The base MHIT plan is designed as a hospitalisation policy that covers large hospital bills based on shared-room costs, with expanded options for pre and post-hospitalisation care. These include consultations and follow-ups at GP clinics, physiotherapy, and home nursing care.
There will be no lifetime limit under the plan, while the annual limit is set at a level sufficient to cover treatment costs for most common conditions, representing 99% of hospitalisation bills. Coverage will be guaranteed for renewal up to the age of 85.
The scheme was announced by health minister Dzulkefly Ahmad during a joint press conference with finance minister II Amir Hamzah Azizan and Bank Negara Malaysia (BNM) governor Abdul Rasheed Ghaffour.
The plan provides an annual coverage limit of RM100,000. Indicative monthly premiums range from RM80 to RM120 for those aged 31–35, RM280 to RM350 for ages 61–65, and RM500 to RM780 for those above 75.
Premiums for the standard-plus plan, which has a higher coverage limit (RM300,000) but also higher deductibles, are an estimated RM50 to RM70, RM220 to RM280 and RM400 to RM660 respectively.
Final premium rates will be announced closer to the plan’s early 2027 launch following a pilot implementation in the second half of 2026.
The 2027 launch coincides with the expiry of BNM’s interim measures on medical insurance repricing, under which the central bank imposed a 10% cap on premium increases for most policyholders over a three-year period.
“High-cost treatments, including both inpatient and outpatient cancer treatments and drugs, will be covered based on cost-effectiveness assessment,” said Dzulkefly.
“Benefits and premiums under the base MHIT plan will be standardised, supporting broader risk pooling and portability across insurers and takaful operators (ITOs), as well as a consistent approach to underwriting and claims assessments.”
Dzulkefly said the plan is also intended to serve as a benchmark for the market, establishing a baseline for ITOs to improve their MHIT offerings and ensuring alignment with the principles of the base plan.
Under the base MHIT plan, policyholders will have access to optional, self-funded preventive care and wellness packages offered at discounted rates negotiated by the health ministry.
To contain costs and support value-based care, the plan will feature tiered co-payment structures aligned with hospital coverage, with co-payments applied based on treatment type and cost levels.
In addition, the phased introduction of diagnosis-related group (DRG) payments is aimed at helping manage costs while improving transparency, predictability, and efficiency in the healthcare system.
The base MHIT plan aims to enable more Malaysians to obtain a basic level of financial protection against essential healthcare expenditures through an affordable and sustainable product.
It is also expected to help ease congestion in public hospitals by encouraging those who can afford insurance to seek care in the private sector.