Malaysians Can’t Keep Up With Their Medical Insurance Price Hike

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If you’ve ever looked through your insurance policy and thought, “Wait… what exactly am I paying for?” you’re definitely not alone.

Data from a recent 2026 survey on Malaysian healthcare and insurance, shared with TRP by an industry source, suggests that many Malaysians are struggling to understand their medical insurance coverage, with rising premiums, unexpected out-of-pocket costs, claim disputes, and changing policy terms among the biggest frustrations reported by policyholders.

To find out if these concerns resonated with regular Malaysians, TRP asked our readers about their insurance experiences through a quick survey on Facebook and street interviews, and the responses we received highlighted many of the same frustrations.

TLDR, the comments section was filled with Malaysians sharing their own insurance headaches like, “Premium naik (increases) every year, but coverage macam sama je (pretty much the same),” one commenter wrote.

While another was even more direct, saying, “Insurance feels like a scam.”

These frustrations come at a time when more and more Malaysians appear to be reconsidering their healthcare plans, as reports show that over 340,000 medical insurance and takaful policies were cancelled or surrendered between January 2024 and June 2025.

So, why are Malaysians starting to question whether their insurance is still worth paying for?

Paying More, But Feeling Like You’re Getting Less

For many policyholders, the biggest frustration right now is simple: their premiums keep going up, but their coverage doesn’t seem to be improving at the same pace. In some cases, they are even getting worse coverage while paying the increased price.

However, for others, higher premiums may come with expanded coverage or additional benefits, depending on the changes made to their policies.

The 2026 survey found that 34.6% of respondents no longer felt their current insurance plan was worth keeping, with the most common reasons for cancelling being high premiums and not being able to afford further increases.

Among those paying below RM150 a month, 74% said they were satisfied with their coverage. However, for those paying more than RM300 monthly, satisfaction dropped to between 33% and 37% after experiencing a claims issue.

And paying more doesn’t always mean getting a smoother claims experience either.

The survey found that plans costing between RM300 and RM500 per month recorded an 85.7% claim approval rate, while plans costing above RM500 recorded a slightly lower approval rate of 81%.

For some policyholders, the bigger question is whether the higher premiums are still worth it when the coverage and claims experience don’t seem to improve.

“Pay more every year for poorer service, what’s the point?” one TRP commenter asked. While another shared that their premium had doubled within two years, but they still “can’t utilise it for anything either.”

Extra Costs Nobody Expects

You’d think having medical insurance means your hospital bills are pretty much sorted, right? But according to the survey, some policyholders are finding out that their healthcare coverage isn’t always as straightforward as they expected.

64.7% of respondents said they still had to fork out their own money for their most recent hospital bill, with some paying more than 20% of the total cost themselves.

Think this is expensive? Well, the extra costs don’t stop there.

Medication was another major pain point, with 71% of policyholders saying they had to pay more because their insurance did not fully cover the medicines that their doctors had prescribed.

Among the 815 valid responses, some of the issues highlighted included:

• 284 people said their insurer only covered generic medication instead of the original brand prescribed by their doctor.
• 230 people had their medication claims rejected because the items were classified as “supplements”.
• 225 people said their medication coverage was limited, like receiving only three days’ supply despite being prescribed seven days’ worth.

Interestingly, paying higher premiums did not always mean fewer unexpected costs, too.

The 2026 survey found that out-of-pocket expenses remained relatively similar across different premium brackets, and for some policyholders, this has left them questioning whether the higher premiums are actually giving them better protection when they need it most.

One commenter shared their frustration, saying, “My kid got sick, and I had to co-pay the medical bill after already paying the monthly premiums. And the insurance company raised my premiums.”

Your Hospital Is No Longer Covered

For some policyholders, the real test only comes when they actually need to use their insurance.

The survey found that 31.7% of respondents could no longer see their regular doctor after their hospital was removed from their insurer’s panel. Meanwhile, 28.3% said they didn’t even know this was something that could happen, while another 31% were unsure whether their policy terms had changed over the past two years.

That uncertainty was also reflected in TRP’s reader responses.

“TBH, I pay every month, but I’m unclear with my medical insurance coverage,” one commenter admitted. While another said they were only expecting to fully understand their coverage when they actually needed it.

So I’m just waiting to kena something (for something to happen) to figure out what is covered.

Commenter.

To make matters worse, the issue extends beyond policyholders themselves. Apart from certain doctors and specialists being removed from insurance panels, there have also been reports of doctors being fined tens of thousands of ringgit by insurance companies over past patient admissions, with disputes reportedly involving unclear changes in procedure codes.

Finding Out What Isn’t Covered When It’s Already Too Late

Some readers also felt that even explanations from agents did not always clear things up.

According to the survey, nearly 30% of policyholders experienced either a partial or full claim rejection within the past two years. Among those affected, 24% said the reason for the rejection was never clearly explained to them.

And some TRP readers also shared similar frustrations. “Bila claim baru tahu banyak benda tak cover,” one commenter wrote. Meaning they only discovered certain exclusions in their healthcare plan when they actually tried to make a claim. Some even found that their preferred hospitals have been removed from their panel list.

Another said the explanation they received beforehand did not match what happened during the actual claim process.

Agent explain lain, actual claim jadi lain.

Commenter.

Tired Of The Waiting Game

For patients waiting for a Guaranteed Letter (GL), the document insurers issue to confirm coverage for a hospital admission or procedure before treatment begins, even a few days can feel like a long wait.

The survey found that over 51% of respondents waited at least three working days for approval, while 23.1% waited more than five working days.

The back-and-forth between hospitals and insurers also became a source of frustration, with over half of respondents saying administrative delays affected their treatment timeline. Some even said they had to postpone or reschedule procedures while waiting for approvals.

One commenter shared their experience and said that, “Whenever it came to claims or hospital admissions, the agent was often unreachable, and I had to manage everything on my own.”

Insurers Making Medical Calls

For some policyholders, the issue isn’t just about how much they pay or whether their claims get approved, it’s also about who gets a say in their treatment.

Almost 70% of respondents said their insurer had imposed some form of limitation on their treatment plan, and among them:

• 49.6% said the limitation was imposed without their doctor’s agreement.
• 10.6% said their doctor explicitly disagreed with the insurer’s decision.
• 25% said the limitation affected their treatment outcome or comfort.

This left some patients questioning whether healthcare decisions were being shaped by medical needs, or by coverage restrictions.

So, What Now?

Put them all together, and these concerns paint a clearer picture of why some Malaysians are starting to reconsider whether they can or should continue paying for their healthcare plans.

But the impact could go beyond individual policyholders, one reader noted, as the pressure could eventually shift back to the public healthcare system.

More senior citizens will give up on insurance coverage because of yearly increases in premiums. Government ends up spending more to care for them in government hospitals.

Commenter.

Ultimately, Malaysians are not questioning the need for medical insurance itself, but whether they can trust that the coverage they’re paying for will provide the protection they expect when it matters most.

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