Complete Guide Before Choosing Medical Card in Malaysia

Kali terakhir diperbaharui September 6, 2023 oleh Shafiq Wahab
Complete Guide Before Choosing Medical Card in Malaysia

Many Malaysians still do not know the importance of medical card. Medical Card not only serves as a protection plan, but it also acts as a savior especially when you need it. According to reports, about 85 percent of Malaysian population still lack adequate takaful or insurance protection in the event of an emergency.

11 Things You Must Know About Medical Card

When examined, the cost of treatment at the hospital is increasing. Therefore, a medical card or health card plan is one of the requirements you need to have as it can provide protection and comfort to you and your family in the event of a disaster. Although many think that government hospitals are sufficient and provide free treatment, it does not mean that you do not have to pay directly.

Some treatments at government hospitals especially related to serious and chronic illnesses require relatively expensive expenses even if they have been subsidized. Before you decide on the health insurance company that needs to be selected, here are 11 things you need to know about medical card:

1. Annual Limit, Lifetime Limit

Before selecting a medical card, you need to consider these two things that are usually offered by the insurance company – the annual limit and the lifetime limit. Most medical plans have a lifetime and annual limits that act as a guide for policyholders on the amount that can be claimed from the insurance company.

The Annual Limit

Basically, the annual limit refers to the maximum limit set by the insurance for medical costs. This means that the insurance will bear the cost of your treatment during your medical card policy period. Therefore, this use limit is very important before you select any medical card.

For example, assume your annual medical card limit is RM100,000 a year. You are always sick and need to be hospitalized more often. The use limit set by this insurance company has led to your claim to be limited to the amount specified during the year. This means that you can only claim RM100,000 for your medical treatment.

If the medical card or health card has reached a fixed limit or exceeds RM100,000, you need to pay the rest of the medical expenses for the rest of your savings or salaries. However, these benefits will be renewed next year and you will be allocated another RM100,000 up to a lifetime limit.

It is advisable to choose a medical card with a high annual limit especially if it takes into account the medical costs in Malaysia increasing over the years.

A Lifetime Limit

In addition to the annual limit, it is also a lifetime limit. What is a lifetime limit? Lifetime limit refers to the total amount of eligible medical benefits that can be claimed during the medical plan period as prescribed by the insurance company. The medical plan will end directly when the benefits of the plan paid have reached a lifetime limit for a policyholder.

For example, your medical card has an annual limit of RM100,000 and a lifetime limit of RM1 million. This means that a policyholder can only spend RM100,000 per year for a 10 -year treatment cost to enjoy the RM1 million benefits. Therefore, you need to consider a lifetime limit before choosing the best insurance for you.

If taking into account the rising medical costs at inflation rate of 10 to 12 percent a year, you need to choose the amount of annual limit and a reasonable lifetime limit with your ability and needs.

2. Premium/Contribution

It refers to the payment made by the policyholder to the insurance company or operator of the Takaful Medical Card. This insurance premium or donation can be paid monthly, quarterly or annual depending on the insurance company or takaful operator. For some insurance companies, annual premium payment options can provide better long -term savings.

3. Full protection, Deductible or Co-takaful

In addition, terms such as full coverage, deductibel (deductible) and co-kakaful (co-takaful) may also be able to make you cry. To help you understand better, you can refer to the following:

Full Cover

This insurance plan offers full and comprehensive protection. This means that all related treatment costs will be borne by the insurance company.


Deductibel is a fixed amount that needs to be issued for medical expenses before payment is made by your medical insurance company. If the deductible amount set by the insurance company is RM300, you will have to pay RM300 of the total medical expenses under your policy protection (except for the cost of the room and the daily hospital accommodation).

For example, Ali was admitted to the hospital and had to bear the overall cost of RM20,000. The ABC takaful company imposes a maximum deductible rate of RM500. This means that Ali will have to pay RM500 himself and the rest will be borne by the insurance up to the annual limit and the lifetime limit, subject to reasonable and common charges.


What is Co-Takaful? In general, it refers to a joint partnership between policyholders and takaful or insurance companies. In other words, you need to withdraw your own money to bear part of the medical cost usually about 10 percent of the total cost of medical treatment, depending on the insurance company you choose. You are advised to refer to your insurance panel first for more information. However, the calculation cost is as follows:

Sabri was admitted to the hospital and the overall treatment charges payable RM20,000. Takaful PRS Company charges a co-kakaful charge of 10 percent of the total amount payable. Therefore, Sabri will have to pay RM2,000, while the surplus of treatment costs will be borne by the insurance. This has led to the price of an insurance plan with co-insurance offered much cheaper than the price of an insurance plan without a co-insurance.

4. Guaranteed reforms or unsecured reforms

You may not notice that a medical card needs to be renewed every year just as you renew a car insurance. If your insurance policy is using this clause, here are some things you need to pay attention to:

Guarantee Renewal

Insurance companies are required to renew your insurance policy if you choose to continue the policy and as long as the premium payment is made on time. However, it is subject to certain conditions such as you have not exceeded the limit of lifetime claims and has not reached the maximum eligibility age.

Insecure Renewal

If you are a critical illness or a risk that is at risk for recurrence in the future, the Takaful Medical Card or Insurance reserves the right not to renew your insurance policy. In other words, your policy or certificate is subject to the approval of an insurance company or takaful operator. If you have a critical illness or a risk of recurrence, the takaful or insurance reserves the right not to renew an existing policy.

If you want to get a new protection plan, you need to inform your current health status. It can also cause you to be charged a more expensive insurance premium or contribution. In some cases, the disease may be excluded from your insurance coverage.

5. The Waiting Period

Most medical insurance plans are subject to the waiting period that the policyholder must be complied with. This means that you cannot use the medical card at any Hospital panel or make any insurance claims for a period of time usually around 30 to 120 days from the date of purchase of insurance policy. This waiting period is intended to ensure that you are in good health without any critical illnesses during this period.

However, there are some insurance companies that do not offer a waiting period for specific types of protection such as accident protection. Protection against accidents is in force immediately due to risk accidents occur at any time.

6. Exception

Exceptions are specific conditions or conditions listed in the policy that outlines certain health situations that are not subject to insurance coverage. For example, if the policyholders are already suffering from cancer, kidneys and so on, the cost of treatment for the disease will not be borne and will be excluded by the insurance company.

7. Panel Hospital

The medical card you list has a list of participating panel hospitals. This means that you can get treatment at any Panel Hospital listed on a medical card to enjoy the insurance or takaful guarantee. Therefore, it is important for you to obtain health insurance that offers access to more comprehensive panel hospitals to facilitate your affairs in the event of an emergency.

8. Rider or Standalone

Here are two types of medical cards that are commonly offered in the market:

Rider Medical Card

Medical or medical cards can also be offered as additional protection (riders) to key plans (basic products) such as life insurance plans and investment -related plans. For this type of plan, medical protection benefits cannot be purchased separately. For example, policyholders can increase protection for critical illnesses in life insurance or storage policies. This means that the policyholder will be protected if diagnosed with critical illnesses such as stroke, cancer and so on. In other words, policyholders will not only receive medical protection but also receive life protection and savings.

The price of this plan is usually higher than the standalone plan as you not only pay for medical protection but also include life insurance and investment. The premium rate is fixed according to the age of the policyholder when entering the plan at the beginning. Usually, a small increase in premium rates may occur due to increased medical inflation.

Standalone Medical Card

Standalone Medical Card is a medical plan that can be purchased separately without any other additional plan. This means that you will only benefit from medical protection without any additional protection such as death, savings or investment. Standalone medical card premium rates are irregular – contribution prices are usually lower in the early stages of participation than rider contribution rates. These contribution rates usually increase according to the age schedule, usually every four to five years. Insurance companies will also raise rates from time to time according to the increase in medical inflation rates.

Standalone’s medical card protection is comprehensive – it offers the cost of surgery, room and hospital accommodation, hospital allowance, critical illness, specialist consultant costs and so on depending on the policy. But basically, here are some of the three benefits that are commonly obtained in Standalone Medical Cards:

1. The Cost of Admission to the Hospital and Surgery

It includes all the costs associated with hospitalization, surgery, room and accommodation, ambulance services, medicines and more.

2. Critical Illness

It covers over 36 types of critical diseases including cancer, heart attack, stroke and more. You can refer to the information in your policy for more information on the critical illness listed.

3. Long -term treatment

It is especially useful for individuals with chronic illnesses that require long -term treatment and care such as kidney patients who require prolonged dialysis treatment.

9. Medical Card: Individual Plan vs Family Plan

For parents, for example, of course, family members’ takaful is one of the compulsory expenses that need to be included in the planning of monthly commitments in addition to home buying, vehicle road tax, sacrifice funds and more. It can be a relatively high financial commitment especially if you have a large number of dependents.

Therefore, many individuals who are family choosing a family protection plan rather than an individual plan. But, is it profitable to take a family medical card plan? Here are the estimates of calculations for spouses and two children:

Option A – Individual Plan

Assume that each family is protected by a standard plan with an estimated medical card price of around RM150 per person. Therefore, the total cost that needs to be borne for four people per month is RM600 or RM7,200 a year.

Option B – Family Plan

Typically, the medical card price for a family insurance plan for four people starts at RM350 and above depending on the policy you choose. For example, if the cost of a family plan is RM450 a month (assume that you add other additional protection), this means you can save at least RM150 per month or RM1,800 a year.

10. Room Prices and Accommodation

Each medical card provides a specific amount for room prices and hospital accommodation. If you choose a plan for the RM200 room price, you are entitled to a room that is worth not exceeding the specified qualification. If you want to stay in a more expensive room, you will have to bear the extra payment.

11. Daily Cash Allowance

This allowance is given to the policyholder according to the number of days staying in the ward. This allowance can be used to cover any additional costs if admitted to the hospital such as the cost of paying a child at home or the cost of the hospital. If you work alone or do business, the benefits of this cash allowance can act as a replacement for your income throughout your time.

While the Insurance Protection Plan subscription can qualify for your tax exemption, you can choose any insurance plan that can save you. With this extra money, you can use it for family vacation, create an education fund for kids or the like.

What Is the Best Medical Card You Can Get?

To get the best medical card or medical card in Malaysia, it is not based on cheap medical card prices. It should include your needs and wants, in addition to taking into account current economic rates and medical costs. For example, the cost of shortcuts in private hospitals can now reach up to RM140,000. Therefore, consider these factors before getting the best medical card for you.

Take into account the estimated cost of this treatment over the next 10 years whether it will increase or not. Before selecting the appropriate insurance, compare your preferred medical insurance with the limits offered. If enough, it should be the best option that can protect you in the event of unwanted things. Most importantly, choose a medical card that best suits their own needs and abilities.

Hopefully these tips will help you choose the best medical card for yourself as well as your loved ones. If you want the best self-protection insurance, visit the Qoala website for more info. Qoala provides a series of health insurance products from some of the best and most popular insurance companies in Malaysia with a simple, fast and safe process.

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Personal finance management expert to help you manage your finances better!

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