Written by Mei Ling
Published 16 October 2026 | Last updated -
Who we are: Home Care Apps Team
Quick answer: As of October 2026, MediAsas for insurance agents comes down to five things: the two plans, pilot eligibility, waiting periods and disclosure, how claims work, and post-discharge benefits. MediAsas is a voluntary plan from licensed insurers and takaful operators, not a government scheme. Pilot terms may change in January 2027.
Key points
- MediAsas is voluntary insurance or takaful, not a government scheme.
- Two plans: Teras (standard) and Fleksi (higher deductible).
- Pilot applicants must be aged 16 to 70 with a MyKad.
- Waiting periods and pre-existing condition rules need a plain explanation.
- Home nursing after discharge has set limits, and the insurer decides each claim.
1. What are the two MediAsas plans an insurance agent will explain?
MediAsas has two plans: Teras, the standard plan, and Fleksi, the enhanced plan with a higher deductible. Each has a takaful version, MediAsas Takaful Teras and MediAsas Takaful Fleksi, with the same coverage and benefits (BNM pilot FAQ, A1 and A10). The deductible is the amount the client pays first, and "per disability" means one period of illness from the same cause (B5). BNM says a customer with employer cover may consider Fleksi to complement it (A7). BNM's page calls MediAsas voluntary and "not a social insurance/ takaful scheme" (BNM MHIT page).
| Teras | Fleksi | |
|---|---|---|
| Overall annual limit | RM100,000 (age 0 to 59); RM150,000 (age 60 and above) | RM300,000 |
| Deductible at a Preferred In-Network hospital | RM500 per disability (age 0 to 59); RM1,000 (age 60 and above) | RM10,000 per year |
| Out-of-network hospital | Same deductible plus 20% co-insurance, capped at RM3,000 per disability | RM15,000 per year, no co-insurance |
| Co-payment waiver | Yes (government facility, emergency, outpatient cancer treatment) | No |
These are pilot figures (BNM FAQ B2, B4 and Appendix I, 29 July 2026) and may change at the January 2027 launch.
2. Who can apply in the pilot, and can a client hold two plans?
In the pilot, only Malaysian citizens with a valid MyKad, aged 16 to 70, can apply, through one of six insurers or takaful operators: AIA Berhad, Allianz Life Insurance Malaysia Berhad, Etiqa Family Takaful Berhad, Great Eastern Life Assurance (Malaysia) Berhad, Prudential BSN Takaful Berhad and Syarikat Takaful Malaysia Keluarga Berhad (BNM FAQ, C1, C8 and A19). A client can hold only one MediAsas at a time across all insurers (A13). In the pilot, switching insurers, moving from an existing plan with the same insurer, and switching between Teras and Fleksi are not available (A8, A9 and A15).
The pilot runs in the Klang Valley until October 2026. BNM's page says it involves selected participants, including staff of selected statutory bodies, government-linked companies and SMEs, and that "Most Malaysians will not be affected during this phase" (BNM MHIT page). So ask the insurer whether a walk-in client can apply now. Our guide to the six pilot insurers has more on each.
3. What do waiting periods and pre-existing condition rules mean for clients?
Clients must disclose their health honestly, because MediAsas is fully underwritten and pre-existing conditions are excluded (BNM FAQ, C3 and B16). A pre-existing condition is one the client had treated, sought advice about, had noticeable symptoms of, or reasonably should have known about before cover began (C4).
- 30 days: conditions arising in the first 30 days are not covered, except accidental injury (C10).
- 120 days: treatment for Specified Illnesses has a 120-day waiting period (C10).
- Seven years: after seven continuous years, claims cannot be contested for non-disclosure, unless it was fraudulent, deliberate or reckless, or the claim relates to a Pre-Defined Medical Condition such as cancer (C5 and C7).
The Star reported on 28 September 2026 that some applicants with certain conditions may be accepted while claims linked to that condition may still be excluded (The Star). The FAQ does not list such conditions, so ask the insurer. BNM's agent professionalism policy also requires insurers' codes of ethics to make agents consider a customer's risks, needs, affordability and existing cover when recommending a product (BNM, para 8.2(d)).
4. How do MediAsas claims work, and what will clients still pay?
At a Preferred In-Network hospital the client can use the cashless route through a guarantee letter (GL), and at other hospitals the client pays first and claims later (BNM FAQ, C11 and C13). The client shows the MediAsas e-medical card at registration, the hospital requests pre-authorisation, and BNM says GL approval is subject to assessment and policy terms (C14 and C15). If no GL is issued, treatment can still go ahead on pay-and-claim (C16). Our guide explains the guarantee letter.
Clients can still owe money. BNM's example is a RM6,000 bill under Teras: the client pays RM500 at a Preferred In-Network hospital, but RM1,700 out of network (RM500 deductible plus RM1,200 co-insurance) (B3). The pilot list has ten Preferred In-Network hospitals and may change without notice (B7 and B17). Claim status is viewed on the insurer's official channels (C19), and our claim checklist for agents covers the steps.
5. What does MediAsas pay after discharge, including home nursing?
MediAsas lists four post-discharge benefits, and each has limits an agent should quote exactly (BNM FAQ, Appendix I items 10 to 13):
- treatment within 30 days before admission
- treatment and doctor follow-up within 90 days after discharge
- physiotherapy within 90 days after discharge: up to RM200 a session, 10 sessions per disability
- home nursing care: as charged, up to RM3,000 a year and a maximum of 90 days per lifetime
All are subject to the overall annual limit. The FAQ does not say how the 90 days are counted, whether a doctor's letter is needed, or whether cashless applies to home nursing, and exclusion 15 removes private nursing care apart from this benefit (B16). Tell clients to check the policy wording and Product Disclosure Sheet, and never say a nurse's visit is certain to be paid. Home Care Apps arranges registered nurse home visits, with "from" prices on our home page, but is not a panel provider of any insurer. See home nursing under MediAsas and the RM3,000 and 90 days explained.
What to do next
- Read the BNM pilot FAQ, then your insurer's Product Disclosure Sheet and policy wording.
- Ask your insurer what MediAsas training and agent materials exist.
- Tell clients plainly that pilot terms may change in January 2027.
- Point families planning home recovery to the free care assessment.
FAQ
What should an insurance agent know about MediAsas before talking to clients?
Know the five points above: the two plans, pilot eligibility, waiting periods and disclosure, how claims work, and post-discharge benefits. Use the BNM pilot FAQ (29 July 2026), the policy wording and the Product Disclosure Sheet as your sources. Say that terms may change in January 2027.
Which plans does MediAsas have?
Two: Teras and Fleksi, plus the takaful versions, MediAsas Takaful Teras and MediAsas Takaful Fleksi. Conventional and takaful versions give the same coverage and benefits (BNM FAQ, A1 and A10). The plans differ in annual limit and deductible.
Can a client hold two MediAsas plans?
No. BNM says a customer may hold only one MediAsas, either Teras or Fleksi, at any one time across all insurers and takaful operators (BNM FAQ, A13). Plan switching is not available in the pilot.
Is there an official MediAsas guide for insurance agents?
We did not find one. The BNM document we read is a customer FAQ, and no BNM, LIAM or PIAM agent guide was published on the pages we checked on 16 October 2026. Ask your insurer for current training and product materials.
How we can help
Home Care Apps arranges registered nurse home visits across Peninsular Malaysia, subject to nurse availability in your area. If a client or their family wants to know what a visit involves and costs, they can try the free care assessment or send us an enquiry. We are a home nursing provider, not an insurer or insurance agent, and we take and pay no referral fees.
Sources
- Bank Negara Malaysia, MediAsas Frequently Asked Questions, Version 1: Pilot Programme, 29 July 2026. PDF. Items A1, A7, A8, A9, A10, A13, A15, A19, B2, B3, B4, B5, B7, B16, B17, C1, C3 to C5, C7, C8, C10, C11, C13 to C16, C19 and Appendix I.
- Bank Negara Malaysia, Medical and Health Insurance/Takaful (MHIT). bnm.gov.my/mhit, page read 16 October 2026.
- Bank Negara Malaysia, Policy Document on Professionalism of Insurance and Takaful Agents, issued 17 April 2023, effective 1 January 2024. BNM page.
- The Star, "MediAsas to cover some pre-existing conditions", 28 September 2026. Link.
Note
This is general information, not medical, financial or legal advice, and Home Care Apps is a home nursing provider, not an insurer, takaful operator or insurance agent.