PETALING JAYA: Rising premiums and new insurance upgrades have caused policyholders to question their value, with some of them opting to maintain their existing coverage rather than switch to costlier plans.
Their concerns came as Malaysia moves towards implementing the Medical and Health Insurance/Takaful (MHIT) framework to address rising medical inflation and improve long-term healthcare affordability.
A 58-year-old policyholder from Subang, who only wanted to be identified as Jo, said she recently declined an insurance upgrade that would extend her medical coverage up to age 100 with RM1mil coverage, subject to the sum insured limit.
She said the new plan would double her monthly premium from about RM300 to more than RM600.
She is also required to pay the first RM20,000 of medical claims annually before insurance coverage kicks in.
“What is the point of paying extra when I still have to pay the first RM20,000 every year?” she said, adding that the amount was not claimable.
Jo, who has held her policy for 25 years and has never made a claim, said she had previously asked to extend her coverage beyond age 70 to 85, but was told she would need to surrender her existing policy and reapply under fresh underwriting.
“I instead opted to retain my current plan after rejecting the latest offer. But I am still unsure about whether the government plans for a new insurance scheme will provide a clearer or more affordable alternative.”
Jo said as Malaysia is becoming an ageing nation, the government and Bank Negara must instruct all insurance companies to automatically increase the existing policyholders’ policies to 80 years of age, without new underwriting.
The MHIT framework is being developed as part of efforts to address rising medical inflation and improve the long-term affordability of healthcare financing in Malaysia.
The government said the initiative aims to create a more sustainable healthcare and insurance system, although details on its rollout and structure have yet to be finalised.
Another policyholder, Nizah, is concerned whether she can maintain coverage after retirement following rising premiums and new add-on plans.
The 50-year-old said most working adults may still manage higher monthly payments now, but the real burden comes later when income drops and that insurance costs also tend to rise significantly with age.
“At this age I can still pay, but what happens when I retire? Medical coverage is something we need to keep for life, but the cost is becoming unpredictable.”
While she acknowledged that medical costs are rising, she said there should be clearer long-term pricing stability so policyholders can plan for retirement without fear of sudden premium jumps or restrictive new terms.
She also said that relying on government healthcare is not always practical due to long waiting times and overcrowding, especially for elderly patients who may need repeated visits or ongoing treatment.
Federation of Malaysian Consumers Associations (Fomca) deputy president Datuk Paul Selvaraj said co-payments in upgraded medical plans should be kept to the “absolute minimum”, especially for low-income households, warning that poorly designed safeguards could leave policyholders with unexpected out-of-pocket bills.
He also called for clearer, more standardised explanations from insurers and agents.
“Agents may prefer to market normal policies as their commissions would likely be higher.”
He said the aim should be to keep private healthcare accessible through affordable premiums, while regulators strengthen oversight and rein in rising private healthcare costs.
