MediAsas Teras is the national baseline medical insurance policy established jointly by Bank Negara Malaysia (BNM), the Ministry of Health (MOH), and the Ministry of Finance (MOF) under the RESET healthcare reform initiative. It serves as a standardised, affordable safety net designed to protect Malaysians from high private healthcare expenses while moderating broader medical inflation.
Unlike traditional medical insurance packaged with investment-linked funds or high agency markups, MediAsas Teras operates purely as a medical reimbursement plan. Muslim policyholders and those seeking Shariah-compliant coverage can enrol in its Islamic equivalent, the MediAsas Takaful Teras plan, which mirrors the identical regulatory framework, benefits, and pricing rules under takaful principles.
Following a pilot rollout that began in late July 2026 across selected private healthcare institutions in the Klang Valley, the full industry-wide nationwide rollout officially launches in January 2027. Under BNM’s regulatory mandate, every licensed life insurer and family takaful operator offering health coverage in Malaysia must provide this standardized basic medical card.
Key structural highlights of the MediAsas Teras basic medical card include:
The MediAsas Teras benefits focus on essential, clinically necessary hospitalisation and day surgeries, providing an annual limit of RM100,000 for individuals aged 59 and below, which automatically increases to RM150,000 per policy year at age 60.
According to BNM industry claims statistics, over 99% of private hospitalisation episodes in Malaysia incur bills below RM60,000. Consequently, the MediAsas Teras annual limit is calibrated to cover catastrophic and major medical events—including cardiovascular surgeries, stroke care, and cancer treatments—without exposing policyholders to unsustainable premium inflation.
| Benefit Category | Coverage Scope | MediAsas Teras Limit & Terms |
|---|---|---|
| Annual Limit (Ages ≤ 59) | Overall medical claims per policy year | RM100,000 per year |
| Annual Limit (Ages 60–85) | Upgraded limit for senior healthcare needs | RM150,000 per year |
| Lifetime Limit | Cumulative claims across the policy lifetime | None (Zero lifetime limit) |
| Room & Board Limit | Daily hospital accommodation rate | Standard shared-room hospital rate |
| Inpatient & Day Surgery | Surgical fees, anaesthetist, operating theatre, and ICU | Reimbursed up to eligible actual charges |
| Pre-Hospitalisation | Diagnostic investigations, imaging, and specialist consultations | Covered within 60 days before hospital admission |
| Post-Hospitalisation | Follow-up specialist visits, medication, physiotherapy, and home nursing | Covered within 90 days following discharge |
| Outpatient Cancer Care | Chemotherapy, targeted therapy, and radiation treatments | Covered up to the annual limit; deductibles waived |
| Outpatient Kidney Dialysis | Regular haemodialysis and peritoneal dialysis treatments | Covered up to the annual limit |
The MediAsas Teras room and board limit is structured around standard shared-room hospital rates. This design keeps underlying claims predictable while granting patients the option to upgrade to private single rooms or executive suites by paying the room price differential out-of-pocket upon discharge.
The MediAsas Teras premium price is engineered to remain accessible by incorporating a mandatory RM500 deductible per disability, enabling young adults to secure comprehensive private medical protection from approximately RM60 to RM65 per month.
Understanding how the deductible operates clarifies why MediAsas Teras maintains competitive pricing:
Indicative monthly premiums range from RM60 to RM65 for individuals in their early twenties, RM80 to RM120 for ages 31 to 35, and adjust progressively for older age bands. This positions MediAsas Teras as a practical option for gig workers, fresh graduates, and self-employed individuals who previously found comprehensive private insurance unaffordable.
The MediAsas Teras waiting period follows standardised underwriting conventions to ensure immediate coverage for unforeseen accidents while establishing fair timeframes for non-emergency medical conditions.
Policy waiting periods are defined as follows:
Admission rules differ between panel and non-panel private medical centres:
Consumers can fund their MediAsas Teras policy directly through the Employees Provident Fund (EPF), download product brochures for due diligence, and apply through direct digital platforms without agent intermediaries.
MediAsas Teras is a standardised, standalone basic medical card regulated by Bank Negara Malaysia, featuring an annual limit of RM100,000 to RM150,000 and an RM500 deductible per disability to keep monthly premiums as low as RM60 to RM65. In contrast, conventional private medical cards frequently bundle investment-linked funds or savings riders, offering multi-million-ringgit annual limits that come with substantially higher, less predictable premiums.
Yes, eligible Employees Provident Fund (EPF) members can pay annual MediAsas Teras premiums directly through their EPF Akaun Sejahtera (Account 2). This payment facility covers policies purchased for yourself as well as eligible family members, eliminating out-of-pocket cash requirements from monthly household budgets.
Pre-existing conditions that are active and unstable are generally excluded from claim coverage under standard underwriting guidelines. However, unlike traditional insurance plans that may reject applicants entirely, MediAsas introduces a reformed underwriting framework where individuals with well-managed conditions (such as cancer in remission or controlled single-vessel heart disease) can secure coverage for other, unrelated illnesses, subject to transparent policy exclusions.
When admitted to an in-network panel hospital, the insurer issues a Guarantee Letter for cashless admission. If the total eligible medical bill is RM20,000, you pay only the RM500 deductible directly to the hospital upon discharge, while the insurer settles the remaining RM19,500. If you are admitted to a government hospital, the deductible is completely waived.
Consumers can apply for MediAsas Teras directly through the official digital portals of licensed life insurance and family takaful operators participating in the scheme. The online application process involves choosing your plan tier, completing a standard digital medical declaration, and submitting payment via online banking or EPF Akaun Sejahtera for instant policy issuance.
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.
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