya. MediAsas menggunakan pembayaran bersama untuk mengawal kos.
Cadangan semasa bagi Teras mengenakan deduktibel RM500 bagi setiap keadaan perubatan di hospital dalam rangkaian, meningkat kepada RM1,000 pada umur 61 tahun. Tiada bayaran peratusan tambahan di hospital dalam rangkaian.
Di hospital luar rangkaian, deduktibel yang sama dikenakan, diikuti bayaran bersama 20% yang dihadkan pada RM3,000 bagi setiap keadaan perubatan.
Contohnya, bagi bil layak RM10,000 di hospital dalam rangkaian, pesakit lazimnya akan membayar RM500 pertama dan pelan membayar baki yang layak. Jumlah sebenar tetap bergantung pada terma polisi dan caj yang dilindungi.
Senarai akhir hospital dalam rangkaian belum diumumkan. Oleh itu, jangan anggap semua hospital swasta akan menawarkan kos yang sama.
Bagaimana dengan Penyakit Sedia Ada dan Polisi Semasa?
MediAsas bertujuan memperluas akses bagi mereka yang mempunyai keadaan perubatan terdahulu yang stabil dan terkawal. Namun peraturan pengunderaitan, tempoh menunggu dan pengecualian akhir belum diterbitkan.
Bank Negara sedang mempertimbangkan peruntukan “tiada semakan semula” selepas satu tempoh perlindungan berterusan. Ia masih dalam pertimbangan dan tidak bermakna semua penyakit sedia ada akan dilindungi secara automatik.
Pemegang polisi sedia ada pula boleh bertukar kepada MediAsas dengan syarikat insurans atau pengendali takaful yang sama tanpa pengunderaitan baharu atau tempoh menunggu baharu. Maklumat lanjut hanya akan diberikan lebih dekat dengan pelancaran.
Jangan batalkan kad perubatan semasa hanya kerana MediAsas telah diumumkan. Pelan yang lebih murah mungkin mempunyai had lebih rendah, bayaran sendiri lebih tinggi atau rangkaian hospital yang lebih kecil.
Bolehkah KWSP Digunakan?
Cadangan semasa membolehkan ahli KWSP membayar premium secara sukarela daripada Akaun Sejahtera. Ia bukan wajib.
Pilihan ini boleh meringankan aliran tunai hari ini, tetapi ia juga mengurangkan simpanan persaraan. Sebelum menggunakannya, pertimbangkan sama ada premium boleh dibayar daripada pendapatan biasa dan bagaimana kos akan meningkat apabila umur bertambah.
Apa yang Patut Dilakukan Sekarang?
MediAsas berpotensi memberi lebih ramai rakyat Malaysia akses kepada perlindungan asas swasta. Namun ia tidak dengan sendirinya mengurangkan harga rawatan hospital, dan tidak akan memenuhi keperluan semua orang.
Buat masa ini:
1. Kekalkan polisi sedia ada sehingga butiran akhir diumumkan. 2. Bandingkan had tahunan, deduktibel, bayaran bersama dan hospital dalam rangkaian, bukan premium sahaja. 3. Semak dengan teliti bagaimana keadaan perubatan terdahulu akan dilayan. 4. Fikirkan kesan persaraan sebelum menggunakan simpanan KWSP.
Nilai sebenar MediAsas hanya boleh dinilai selepas harga, manfaat, pengecualian dan hospital peserta dimuktamadkan menjelang pelaksanaan seluruh negara.
Maklumat adalah berdasarkan pengumuman rasmi yang tersedia pada 3 Ogos 2026. MediAsas masih dalam program perintis dan sebahagian cirinya boleh berubah sebelum pelancaran yang dirancang pada 2027.
