STARTS ON 15 JUNE 2023
Skim Perubatan MADANI
Free Treatment for Sumbangan Tunai Rahmah Recipients at Registered GP Clinics
Welcome GP Participation in Skim Perubatan MADANI
Skim Perubatan MADANI is a pilot initiative by the Government of Malaysia through the Ministry of Health that is implemented to accommodate the health needs of the B40 group for Acute Primary Care Services.
Sumbangan Tunai Rahmah (STR) recipients in the B40 group can seek treatment at private medical clinics (GP) registered under the Skim Perubatan MADANI.
Approximately 700,000 households will gain access to the Acute Primary Care Services when needed at GPs for free, which can reduce the burden of healthcare treatment costs whilst improving the well-being of low-income group.
Skim Perubatan MADANI focuses on partnership between the public and private sectors, especially in delivering Acute Primary Care Services.
Eligibility of Skim Perubatan MADANI
- Sumbangan Tunai Rahmah (STR) recipients who are family households, senior citizens (without spouse) and singles.
- Eligibility is automatic.
- Eligible beneficiaries MUST 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.
Treatment of Acute Primary Care Services inclusive:
- Cough and Cold
- Diarrhoea and Vomiting
- Sprains and Strains
- Headache
- Mild Trauma, such as Superficial Wounds & Others
Treatments that are not included are 1) Routine Vaccination; 2) Health screening; 3) Routine NCD Follow-ups; 4) Routine Perinatal Follow-ups; 5) Family Planning; 6) Rehabilitation Request 7) Medicines without doctor’s consultation; and 8) Supplements Request
Treatment Benefits of Skim Perubatan MADANI
Family Household
RM 250
* List of households registered with LHDN
Senior citizens
(without spouse)
RM 125
* Aged 60 years old and above
Singles
RM 75
* Singles aged between 21 - 59 years old
* Singles OKU aged between 19- 59 years old
Steps To Obtain Skim Perubatan MADANI Treatment
Step 1, Check Eligibility : Check your eligibility on the website or via MySejahtera application.
Step 2, Clinic Visit : Proceed to any GP registered with Skim Perubatan MADANI (which can be identified by the Skim Perubatan MADANI sticker) with your identification card/document.
Step 3, Receive Treatment: If you are eligible, you can receive Acute Primary Care Services for free.
Step 4, Balance of Benefit: The limit of your Skim Perubatan MADANI benefits will be deducted after each visit. The benefits of Skim Perubatan MADANI are subject to the Terms & Conditions by ProtectHealth Corporation Sdn. Bhd. as stated in our website.
Frequently Asked Questions
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 (until December 2023.):
- Family Household – RM250
- Senior citizens (without spouse) – RM125
- Singles – RM75
This allocation limit will be maintained until December 31, 2023. 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.