PETALING JAYA: The Health Ministry’s assurance that Malaysians with pre-existing medical conditions will not be left out under the base medical and health insurance/takaful (MHIT) plan sparked cautious optimism among insurance professionals who raised concerns over its sustainability.
Veteran insurance agents who spoke to StarBiz yesterday said the devil will be in the details of the final and formal policy.
Senior insurance consultant Leonard Tan said insurers typically scrutinise major pre-existing conditions such as diabetes, high blood pressure and cardiovascular-related illnesses when assessing medical insurance applications.
“The list of pre-existing conditions is long but diabetes is especially of great concern because it often leads to a string of secondary health issues,” he said.
Tan noted that without precise details on how the base MHIT will be structured, it would be a guessing game to determine how insurers would accept applicants with such conditions.
“They may impose exclusions or loading resulting in higher premiums or lower coverage. It is a good move as it is essential for Malaysians to have medical insurance as public healthcare facilities are congested to the brim.
“However, sustainability is essential for insurance companies to stay in business. We hope this does not fizzle out after a few years like the Sihat Malaysia scheme in the past,” he said.
Tan also urged the government to regulate private hospital charges, warning that extreme charges would burden insurers with high claim payouts.
Senior insurance district director L.P. Chong welcomed the inclusion of those with pre-existing conditions but echoed concerns over insurers’ strict underwriting practices.
He said conditions such as diabetes, high blood pressure and high cholesterol levels often determine whether a policy is approved.
“Those with pre-diabetes or a blood glucose reading of 6.8mmol/L and above are usually refused coverage and such conditions are increasingly common even among young adults.
“Until the government releases the final structure of the base medical scheme, we really would not know how this will pan out,” said Chong who also urged the government to regulate private hospital charges.
Health Minister Datuk Seri Dr Dzulkefly Ahmad said yesterday that individuals with pre-existing conditions would be included under the scheme in a move to widen access to medical coverage to all Malaysians.
