Malaysia has a two-tier healthcare system, consisting of a public scheme alongside a private health sector, but your options as an expat will be limited when it comes to public healthcare. We will look at those options below.
Malaysia does not have a national health insurance scheme as such, and the current system is not universal. As an employee, you may nonetheless have to be registered with PERKESO (Pertubuhan Keselamatan Sosial), the social security organisation. This covers you for injury when employed.
You may also be registered for the Foreign Worker Hospitalisation and Surgical Insurance Scheme (FWHS or SKHPPA), a compulsory scheme run by the Ministry of Health & Immigration Department for expat workers, to protect overseas workers in case of illness or accident.
In addition, you may be entitled to access the public health insurance scheme if you are on the Malaysia My Second Home (MM2H) scheme, for expats with a monthly offshore income of 10,000 MYR (USD$2400).
How to register with the health system in Malaysia
Your employer should register you with the FWHS, but check that this has been done.
Under the FWHS you will be covered for a fixed amount of care in public sector hospitals: treatment will be free at delivery and your coverage will entitle you to a third class room plus board for up to 30 days (15 days in an ICU), plus some inpatient medical consultations and care. You will also be entitled to free at delivery treatment in public hospitals in the case of an emergency.
If you are a retired expat or an international student, you will need to take out private cover.
You will also need to take out private cover for your dependents, as the FWHS will not cover them.
You will be allowed to access the public healthcare system if you pay, but note that you will need to pay more than Malaysians do. Compared with Western hospitals, though, you will still find this to be comparatively cheap.
In order to find your local GP, check online or with local colleagues or friends. Medical practitioners are required to be registered with the Malaysian Medical Council, so if you check with them you will be able to see if your local practice is accredited. Once you have located a practice, you can visit them and sign up.
Finding reliable and trustworthy banking services is an important part of living and working abroad, and expats will find that, in most countries, a range of options are available. You may well wish to maintain a bank account at home, for paying bills and other activities, but you will probably also need a local bank account, in order to receive salary payments and handle your living expenses.In most countries, a range of options are available. It is even possible that your existing bank will have international facilities. Alternatively, you may wish to open an off-shore bank account. Different countries have different rules with regard to banking. In many, you will need a local bank account in order to acquire residence. In others, employers may only be able to pay you via a local account. This may also apply if you are self-employed.
Malaysia is an attractive destination for expats, and once you have obtained your visa, opening a bank account is generally not difficult. Both local and international banks operate in the country, and they are usually welcoming to foreign customers. The language of business is officially Bahasa Malaysia, but many people speak English, and you will not find that language is a barrier.
The sector is well regulated. Under the Financial Services Act (2013), banks are subject to supervision by several different authorities, including Bank Negara Malaysia (BNM, the Central Bank of Malaysia) and the Minister of Finance, with the aim of ensuring stability, risk management and liquidity. In addition, since 2018, Malaysia has taken significant steps to combat money laundering and the funding of terrorism, following the guidance laid down by the global watchdog, the Financial Action Task Force (FATF). The country is highly rated by the FATF for compliance.
While Malaysian banks are well buffered and resilient to risk, the combination of recent political changes and the COVID-19 pandemic are likely to create some difficulties and reduced returns.
Major banks in Malaysia
You will find you have a wide choice of banks in Malaysia, including international banks, which offer both personal and business banking services. The biggest local banks are:
• Malayan Banking Berhad (Maybank)
• Public Bank Berhad
• RHB Bank Berhad
• Hong Leong
These all have multiple local branches across the country and a strong network of ATMs, so finding a bank that is convenient for you is easy. International banks with a presence in Malaysia include:
• BNP Paribas
• Bank of America
• Deutsche Bank
International banks tend to cluster in cities, so if you live in a more rural area, you may find one of the local banks more convenient. If you wish to open an account online before you arrive in Malaysia, the international banks are recommended, as most local banks only offer this service to people who already have an account with them.
Opening an account
Once you have decided which bank is right for you, the process of opening an account is straightforward. In most cases, you will need to visit your local branch in person. While different banks may ask for different documentation, typically, you will need:
• Your passport or another appropriate office photo ID
• Proof of your right to be in Malaysia – i.e. your visa or residence permit
• Proof of employment or business activities in Malaysia, or proof of income and/or assets if you are retired
• A set minimum deposit – this varies according to the bank and the type of account
• Proof of address
You may also be asked to give your fingerprints, or to supply a reference from someone who already has an account with the bank and is in good standing. The procedure takes around an hour to complete, and your account will usually be set up within three working days.
As an expat, the easiest account type to open is a personal savings account. This provides you not only with a passbook, but also with an ATM card, which can be used at any ATM belonging to your bank. Often, your savings account will be active and available for you to use at the end of your appointment.
You can also open a combined savings and current account or a current account, which will provide you with a chequebook, but which may take longer to open (around three days). You may have a joint account with your spouse, provided they also have the appropriate visa or residence permit.
You should also be able to apply for a credit card, although you may be asked for additional proof of earnings or income in order to qualify.
Islamic banking system
As well as having conventional banks, Malaysia has an active Islamic banking sector. Islamic banks comply with religious rules on financial matters, such as around charging interest (which is forbidden under Sharia law) and investments. Like the conventional banking sector, Malaysian Islamic banks are regulated and overseen by the BNM, and they must comply with the 2013 Islamic Financial Services Act. You do not have to be Muslim to open an account with an Islamic bank.
Banking fees and charges
Fees and charges vary from bank to bank, and most banks charge you to use any ATM that does not belong to them. As of September 2019, all commercial banks have stopped charging their customers for transactions in-branch and for using their own banks’ ATMs. Some accounts require you to maintain a minimum balance, or to pay in a certain minimum amount monthly, to avoid other charges.
It’s worth shopping around to see which bank and which account is best for you. Charges for foreign currency transactions can be high, and if this is something you intend to do regularly, you may find it best to open your account with one of the international banks.
ATMs, branches, and banking hours
The large local banks in Malaysia have widespread networks of ATMs and branches across the country. International banks are more concentrated in the cities. Banking hours are generally from 10 am to 3 pm Monday to Friday and from 9.30 am to 11.30 am on Saturdays.
Malaysia has a two tier system of healthcare. Overall, healthcare in the country, both in the public and the private sector, is of a high quality. Malaysia is a growing destination for medical tourism, such as for dental and optical treatments, and more private clinics have been springing up in recent years. Health in Malaysia is generally on a par with that in developed countries.
Public healthcare in Malaysia
Around 4.4% of Malaysia’s GDP is spent on healthcare, with a further 44% of costs being funded by patients making nominal out-of-pocket payments. However, healthcare coverage is not universal, and the standard of care may vary between urban and rural areas. Moreover, although healthcare is subsidised, there is no national insurance scheme per se. A national plan, 1Care for 1Malaysia, was proposed in 2009, relating to overhauling the system. It was based on the principle ‘use according to need; pay according to ability.’ However, implementation of this has so far been slow to non-existent.
In 2011, the Malaysian government introduced the Foreign Worker Hospitalisation and Surgical Insurance Scheme (FWHS or SKHPPA). This is a compulsory scheme run by the Ministry of Health & Immigration Department for expat workers, to protect them in cases of illness or accident. However, as an expat, this will be your only provision, if you are indeed eligible, and it will not cover your dependants. Malaysia does not currently have reciprocal healthcare agreements with other countries.
You can access the public healthcare system either by paying out of pocket, or by making a claim using your private health insurance. As is often the case, public hospitals cost less than hospitals in the private sector. However, you may find yourself battling with long waiting times and overcrowding.
The World Health Organisation (WHO) reports that life expectancy in Malaysia is around 73 years for men and 77 for women. This is good compared to neighbouring Indonesia, but not so good when compared to Singapore, where the average life expectancy is 82 years. Infant mortality is relatively low.
Heart disease is the main cause of death among the Malaysian population, followed by communicable diseases, such as flu, pneumonia and HIV. Residents in lower economic brackets also suffer from diabetes, hypertension, and high cholesterol levels.
The National Health and Morbidity Survey (2015) for non-communicable diseases (NCDs) reports that 30% of the Malaysian population were hypertensive and 3.5 million had diabetes, while 47.7% had a high cholesterol level. The level of NCDs and the lack of awareness about them is held by medical authorities to be the reason for the longevity plateau.
Malaysia’s public healthcare system is a victim of its own success. A rapidly ageing population, which is also growing, means that the public system has been placed under strain. Malaysian citizens, as in other countries, are living longer, and they are requiring more treatments as they get older. This results in a burden on public healthcare.
Costs have been rising in both healthcare sectors, and a ‘bundle’ system has been suggested to deal with the treatment cycle. This would group illnesses into different ‘bundles’, in order to control and separate the costs between common and uncommon illnesses. It entails that specific insurance coverage – such as critical illness insurance – may be needed.
Personnel are highly trained both in the private and the public sector, and many medics have trained abroad, such as in Australia or the US. You will find that the standard of English among medical personnel in Malaysia is high. The standard of hospital equipment is also very good. However, many doctors have left the public sector to work privately, which naturally has had an impact upon public services.
Provision of basic primary care in rural areas has proved effective in improving public health generally, and the Malaysian government has also set up healthy lifestyle campaigns, immunisation programmes, disease prevention and control programmes, environmental health care and hygiene, school health services, nutrition, and occupational safety and health programmes.
Private healthcare in Malaysia
The Health Care Facilities Act of 1998 stipulates that all healthcare providers in the country must be licensed. The Association of Private Hospitals in Malaysia insists on a high standard, and a large number of Malaysian hospitals have both national and international accreditation.
Medical tourism is on the rise. Malaysia’s Healthcare Travel Council (MHTC) recorded in the region of one million healthcare tourists per annum, who contribute around RM1 billion in hospital revenue. The MHTC has stated that they aim to achieve RM1.3 billion in revenue by the 2020s, and they plan to contribute approximately RM5 billion to the nation’s GDP through other sources of medical travel revenue, including:
• Hospitality services
The most popular treatments are:
• Fertility treatments
• Cosmetic surgery
• Rehabilitation services
They have registered tourists coming from Indonesia, India, China, Japan, the United Kingdom (UK), Australia, and the Middle East. They have selected 35 private hospitals to promote medical tourism in Malaysia, and the Malaysian Ministry of Health has also launched a website in support. Wellness centres, in addition to hospitals, are also likely to be promoted in medical tourism packages.
Malaysia was awarded ‘Best Country in the World for Healthcare’ by IL’s Global Retirement Index for three consecutive years, from 2015 to 2017. The country was also designated the Medical Travel Destination of the Year by the International Medical Travel Journal at the Medical Travel Awards for two consecutive years (2015 and 2016).
Malaysia has its own national accreditation programme: Malaysia Quality in Healthcare (MSQH), which is independent and not-for-profit.
Medical costs in Malaysia are low in comparison to those in Western nations, and so are hotel costs – this is an important factor to consider, as you may need to stay in the country for several days or longer, depending on the type of treatment you have and the number of follow up appointments you need.
A visit to a private GP can cost around US$5, while a consultation with a specialist can cost in the region of US$30. An increasing number of travel agents are offering packages that include medical treatment, accommodation, and other elements of a medical holiday. You can visit the country on a tourist visa, as medical tourists do not currently need a special visa.
As an expat living in Malaysia, your eligibility for national insurance coverage will be limited. However, your employer may sign you up with a private healthcare package, or you may take out comprehensive private cover elsewhere. Either way, it is advisable to make sure that your insurance at least partly covers the cost of prescriptions, particularly if you have a chronic condition requiring extensive repeat medication. However, if you would prefer to pay out of pocket, then this is also an option.
What is available?
Be aware that there are restrictions on bringing some forms of medication into Malaysia. Pharmaceutical products, including vitamins and health supplements, are controlled under several different types of legislation. Only those products that are registered with the Drug Control Authority and the Ministry of Health Malaysia (MOH), as well as cosmetics that are registered with the MOH, are allowed to be imported. Importing must be done by a licensed importer. The government has a ‘products search’ webpage, which lists restricted substances. Penalties for violation of this are strict and can involve fines or even imprisonment.
International visitors – including yourself, as an expat – are allowed to bring in medicines for personal use based on the legislation above. Anyone coming into the country is allowed to carry medication with them for their own personal use or for the use of an immediate family member who is travelling with them. However, you will only be allowed to bring in one month’s supply.
Prescription medicines that contain dangerous drugs (such as cannabis or narcotic based medication) that may be subject to ‘abuse, misuse or dependence’ need to be declared at the border on arrival. If you are unsure whether this applies to your medication, you should bring with you your prescription and a letter in English from your doctor. This should outline the name of the medicine and the dosage, as well the quantity you are bringing with you.
You should keep the dispensing label and the original packaging of your medication. If you are going to be living and working in Malaysia, then you will need to register with your local GP in order to continue with prescriptions.
Pharmacists need to have a degree, and they must be registered yearly with the Pharmacy Board of the Ministry of Health. Malaysia also has a governing body in the form of the Malaysian Pharmaceutical Society (MPS). There are around 7000 pharmacists in the public sector, and there are roughly 5000 pharmacists in the private sector.
The Malaysian government is attempting to give community pharmacies wider dispensing powers in a number of initiatives designed to improve public health. Currently, there is a perception that community pharmacists are just ‘medicine sellers’, and this, the health authorities say, needs to change, in order to streamline healthcare provision.
The Malaysia Retailers Association says that pharmacies have been enjoying substantial growth in recent years, and the pharmacy and personal care sectors forecasted a growth of 12.7% in the first quarter of 2019, up from the four preceding quarters. Big chains say that they are actively seeking to buy up smaller companies, as the market is set to expand.
How much do prescriptions cost?
Malaysia ranked 48th out of 50 countries, i.e. third cheapest, for its prices of generic medicines treating conditions like heart disease, asthma, and high blood pressure. The prices of originator and generic drugs combined is 90.8% lower in Malaysia than the global median prices. However, a few drugs cost more in Malaysia than in Thailand and Indonesia.
How to get the care you need
Although there are still not enough pharmacists per capita in Malaysia, you should have few problems in accessing the care that you need in urban areas. The number of pharmacies has been increasing in recent years. Malaysia has a number of big pharmaceutical chains, including those within retail stores. Some, like Watsons, have more than 400 stores across the country and offer vouchers and a point collection system.
Guardian, which has been in operation for decades, also has around 400 outlets, as well as over 90 licensed pharmacists, who are registered with the Pharmacy Board of Malaysia. Other pharmacies, like the Health Lane Family Pharmacy, Caring Pharmacy, and Big Pharmacy, have also been established for a long time.
Authorities are concerned about the selling of illegal medicines online, which pose a threat not only to community pharmacies but also to public health. However, there is a growing number of delivery systems. Some are run by the pharmacies themselves, but others are run by start-ups, such as Esyms, an online platform that delivers medication from a range of pharmacies across the Klang Valley. It has recently extended its partnership to over 350 pharmacies and 80 health service providers, and it serves 33 corporate clients, in addition to several thousand individuals.
Expats report that medication, whether prescription or over the counter, is relatively cheap, particularly when compared to prices in Western nations. However, do take care that you source your over the counter meds from a legitimate pharmacy, such as one of the above chains or your local family-run business.
Malaysia has over 100 hospitals that can provide maternity care, and around 40 of these have specialist Ob/Gyn services. Healthcare in the country is generally of a good standard, although overcrowding has been reported in the public sector.If you are an expat in the country and are expecting a baby, then you may wish to consider giving birth in the private sector. This is because the limited national insurance schemes available, even if they are open to you as an expat, do not cover maternity care.
However, if you would like to use the public scheme, then you can either pay out of pocket or charge your private insurer for the costs. We will look at some of your options below.
How to decide on a birth plan
A birth plan is a list of what you would like to have happen during labour and afterwards. It is written so that your doctor knows what your wishes and expectations are. When writing your birth plan, you may want to consider the following questions:
• Where do you want to give birth?
• Who do you want to have with you (e.g. your partner)?
• What kind of birth do you want (e.g. vaginal birth or a Caesarian)?
• Do you need any birthing aids?
• Do you want pain relief, and if so, what kind?
• What kind of birthing environment would you prefer?
Maternity care in Malaysia tends traditionally to be consultant-led and hospital-based, but more options are now opening up to women, including home births, births at alternative maternity centres, hypnobirthing and water birthing. For example, Pantai Hospital, with branches in Bangsar and Cheras, offers water births.
You can also contact a doula. She will not be able to carry out medical procedures, but she will be able to help you with your birth plan and provide support for you during the process of labour.
Active birth, in which you move around during labour and adopt different positions, is also becoming increasingly popular in Malaysia. Again, your midwife or doula will be able to advise you.
Epidurals are available in some hospitals but not all. An assessment in 2015 suggested that around 36 maternity units had provision for this form of pain relief. Make sure that you discuss this aspect of your birth plan with your medical provider.
If you would like a home birth, be aware that, among Malaysian locals, most home births are unassisted if they are low risk. This may not be something that you are comfortable with. In saying this, there is the option of having medical professionals with you, too. Unassisted birthing is a controversial practice due to the risks involved.
You can also choose a traditional practice, such as ‘lotus birth’, in which the umbilical cord is not cut, but instead allowed to dry. Such practices may not be your choice, but they are available.
Malaysian maternity care
Prenatal care is available in Malaysia, and you should be offered routine checkups at your local clinic. These will be monthly and then biweekly during your pregnancy. Some hospitals, such as the Pantai chain, offer prenatal classes, including:
• Understanding labour and the delivery process
• Relaxation and breathing techniques
• Basics of infant care
• Preparation for breastfeeding
• Prenatal fitness
You will be offered blood tests for anaemia and other conditions, and ultrasound scans will also be available. Your doctor will issue you with a medical booklet. You will need to inform your employer as soon as your pregnancy has been confirmed.
If you want a C-section, you will need to discuss this with your gynecologist, as this is only available in hospitals in Malaysia, rather than in birth centres. If you would like your partner in the labour room with you, then you will need to check whether this is possible with the hospital. Some Malaysian hospitals offer giveaways after the birth, such as motherhood kits and breast pads.
Some average costs are as follows:
• Monthly checkups: free (public sector); RM 3,000 / US$ 675 (private sector)
• Tests/scans: free (public sector); RM 1,000 / US$ 224 (private sector)
• Normal delivery: RM 60 to RM 2000 / US$ 13 to US$ 450 (public); RM 3000 to RM 10,000 / US$ 675 to US$ 2250 (private)
• C-section: RM 100 to RM 800 / US$ 22 to US$ 180 (public); RM 6,000 to RM 15,000 / US$ 1349 to US$ 3375 (private)
• Subsequent vaccinations: RM 70 to RM 150 / US$ 15 to US$ 30
There is quite extensive post-natal care available, particularly for high risk mothers (e.g. those suffering from high blood pressure or heart disease). The Malaysian authorities say that every hospital birth, alternative maternity center (ABC), or home birth should be notified to a nurse at a nearby health clinic, so that postnatal care can be provided to you at home. You will need to take your baby into the local clinic for a full range of vaccinations, such as hepatitis and diphtheria.
One to three months is considered a normal confinement (at home) for mothers in Malaysia.
Most local insurers that cover maternity benefits only give a small lump sum for delivery or will only pay out if there are complications. Some companies will pay out maternity benefits, but this, and maternity leave, will need to be negotiated privately with your employer. However, in general, if you have worked for your employer for at least 90 days in the four months before starting maternity leave, you will then be entitled to at least 60 consecutive days of maternity leave at full pay. You may be eligible for more leave if you are working for an international company, but check this with your employer. You may also have to negotiate time off for your ante-natal appointments.
The Malay press reports that there is a growing demand for Full Paying Patient (FPP) services that provide private healthcare in government hospitals. Klinik Kesihatan Ibu & Anak, an initiative by the government, provides free checkups and anti-tetanus injections for the expectant mother, but you may find queues or lengthy appointment times.
Will the baby be a Malaysian citizen?
Your child will not be Malaysian simply because they have been born in Malaysia, and Malaysia does not allow dual citizenship.
Malaysia is currently a destination for medical tourism, and you can find a high standard of healthcare in its private sector. Government-sponsored healthcare is also deemed to be of a good quality there.As an expat, your options for accessing government-sponsored healthcare under national health insurance will be limited, since Malaysia does not run such a scheme for expats. However, if you would like to use the public sector, then you can pay for this out of pocket. You will find that costs are significantly less than in the US.
You may wish to take out private insurance during your stay in Malaysia, either as an alternative to using public healthcare or as a top up.
How does the Malaysian state health insurance system work?
The Malaysian government heavily subsidises healthcare, which is paid for out of taxation. It is not a universal system, however, and Malaysia does not have a national health insurance scheme as such. A national plan, 1Care for 1Malaysia, was proposed in 2009 relating to overhauling the system. It was based on the principle ‘use according to need; pay according to ability.’ However, implementation of this has so far been slow to non-existent.
In 2011, the Malaysian government introduced the Foreign Worker Hospitalisation and Surgical Insurance Scheme (FWHS or SKHPPA), a compulsory scheme run by the Ministry of Health & Immigration Department to protect overseas workers in case of illness or accident. If you are entitled to register with this scheme, you will have a choice of insurance providers, as a number of them are contracted to it.
How to register
As an expat, you will only be eligible for the Foreign Worker Hospitalisation and Surgical Insurance Scheme (FWHS). Malaysia currently does not have any reciprocal healthcare agreements with other nations. Your employer should register you with the FWHS, but check that this has been done.
Under the FWHS, you will be covered for a fixed amount of care in public sector hospitals. Treatment will be free at delivery, and your coverage will entitle you to a third class room, plus board for up to 30 days (15 days in an ICU), as well as some inpatient medical consultations and care. You will also be entitled to free at delivery treatment in public hospitals in the case of an emergency.
If you are a retired expat or an international student, you will need to take out private cover. You will also need to take out private cover for your dependants, as the FWHS will not cover them.
You will be allowed to access the public healthcare system if you pay, but note that you will be charged more than Malaysians are.
In order to find your local GP, check online, or ask local colleagues or friends. Medical practitioners are required to be registered with the Malaysian Medical Council, so if you check with them you will be able to see if your local practice is accredited. Once you have located a practice, you can visit them and sign up.
Private health insurance in Malaysia
Because of the restrictions on the public healthcare scheme, most expats take out private health insurance to cover them during their stay in the country. The country is a destination for medical tourism, and private healthcare is of a high standard, so you should have no difficulty in finding a clinic. You can also ask for a list of these from your international health insurance company or your local embassy. You may additionally like to ask friends or colleagues whether they can recommend any good private providers.
When registering with a private healthcare provider, check the terms and conditions. For example, make sure they accept your insurance, and have a look at what form of payment they prefer. Do not be shy of asking for references or proof of accreditation.
Malaysia does not run a national health insurance scheme, as such, for expats, so you will have three options. You can access public healthcare, which you can pay for either out of pocket or through your existing international health insurance; you can use private clinics, which you can again pay for either out of pocket or through international insurance cover; or you can employ a combination of both, using your private insurance as a top-up. We will consider your choices in more detail below.
Personalising your health insurance cover
In 2011, the Malaysian government introduced the Foreign Worker Hospitalisation and Surgical Insurance Scheme (FWHS or SKHPPA). This is a compulsory scheme run by the Ministry of Health & Immigration Department to protect overseas workers if they become ill or have an accident. You will have a choice of insurance providers, as a number of them are contracted to the government scheme. However, the scheme is limited in scope and will not cover your dependants.
You may wish to check with your employer whether you are covered under a group health insurance package. This will be a private scheme, but is worth considering depending on what is covered.
Your other option is to pay out of pocket expenses. This is worthwhile if you have only minor medical issues, as costs in Malaysia are substantially lower than in other countries, such as the USA. However, costs can escalate rapidly if you have a chronic condition or need to see a specialist, or if you have to spend a night or more in hospital. Most expats resident in the country take out private cover.
Check the small print of any private health insurance policy you are interested in to see whether it covers treatments that you may want to access, such as specialist surgical treatment or more advanced dental care, such as crowns or dental implants.
Remember to check whether your potential policy covers pre-existing conditions. The definition of this will vary between insurers. Usually the term applies to any conditions that present symptoms or for which you’ve been treated in the last five years. This normally includes any conditions you were diagnosed with over five years ago, but some insurers have different time limits for when the diagnosis must have been given.
You may also want to check whether your policy has a ‘hospitalisation’ clause covering you for occasional hospital visits. You may need to discuss this directly with your insurer. You may also wish to check whether there is a medical evacuation clause. Some expats choose to seek treatment in Singapore, which is relatively close, as private medicine there is of a world-class standard.
Take a good look at any potential policy for any cover relating to healthcare that does not apply to you. Some policies have provision for maternity care, for instance, and if you are not intending to become pregnant then you may wish to reduce your policy costs by having such options removed.
You may also be able to reduce the cost of your premium through ‘cost sharing’. This is where you and your insurer share the costs of any treatment. You will pay up to an agreed limit, and your provider will cover the rest. Different insurers will have different ways of arranging cost sharing.
This is where you pay a fixed sum for your treatment and your insurer covers the rest. For instance, if the total cost of your treatment is €85, and your co-pay amount is set at €40, then you will pay €40 and your insurer will pay €45.
This is where you pay a fixed percentage of the total cost and your insurer covers the rest. For instance, if your coinsurance is set at 20%, you will pay 20% of €85 and your insurer will cover the remaining 80%.
This is where you pay the entire amount allowed for all services provided until the deductible is met. For instance, if your policy has a €1,000 annual deductible, you would pay €85 for each visit to your healthcare clinic and then, once you have had 11 such appointments (€1000/€85 = 11.8), your insurance will begin to pay out to the doctor directly.
You may also need to look at whether there is an out-of-pocket maximum that you would be expected to pay after your deductible has been met. Let’s say that your plan above, with a €1000 deductible, also has a co-insurance option of 20% and an out-of-pocket maximum of €1500. In this instance, you would pay €85 for 11 visits to the doctor under your deductible until it is met. You will then pay €17 for each visit as your 20% coinsurance, until you reach the co-insurance ceiling of €500 (€1500 minus the deductible of €1,000). At that point, you would pay nothing more for the remainder of the plan year.
It is worth doing the maths, especially if you don’t think that you’ll need to make more than a couple of visits to your GP in any one policy period. For example, if you just want dental check-ups with an occasional filling, it might be worth working out whether one or two out-of-pocket costs might be cheaper than full dental cover.
International private medical insurance
As so many variables have an effect on the cost of international private medical insurance, it is very difficult to give accurate estimates without knowing the full details of what coverage you require. However, as a very rough guide, using a standard profile of a 40-year-old British male with no deductibles, no co-insurance, a middle tier plan/product, all modules included and worldwide coverage excluding the US, a ballpark price of around £4,000/$5,000 might be expected. If you want your coverage to include the US, the premium could increase to almost double this amount.
It is not difficult to keep fit and well in Malaysia. From jungle trekking and trail hiking to cycling and watersports, there are many forms of exercise available. We will look at some of your options below.If you are living in Malaysia, it would be a shame not to make the most of the country’s unique landscape. For example, you could go trekking in the rainforest or jungle. Most trekking activity is done with experienced guides and is based around national parks and forest reserves. Hiking in places such as the Cameron Highlands is a popular activity. You can follow trails up into the mountains or through tea plantations. Templer Park in Selangor also offers some mixed trails, some of which take you past beautiful waterfalls.
Some of these hikes are relatively easy, whereas some are more challenging, so gauge your level of fitness carefully and choose appropriate walks. Even up in the hills, the tropical Malaysian climate can be very warm, and you do not want to risk sunstroke or overheating. Make sure you take a hat and some water with you, and check that it is possible to buy food on your chosen trail – some parks do not have extensive food outlets. Avoid jungle trekking at night, and take a lightweight waterproof jacket. Hiking shoes and/or trekking sandals are advised. It is also a good idea to take a swimsuit with you.
Cycling is also popular in Malaysia, and there are cycle routes across the country, including in Borneo and the Cameron Highlands, where there are some routes for dedicated mountain bikers. Cities like Kuala Lumpur also have cycle routes. If you intend to go cycling, make sure you check the weather first; Malaysia is prone to daily tropical storms, so you may need a light waterproof. Roads are generally considered to be of a good quality.
If you are trekking or cycling during Ramadan (Malaysia is a Muslim country), you may experience difficulties getting served during fasting hours, but travellers report relatively few problems. There are sometimes Chinese-run places that you can eat at, as they do not follow Islamic beliefs.
Since Malaysia has such an extensive coastline, you will find a range of watersports in Malaysian resorts, including:
• Scuba diving
• Jet skiing
You can go white water rafting in Sabah and other areas. Some of the islands, such as Sipadan, have a rich biodiversity and are fascinating places to visit. If sailing is your thing, the island peninsula of Langkawi has hosted the world sailing competition of the Monsoon Cup.
In addition to this, team sports are popular in Malaysia, including:
• Field hockey
• Rugby union
• Mixed martial arts
Football and cricket are the most popular, and you may be able to find amateur teams for expats in your community. You might even like to try the national sport of Malaysia, Sepak Takraw, in which the players must kick a takraw (hollow ball) over a net. Sepak Takraw resembles volleyball and badminton, but you are not allowed to use your hands.
You can also go horse riding in Malaysia, and there are a number of horse riding tours across the country that you can sign up for. The Selangor Turf Club offers riding lessons and livery services, plus dressage and carriage riding.
Running in Malaysia is also a popular pastime, but bear in mind that there are some guidelines that ideally you should follow:
• Run early in the morning, before the full heat of the day, or in the evening
• Wear light-reflective clothing (not black)
• Make sure you are hydrated, and if necessary take electrolyte tablets
• Take small amounts of cash with you, but be aware that some runners and pedestrians in Kuala Lumpur have been targeted by muggers, so do not take too many valuables with you; you might like to stick to well lit areas or run in a group
• Make sure you take time to adjust to the humidity
Malaysia also has plenty of gyms. Urban areas, such as Kuala Lumpur and Penang, have a plethora of gyms, many of which are air conditioned, well equipped and with English-speakers. Expats report that their daily rates can be quite high, from RM50 to RM70 (US$11 to US$15), although some will offer an occasional free pass. More basic gyms can be found as well, and these are much cheaper: around US$1 per visit.
It is possible to have a healthy diet in Malaysia. National dishes, such as nasi kerabu (‘blue rice’, which usually has half the calories of the higher fat nasi lemak) and thosai (flatbread, which includes rice, fenugreek seeds and split black lentils) can be healthier options than some of the high-fat choices on the menu. In the same way, seaweed spring rolls will be better for you than deep fried popiah.
Make sure you take responsibility for your own health in Malaysia, and sign up with your local GP and dental clinic (you will not be eligible for national health insurance, so you will need to take out private cover or pay out of pocket).
Malaysia has a good healthcare system, but you should make sure that you are aware of any local issues, such as hotspots of dengue fever or outbreaks of zika virus. Check country-specific health advice before you travel, and ensure that you are up to date with the latest health advice. If you suffer from a chronic condition, such as asthma, or have respiratory issues, make sure that you have sufficient medication for your trip. Also, be aware that the smoke from forest fires over the sea in Indonesia can cause air quality problems.
Make sure that you safeguard your mental health, too. Get plenty of exercise; eat healthily; and take care not to become too isolated from family or friends. Remember that there are many ways to keep in touch digitally, as well as in person, if you are feeling lonely.