People with pre-existing health conditions will be eligible for the upcoming base medical and health insurance or takaful plan, subject to certain conditions. Health Minister Datuk Seri Dr Dzulkefly Ahmad said the plan is meant to expand access to basic health coverage while keeping premiums affordable.

The base plan will be offered to individuals whose medical conditions are stable and under control. This includes people living with mental health conditions.

Stable Conditions To Qualify For Coverage

According to the minister, the plan will use a no look-back approach when assessing pre-existing conditions. This means applicants will not be assessed based on their full medical history, allowing for a clearer and more consistent way to determine eligibility.

The approach is intended to avoid automatic rejection due to past conditions, while still managing costs so the scheme remains sustainable.

Plan Aims To Expand Basic Health Coverage

Dzulkefly also said the plan is designed to ensure more Malaysians can obtain health coverage without being excluded due to existing conditions. He added that the plan aims to support both individuals and the long-term stability of the scheme.

The base plan is intended to complement public healthcare by encouraging shared use of public and private medical services.

Framework Still Being Finalised Ahead Of Pilot Launch

The minister said the framework for the base plan is still being refined. A pilot launch is expected later this year, with more details to be announced around the middle of the year.

The full rollout of the plan is currently expected in early next year, depending on the outcome of the pilot phase.

What Is Known About The Base Plan So Far

The base medical and health insurance plan was announced last month in response to rising medical costs and higher insurance premiums. It is designed as a standard product with basic annual coverage of RM100,000.

Participation in the scheme will be voluntary. Premiums will be based on age and health status, with the aim of remaining affordable. The plan is intended to act as a safety net, covering most essential treatments rather than full private hospital benefits.

What This Could Mean For Malaysians

Allowing people with stable pre-existing conditions to join the base plan could reduce the number of Malaysians who remain uninsured or underinsured due to high premiums or rejection by insurers. This may be especially relevant for older adults and those managing long-term conditions.

The no look-back approach may simplify the application process and reduce uncertainty for applicants, but final eligibility will still depend on how stability and control of conditions are defined in practice. Clear guidelines will be important to ensure consistent treatment across applicants.

As the plan offers limited coverage compared with full private insurance, it is likely to function as a basic safety net rather than a replacement for comprehensive medical plans. Its effectiveness will depend on premium levels, benefit limits, and how smoothly it integrates with existing public healthcare services once fully rolled out.

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