Frequently Asked Questions
Skim Perubatan MADANI
General Information
Skim Perubatan MADANI is a pilot initiative by the Government of Malaysia through the Ministry of Health (MOH) that is implemented to accommodate the health needs of the B40 group for Acute Primary Care Services.
Objectives of Skim Perubatan MADANI are:
- To increase the low-income group’s access to acute primary care services at private sector and improve the welfare and enhance the well-being of rakyat.
- To increase participation of General Practitioners in acute care at primary level, through Public-Private Partnership.
The benefit is eligible beneficiary could receive Acute Primary Care services for FREE at empanelled General Practitioners under Skim Perubatan MADANI. List of GPs can be found here: https://kelayakan-spm.protecthealth.com.my/find-clinics
Rahmah Cash Contribution (STR) recipients who are family, elderly (without a spouse), and singles. Eligible beneficiaries should make a declaration that they are not receiving any benefit equal or similar to this Scheme from any other employer/state government/medical agency scheme such as Iltizam Selangor Sihat, Perak Prihatin and others.
Eligibility checking can be done via Skim Perubatan MADANI website: https://protecthealth.com.my/skimperubatanmadani, MySejahtera or Skim Perubatan MADANI mobile applications. Eligibility is AUTOMATIC during visit to the empanelled GP under this Scheme. Eligible beneficiary only has to present identification card (IC) to check for eligibility.
Three (3) cumulative benefit entitlement by category for Skim Perubatan MADANI are:
- Family Household – RM250
- Senior citizens (without spouse) – RM125
- Singles – RM75
Each household, senior citizen (without spouse), or single individual can receive complete single visit treatment, within the limits for every visit, until the beneficiary fully utilise the above cumulative amount. Please note that this allocation limit may be subject to change in future years depending on Government policies or programs. The benefits of the Skim Perubatan MADANI are subject to the Terms & Conditions provided by ProtectHealth Corporation Sdn. Bhd. as stated on our website.
Skim Perubatan MADANI focuses on 10 districts namely:
- W.P. Kuala Lumpur
- Gombak, Selangor
- Hulu Langat, Selangor
- Petaling, Selangor
- Klang, Selangor
- Johor Bahru, Johor
- Kinta, Perak
- Timur Laut, Pulau Pinang
- Kota Kinabalu, Sabah
- Kuching, Sarawak
List of GPs can be found here: https://kelayakan-spm.protecthealth.com.my/find-clinics
No payment will and shall be charged to beneficairy by any parties involved for any treatment, procedure, and medications under Skim Perubatan MADANI for any treatment, procedure, and medications. If any complaints to be made, kindly send us an email at: [email protected] or contact +603-8687 2525.
High health care cost is causing serious impact to financial status of the B40 group. Therefore, to avoid this group from continuously burdened from accessing primary acute treatment service, this Scheme is created by the Government through Ministry of Health. If any complaints to be made, kindly send us an email at: [email protected] or contact +603-8687 2525.
1) Message/SMS will be sent to the registered mobile phone number after treatment visit.
2) The entitlement balance can be checked through the GP during treatment visit.
3) Can make a call to +603-8687 2525.
Skim Perubatan MADANI Benefit Package
Treatments that are not included are:
- Routine Vaccination;
- Health screening
- Routine NCD Follow-ups;
- Routine Perinatal Follow-ups;
- Family Planning;
- Rehabilitation Request;
- Medicines without doctor’s consultation; and
- Supplements Request
Treatment of Acute Primary Care Services inclusive:
- Cough and Cold
- Diarrhoea and Vomiting
- Sprains and Strains
- Headache
- Mild Trauma, such as Superficial Wounds & Others
Yes, The Skim Perubatan MADANI Benefit package includes consultation, a selection of medications, treatment procedures, and tests that can be provided at private clinics. The maximum treatment limits that the Government pays to private clinics for each visit are as follows:
- The combined limit of consultation and medications is RM70(including consultation fee up to RM35)
- The limit for tests is RM50,
- The limit for treatment procedures is RM50.
This means that the maximum total limit for each visit paid by the Government is RM170.
GPs is prohibited from imposing additional charges to Skim Perubatan MADANI beneficiary.
Can, as long as the GP is empanelled under the Scheme. Beneficiaries can check the list of empanelled clinics in our website or identify through Skim Perubatan MADANI Glass sticker.
General Practitioner
- Sign in/Register: Visit ProtectHealth website https://primis-provider10.protecthealth.com.my/register for empanelment & upload required documents in the PRIMIS Provider Portal.
- Letter of Appointment: Once application is approved, GP will receive a notification email to download the Letter of Appointment (LOA) from PRIMIS.
Note: GP can access to the dashboard of PRIMIS Provider Portal- <Provider Resources> for List of Services and Fee Schedule - Upload signed LOA: GP needs to upload the signed LOA into PRIMIS for ProtectHealth’s verification.
- Successful Registration: Once verified, GP will be notified of successful registration as SKIM Perubatan MADANI Panel GP.
- Onboarding Assessment: GP needs to complete and pass the Online Onboarding Assessment at PRIMIS.
Note: 10 questions. Allow multiple attempts until 80% passing mark. - Status becomes “Active”: GP now can access PRIMIS Clinical Portal. Ready for service provision once program starts.
If our existing provider has both BMS and VCS account credentials, either one of the account can be used to empanel for the program. However, we encourage the use of your VCS account to empanel for Skim Perubatan MADANI.
Can.
The payment mechanism used in this scheme is Fee-for-service. Panel GP will be reimbursed according to the services rendered to the beneficiary. Please find the full list of services and the respective fee in the Skim Perubatan MADANI List of Services & Fee Schedule in PRIMIS Provider Portal.
It will be a FREE web-based digital system called PRIMIS (Primary Care Information System) that will be monitored and managed by ProtectHealth Corporation Sdn. Bhd.
- Clinics must be registered as ‘General Private Medical Clinic.’
- Clinics registered as ‘Specialist Private Clinic’ are not included in this pilot project.
- Clinics must be equipped with a telephone line, Internet access, computer and printer.
- For any additional services (e.g.: Xray services), clinics are required to declare and upload relevant document during registration in the system.
- Clinic registration must be made in the name of the “Person in charge” as stated in the Borang B / Borang F (Certificate of Registration of Clinic). Documents that need to be uploaded are:
- Certificate of registration to operate private medical clinic (Borang B or Borang F)
- MMC full registration certificate of Person in Charge
- Current annual practising certificate (APC) of Person in charge
- Proof of Bank Account (which contains Clinic/Company name as per in Borang B/F)
- Personal Bank account is NOT ACCEPTED.
- Clinics with X-Ray Service are required to upload:
- License of Tenaga Atom (within validity period)
Disclaimer:
Should there be any information or declaration provided herein found to be false or inaccurate, ProtectHealth reserves the right to terminate your appointment.
PeKa B40
General Information
- Skim Peduli Kesihatan for the B40 group (PeKa B40) is a Government initiative via the Ministry of Health which aims to sustain the healthcare needs of low income groups by focusing on non-communicable diseases (NCD).
- PeKa B40 is offered to Malaysian citizens in the bottom 40% household income range, also known as the B40 group.
- Recipients of the Sumbangan Tunai Rahmah (STR) and their spouses aged 40 and above are automatically eligible for PeKa B40. No special registration is required to join PeKa B40
PeKa B40 aims to improve access to healthcare services, alleviate the cost of living, and enhance the wellbeing of the people. This initiative places special emphasis on non-communicable diseases and focuses on enhancing the cooperation between the public and private sectors, particularly at the level of primary healthcare.
- Health Screening
- Health Aid
- Completing Cancer Treatment Incentive
- Transport Incentive
Offered to Malaysian citizens in the bottom 40% household income range, known as the B40 group. Criteria for eligibility is as follows:
- Sumbangan Tunai Rahmah (STR) and their registered spouses.
- Aged 40 and above.
Recipients of Sumbangan Tunai Rahmah (STR) and their spouses aged 40 and above may check their eligibility status here by typing their MyKad number and a combination of other information.
No. No charges will be imposed. All benefits of PeKa B40 are given free of charge.
- PeKa B40 began as a pioneer project and is carried out in stages.
- More members of the B40 group suffer from non-communicable diseases than those in other groups (M40 & T20).
- Those in the over 40 category also have a greater burden of NCDs. Such diseases amongst this group are also more likely to have not been detected or poorly controlled..
- It will also be expanded to include other groups, subject to effectiveness of this program and Government funding.
- Patient must be a recipient of Sumbangan Tunai Rahmah (STR) (or his/ her spouse) and aged 40 and above.
- Has undergone Health Screening (Benefit 1); and
- All applications must be made via MOH hospitals only.
Benefit 1 : Health Screening
- Simply bring your MyKad along.
- No early registration required.
- No charges imposed.
- No fasting required
- No. Screening may only be performed once for eligible recipients, as long as there are sufficient funds.
- After undergoing screening during the first visit at the clinic, recipients’ information would have been recorded, and blood and urine specimens sent to private laboratories for the required testing.
- Should a PeKa B40 recipient attend another clinic for a repeat screening, the process will not progress.
- Any private clinic that is registered with PeKa B40 and has the PeKa B40 sticker displayed on their front door.
- The list of Peka B40 clinics may be obtained here.
- Most services in Government clinics provided by doctors on duty.
- Medical checkup:
- Medical history taking, noting of individual and family illnesses, including risk factors
- Mental health screening
- Physical examination
- Clinical breast examination for female recipients, and clinical prostate examination for male recipients who are at risk
- Laboratory tests:
- Blood test
- Blood sugar control test
- Cholesterol level test
- Urine test
- Kidney function test
- Benefit recipients will not be charged for any of the Health Screenings mentioned above.
- Recipients who have undergone Health Screening may have already been given a date for their second visit. If that is not the case, the doctor/ clinic will contact the recipient via telephone, short messaging system (SMS) or WhatsApp to arrange an appointment for the second visit.
- Should further treatment or examination be required, private doctors will refer recipients to the relevant or nearby government clinics (Klinik Kesihatan) or MOH Hospitals. A PeKa B40 referral letter will be issued by the private clinics to be brought to the MOH facilities.
Benefit 2 : Health Aid
- Application for Medical Equipment Assistance must be made via the Medical Social Work Department at Ministry of Health hospitals only.
- The Medical Officer or specialist treating the Peka B40 recipient will make the referral to a Medical Social Work Officer for the application process.
- The Medical Officer or specialist will also determine what type of medical equipments are required.
- There are 10 categories of Health Aid offered based on the confirmation by specialists at MOH Hospitals:
- Artificial joint equipment
- Hearing aid devices
- Heart pacemakers
- Prostheses and implants for the spine
- Prostheses and orthoses for the limb bones
- Intraocular lenses
- Breathing therapy equipment and oxygen concentrator
- Nutritional support assistance
- Wheelchairs
- The maximum Health Aid that can be funded by PeKa B40 is RM20,000. It is also subject to the price range of equipment in each category.
For as long as PeKa B40 is carried out by the Government, recipients may apply for a variety of medical equipment on the list, provided there is still money left from the RM20,000 allocation. For example, a recipient who has already received intraocular lenses can still apply for a pacemaker at a different time.
Only Sumbangan Tunai Rahmah (STR) recipients and their spouses who are registered, aged 40 and above are eligible for PeKa B40. Each person is entitled to a maximum of RM20,000 in financial assistance. This sum cannot be extended to other family members.
Benefit 3 : Completing Cancer Treatment Incentive
- The amount of the incentive is RM1,000, given to encourage patients to complete their curative treatments at MOH Hospitals as recommended by their treating doctors.
- Benefit 3 does not include traditional or alternative treatments.
- It will be given in two (2) stages.
- First stage – RM300, when the application is received from the MOH Hospital according to the correct procedure and will be credited directly into recipient’s accounts in the same manner as the Sumbangan Tunai Rahmah (STR).
- Second stage – RM700, once the recipient has completed his or her treatment plan as recommended by the treating doctor. This will also be credited directly into recipients’ accounts.
If the PeKa B40 recipient suffers from cancer and is still undergoing treatment, the treating doctor or specialist will make the application on behalf of said recipient.
- This incentive was developed to encourage cancer patients to complete their treatment. The condition for receiving the second incentive is that the patient must comply with the doctor’s treatment plan and complete it with no misses.
- The incentive will be given subject to confirmation by the treating doctor or specialist based on their expertise in determining the level of completion of treatment.
- This incentive will only be given to recipients who are still alive and cannot be claimed by relatives.
Yes. Recipients of PeKa B40 who are undergoing cancer treatment are eligible for this benefit. However, health screening is still compulsory, and/ or the results must be uploaded to the PeKa B40 database. If the health screening has not yet been done, doctors or specialists from hospitals will counsel patients on how to get it done.
Benefit 4 : Transport Incentive
The transport cost incentive will cover the journey to and from cancer treatment (Benefit 3) as well as treatments involving utilisation/ insertion medical devices (Benefit 2) at MOH Hospitals according to set appointment dates.
- The value of the incentive depends on the distance from the patient’s residence to the hospital.
- It is credited into the recipient’s account for each journey to and from the hospital, not exceeding the limit of RM500 for Peninsular Malaysia and RM1,000 for Sabah/ Sarawak/ Labuan.
- For recipients of Benefit 2, i.e. Medical Equipment Assistance, application may be made via Medical Social Work Officers.
- For recipients of Benefit 3, i.e. Incentive for Completing Cancer Treatment, application may be made via the treating doctor at MOH hospitals.
This incentive is provided to encourage patients to come to hospital to receive and complete their treatment. If a patient does not attend treatment sessions, he or she will not be given the incentive.
Yes, this incentive is counted and is given as financial assistance for the return journey, i.e. to and from the hospital, according to set rates and conditions for PeKa B40.
- After the application for Transport Cost Incentive has been made by the Medical Social Work Officer or treating Medical Officer, the system will calculate the amount to be paid based on the distance that has been determined.
- Payment will be made directly into the account of the patient before the next follow-up treatment.
General Practitioners
- The payment to private practitioners is made according to Table 7 of the Private Healthcare Facilities and Services Act 1998, 2006 amendment that is in use nowadays.
- The private practitioner involved is not required to pay any registration fee.
- There is no splitting of fees for health screening services performed under PeKa B40.
- Laboratory tests have been predetermined and will be paid directly to the private laboratory. No payment or sharing of payment occurs between clinics and private laboratories.
- Interested private practitioners may register to participate in this scheme voluntarily (not mandatory).
Private medical practitioners may register online here.
Vaksin Covid
General Practitioner / Specialist Clinic
Registration can be done online via this website. Should there be any clarification required, General Practitioner / Specialist Clinic may email us at [email protected].
General Practitioner / Specialist Clinic registration takes place throughout the National COVID-19 Immunisation Program.
No participation fee.
Yes for vaccination at clinic and community outreach models.
For Pfizer vaccine, low dead volume syringe and vaccination card will be provided by MOH.
No. General Practitioner / Specialist Clinics need to provide their own PPE.
Yes. Further details will be informed soon.
The General Practitioner / Specialist Clinic will manage the vaccination through MyVAS, VMS and ProtectHealth VCS system.
For vaccination at clinic and community outreach models, the payment will be RM19 per dose administered.
Payment will be made by ProtectHealth.
Private Hospital / Ambulatory Care Centre
Registration can be done online via this website. Should there be any clarification required, you may email at us at [email protected].
Registration of Private Hospital / ACC take place throughout the National COVID-19 Immunisation Program.
No participation fee is required.
Yes, training will be provided prior to starting this program.
Yes, Private Hospital / ACC will be given access to IT system used in this programme which includes Malaysia Vaccine Administration System (MyVAS), Vaccine Management System (VMS) and ProtectHealth Vaksin Control System (VCS).
Payment will be made through ProtectHealth.
Healthcare Organisation (HCO)
Registration can be done online via this website. Should there be any clarification required, HCO may email us at [email protected].
HCO registration takes place throughout the National COVID-19 Immunisation Program.
No participation fee.
Yes for vaccination at clinic and community outreach models.
For Pfizer vaccine, low dead volume syringe and vaccination card will be provided by MOH.
No. HCOs need to provide their own PPE.
No. It needs to be provided by the HCO.
The HCO will manage the vaccination through MyVAS, VMS and ProtectHealth VCS system.
The payment will be RM19 per dose administered.
Payment will be made by ProtectHealth.
Non-Governmental Organisation (NGO)
Registration can be done online via this website. Should there be any clarification required, NGO may email us at [email protected].
NGO registration takes place throughout the National COVID-19 Immunisation Program.
No participation fee.
Yes for vaccination at clinic and community outreach models.
For Pfizer vaccine, low dead volume syringe and vaccination card will be provided by MOH.
No. NGOs need to provide their own PPE.
No. It needs to be provided by the NGO.
The NGO will manage the vaccination through MyVAS, VMS and ProtectHealth VCS system.
The payment will be RM19 per dose administered.
Payment will be made by ProtectHealth.