What Is MediAsas Fleksi?
MediAsas Fleksi is the standard-plus tier of Malaysia’s Base Medical and Health Insurance and Takaful (Base MHIT) framework, established under the national RESET healthcare strategy. Jointly introduced by Bank Negara Malaysia (BNM), the Ministry of Health (MOH), and the Ministry of Finance (MOF), Fleksi is a voluntary, non-investment-linked standalone medical scheme designed to protect individuals against devastating private medical bills. It provides an upgraded annual limit while utilising a high deductible to maintain affordable premiums over a person’s lifetime.
Key structural elements of the plan include:
- Standalone Healthcare Protection: MediAsas Fleksi removes traditional investment-linked riders, cash value components, and expensive package bundling. Every ringgit paid in premiums goes directly toward pure medical coverage.
- Dual Framework Formats: Consumers can choose between a conventional medical insurance policy and a Shariah-compliant takaful plan known as the MediAsas Takaful Fleksi plan. Both formats share identical benefit schedules and claim limits.
- Eligibility and Age Limits: The plan allows entry up to age 70 (age last birthday) and guarantees annual renewability up to age 85. This extended tenure ensures critical coverage during retirement when healthcare risks are highest.
- EPF Premium Financing: Policyholders can finance their monthly or annual premiums using funds from their EPF Account Sejahtera (Account 2), easing out-of-pocket cash requirements.
MediAsas Fleksi Core Benefits: RM300,000 Annual Limit and Catastrophic Inpatient Protection
MediAsas Fleksi delivers comprehensive inpatient and surgical protection anchored by an overall annual limit of RM300,000 with zero lifetime limit. Designed specifically for catastrophic illnesses and major operations, this annual limit replenishes fully upon each yearly policy renewal up to age 85. The coverage focuses on core hospitalisation necessities, ensuring policyholders can access private medical treatment without risking financial ruin.
The comprehensive benefit schedule encompasses:
- Substantial RM300k Annual Limit: The MediAsas Fleksi 300k limit provides triple the financial capacity of the standard tier. This expanded cushion comfortably accommodates complex coronary procedures, spinal operations, and lengthy intensive care hospital stays.
- No Lifetime Limit: Claims made during one policy year do not reduce the coverage ceiling for subsequent years. As long as the policy remains in force, the full RM300,000 limit resets every 12 months.
- Essential Inpatient & Surgical Coverage: Eligible charges cover standard shared room and board, Intensive Care Unit (ICU) admissions, operating theatre charges, surgical fees, anaesthetist expenses, and in-hospital medications prescribed during admission.
- Pre- and Post-Hospitalisation Care: Necessary specialist consultations, diagnostic imaging, and laboratory tests incurred within the specified pre-admission window and follow-up consultations post-discharge are covered.
- Critical Outpatient Provisions: Policyholders receive benefits for outpatient cancer treatments (such as radiotherapy and chemotherapy), outpatient kidney dialysis, and home nursing services following surgical discharge.
- Hospital Outpatient Medical Illness Benefit: Specific non-surgical conditions requiring urgent hospital outpatient management—including dengue fever, influenza A and B, bronchitis, and pneumonia—are covered up to set sub-limits.
How MediAsas Fleksi Cost-Sharing Works: Deductibles and Co-Insurance
MediAsas Fleksi keeps monthly premiums substantially lower than standard medical cards by adopting a high annual deductible and selective co-insurance model. Under this structure, the policyholder or an underlying payer is responsible for paying an initial deductible threshold per policy year before the plan begins covering eligible private hospital expenses. By removing minor, frequent claims from the risk pool, the policy can deliver high-limit catastrophic protection at accessible rates.
The plan incorporates specific cost-sharing tiers to balance cost control with provider flexibility:
- In-Network Annual Deductible (RM10,000): When treated at Preferred In-Network panel hospitals, the deductible is RM10,000 per policy year. Once this threshold is crossed through single or cumulative admissions in that policy year, Fleksi covers 100% of all subsequent eligible expenses up to the RM300,000 limit.
- Out-of-Network Annual Deductible (RM15,000): If an individual chooses treatment at a licensed private hospital outside the preferred network for non-emergency care, the annual deductible increases to RM15,000.
- MediAsas Fleksi Co-Insurance Cost Sharing (20% Out-of-Network): For non-emergency admissions at out-of-network private hospitals, policyholders also pay a 20% co-insurance on eligible charges above the deductible, with a mandatory cap of RM3,000 per disability. Preferred panel hospitals carry 0% co-insurance.
- Cost Efficiency Link: Because insurers do not have to process minor claims (such as RM2,000 clinic visits or minor food poisoning stays), the administrative savings and reduced claim frequency translate directly into a lower MediAsas Fleksi monthly premium.
MediAsas Fleksi vs. MediAsas Teras: Which Base MHIT Tier Should You Choose?
Choosing between MediAsas Fleksi and MediAsas Teras comes down to your existing medical coverage and your capacity to handle upfront out-of-pocket costs. While MediAsas Teras functions as an affordable primary safety net with low per-disability deductibles, MediAsas Fleksi provides a much larger RM300,000 annual limit paired with an annual deductible designed for catastrophic protection. Those without existing health insurance typically benefit most from Teras, whereas working adults seeking a high-limit corporate top-up find superior value in Fleksi.
| Feature / Benefit |
MediAsas Teras (Standard Tier) |
MediAsas Fleksi (Standard-Plus Tier) |
| Overall Annual Limit |
RM100,000 (Below age 60)
RM150,000 (Age 60 and above) |
RM300,000 (All ages) |
| Lifetime Limit |
Zero (Unlimited lifetime renewal) |
Zero (Unlimited lifetime renewal) |
| Deductible Structure |
RM500 (In-network) / RM1,000 (Out-of-network) per disability |
RM10,000 (In-network) / RM15,000 (Out-of-network) per policy year |
| Co-Insurance (Out-of-Network) |
20% capped at RM3,000 per disability |
20% capped at RM3,000 per disability |
| Cost-Sharing Waivers |
Deductible waived for government hospital care and emergency admissions |
High deductible applies to all admissions; no general waiver |
| Room & Board |
Standard shared ward (up to 4-bed) |
Standard shared ward (up to 4-bed) |
| Primary Role |
Primary basic medical card for uninsured individuals |
Catastrophic backstop or corporate top-up |
For those who currently hold no personal medical insurance and have limited liquid savings, MediAsas Teras is the safer standalone starting point. The low RM500 deductible per admission ensures private medical treatment remains accessible without requiring thousands of ringgit in upfront payments. Conversely, individuals with sufficient personal savings or existing base protection should choose Fleksi for its higher financial ceiling against severe medical crises.
Strategic Use Case: Using Fleksi as an Affordable Top-Up for Employer Medical Cards
MediAsas Fleksi delivers its greatest strategic value when deployed as a catastrophic top-up to employer-sponsored group medical insurance. Because corporate medical cards generally feature low annual limits between RM10,000 and RM30,000, employees face severe exposure if struck by critical illnesses or complex surgeries. By letting the employer policy absorb the initial RM10,000 hospital bill, the employee satisfies the Fleksi deductible without personal cash outlay and unlocks up to RM300,000 in backup coverage.
Here is how working professionals can execute this top-up strategy effectively:
- Identify Corporate Coverage Caps: Review your company employee handbook to determine your group hospitalisation limit. Most mid-tier corporate packages cap inpatient claims at RM15,000 to RM30,000 per year, which leaves large deficits during critical treatments.
- Align the Deductible Threshold: Because MediAsas Fleksi requires an RM10,000 annual deductible at panel hospitals, your corporate medical card pays the first RM10,000 directly to the hospital. This completely clears your out-of-pocket obligation under Fleksi.
- Absorb Catastrophic Spillovers: If an emergency bypass surgery or multi-week intensive care admission totals RM120,000, the corporate medical card pays its maximum limit (e.g., RM20,000), satisfying the RM10,000 deductible. MediAsas Fleksi then steps in to pay the remaining RM100,000 eligible balance, shielding your family savings.
- Maintain Long-Term Policy Continuity: Unlike corporate medical cards that terminate immediately upon resignation, retrenchment, or statutory retirement, your personally owned MediAsas Fleksi policy remains active up to age 85.
- Optimise Monthly Budgeting: By accepting an RM10,000 deductible rather than paying for an expensive zero-deductible personal medical card, you secure an RM300,000 private hospital safety net at a fraction of standard market premiums.
Panel Hospitals and Claims: Step-by-Step Claim Process for MediAsas Fleksi
The claim process for MediAsas Fleksi operates through cashless Guarantee Letter (GL) issuance at panel hospitals and reimbursement filing for non-panel healthcare facilities. When coordinating with an employer medical card, policyholders must present both policies at the hospital admission counter so billing can be sequenced correctly. Following structured admission protocols ensures that eligible hospital charges transition seamlessly from the corporate deductible payer to MediAsas Fleksi.
Follow these sequential steps when seeking hospital care:
- Select MediAsas Fleksi Panel Hospitals: Verify that your chosen private medical centre is classified as a Preferred In-Network panel hospital under the national scheme. In-network facilities ensure your deductible stays at the lower RM10,000 tier and avoid the 20% out-of-network co-insurance.
- Present Dual Cards at Registration: Upon arrival at the hospital admission counter, inform the billing officer that you hold both an employer group medical card and a MediAsas Fleksi plan. Provide the identification numbers and third-party administrator (TPA) details for both policies.
- Sequence Guarantee Letter Issuance: The hospital initiates the primary GL request against your corporate medical card first to cover the initial hospital deposit and early billing charges. Simultaneously, log your MediAsas Fleksi policy details with the desk so the secondary file is queued.
- Discharge and Billing Settlement: Upon discharge, the hospital applies the corporate insurance payout against the bill. If the total eligible charges exceed the RM10,000 deductible, the hospital submits the remainder to MediAsas Fleksi under its GL clearance. Any non-medical items (such as administrative fees or extra phone charges) must be paid directly by the patient.
- Reimbursement for Non-Panel Admissions: If you seek planned care at a non-panel facility, you must settle the bill upfront and submit a manual reimbursement claim. Retain the original itemised hospital tax invoice, formal discharge summary, and attending physician’s report for claim assessment.
- Diagnosis-Related Group (DRG) Compliance: Ensure your attending doctor documents primary and secondary diagnoses accurately. MediAsas procedures align with standardised DRG guidelines to ensure reasonable and customary cost containment.
Frequently Asked Questions
What is MediAsas Fleksi and how does it differ from a standard medical card?
MediAsas Fleksi is a standardised, government-endorsed standalone medical plan under Malaysia’s Base MHIT framework. Unlike traditional comprehensive medical cards that cover first-ringgit medical expenses at higher premium rates, Fleksi pairs a substantial RM300,000 annual limit with a high deductible (RM10,000 at panel hospitals). This design focuses specifically on shielding policyholders from catastrophic private healthcare costs while keeping monthly contributions economical.
How can I use MediAsas Fleksi to top up my company medical card?
You can use your employer medical card to settle the initial hospital bill up to your corporate limit. Because MediAsas Fleksi requires an RM10,000 annual deductible at panel hospitals, the payment made by your company card fulfills this threshold. MediAsas Fleksi then pays the remaining eligible hospital balance up to RM300,000, leaving you with zero out-of-pocket deductible expenses.
What is the difference between MediAsas Fleksi and MediAsas Takaful Fleksi?
MediAsas Fleksi and MediAsas Takaful Fleksi provide identical hospitalisation benefits, deductible rules, and annual limits. The difference lies in their regulatory and financial structure: the takaful version operates strictly under Shariah-compliant mutual assistance (Ta’awun) principles, where participants contribute to a common risk pool overseen by a Shariah committee.
Can I use EPF Account Sejahtera savings to pay for MediAsas Fleksi premiums?
Yes. Under the approved healthcare financing provisions of the national framework, eligible EPF members can use savings from their EPF Account Sejahtera (Account 2) to pay monthly or annual premiums for MediAsas plans. This reduces immediate cash outlay from household monthly budgets.
Is there a lifetime limit on MediAsas Fleksi claims?
No, MediAsas Fleksi does not have a lifetime limit. The RM300,000 annual limit replenishes completely at the beginning of each policy year, provided the policy is renewed and premiums are paid, up to the maximum coverage age of 85.
What happens if I seek medical treatment at a non-panel hospital?
If you receive non-emergency treatment at a private hospital outside the preferred network, your annual deductible increases from RM10,000 to RM15,000. Additionally, you are subject to a 20% co-insurance on eligible costs above the deductible, capped at RM3,000 per disability, and you will usually need to pay upfront and file a reimbursement claim.
This article is for reference only; the actual coverage terms are subject to the policy.
This article is for reference only and is not medical advice. Please consult a registered doctor if you have any concerns.
Sources
- milliman.com
- finnomalaysia.com
- bnm.gov.my
- imoney.my
- klsescreener.com
- bnm.gov.my
- freemalaysiatoday.com
- bnm.gov.my
- finnomalaysia.com
- tradersunion.com
- ringgitplus.com
- fintechnews.my
- wtwco.com
