PETALING JAYA: The introduction of a co-payment feature in new medical and health insurance policies will help lower premiums and allow policy holders to choose an affordable plan to suit their needs, say insurance experts.

“Such plans are good as they can be tailored to your financial situation.

“Why would someone go for coverage of more than RM1mil and pay through his nose for it?” asked a veteran insurance agent who wanted to be known only as Koh.

“One-fifth of that amount should be sufficient, with premiums costing much lower even after taking the rising costs of healthcare into account.”

In fact, a number of lesser-known insurance companies had been offering policies with co-payment more than a decade ago, he added.

Yesterday, Bank Negara issued a statement on the co-payment option starting Sept 1 for medical and health insurance and takaful (MHIT) products, saying it aims to promote sustainability and affordability.

The central bank said its observations indicated that the premium or contribution level for policies with co-payment could be 19% to 68% lower than similar products without co-payment features.

Public health expert Prof Dr Sanjay Rampal of Universiti Malaya, when contacted, said that co-payments are a good idea as it will allow healthcare to remain sustainable.

However, he suggested that co-payment rates should be a fixed sum to be determined beforehand and not be calculated by percentage.

“If the co-payment is computed by percentage, it may leave policy holders with uncertainties as to how much they will eventually be required to fork out from their own pocket due to the variable cost of medical charges,” he said.

As such, Prof Sanjay said co-payments should be a fixed amount that can be anticipated.

“If co-payments are too high, then people will cease to use medical insurance. What will then happen is the burden of healthcare will be transferred to the government healthcare system,” he added.

He said the government and stakeholders involved should hold further discussions on regulating the cap for the co-payment.

Another public health expert, Datuk Dr Zainal Ariffin Omar, said the soon-to-be introduced co-payment feature appears confusing to ordinary folk and may pose an extra burden on them.

“The new regulation may burden government medical facilities if more people choose to give up medical insurance, so the government should quickly come up with a new health financing scheme for the whole country instead,” he said.

A 51-year-old graphic designer, who wanted to be known only as Eng, said he was appalled that consumers were left to absorb the rising costs of healthcare when the situation is exacerbated by overcharging at private hospitals.

He said the government should keep tabs on this and put a cap on healthcare charges at private hospitals if it were serious about keeping healthcare affordable for consumers.

“If the Domestic Trade and Cost of Living Ministry can monitor prices of goods and services, why not do the same for healthcare services and allow consumers to lodge complaints against private hospitals that overcharge?

“Why do consumers need to bear the brunt of it all the time?” asked Eng, who has a medical insurance policy.

https://www.thestar.com.my/news/nation/2024/07/07/co-payments-will-lower-costs-say-insurance-players