Medical or Travel Coverage
Medical or Travel Coverage
The regulation of medical reimbursements by the Federal Government to pensioners is subject to General Orders Chapter F, 1974, which stipulates that pensioners and eligible dependents may be given free medical services at Government hospitals and clinics. However, if Government hospitals or clinics are unable to supply the medical services needed, pensioners can go to private hospitals or clinics. The expenses incurred will be reimbursed by the Government, and are subject to compliance with the conditions and regulations as set out in Service Circular Number 21, Year 2009.
Eligible Recipients:
- Pensioners
- Pensioner’s Spouse
- Children*
*18 years and below; or under 21 years old who are still schooling; or disabled children due to mental or physical weakness (no age limit)
Application for Medicines, Medical Devices, Medical Services, & Treatment and Kidney Treatment
| Specialist Treatment Application Procedure | Terms of application |
|---|---|
| Procedure |
Application Procedure
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| Terms & Conditions |
Supply of Medicines Approval for medication expenses reimbursement is limited to prescriptions for three (3) months' consumptions only. Reimbursements for food supplements are strictly prohibited. |
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Medical Device
Reimbursement for expenses for medical device:
Application for expenses for supply / replacement / repair for cosmetic purposes is not allowed. Application for expenses for supply / replacement / repair for a purpose other than of treating the ailment is not allowed. Application for expenses for supply of disposable equipment is not allowed. |
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Medical Services
Reimbursement for expenses on medical services for Computed Tomography Scan (CT scan) and Magnetic Resonance Imaging (MRI) may be considered provided that a Government officer/physician has acknowledged and confirmed that government hospitals or clinics are unable to provide the required services. |
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Treatment of Kidney Disease
Reimbursement for haemodialysis and CAPD treatment expenses may be considered, subject to the condition that a Government's nephrologists has recommended such treatments and verified that such treatments is not supplied/provided by Government hospitals/ health clinics. Limited to medical expenses only, based on the actual expenditure and subject to a maximum of RM200.00 for each treatment session. |
Reimbursement for Other Medical Expenses
| Types of Treatment | Application Procedures for Specialist Treatment | Terms of Application |
|---|---|---|
| Specialist Treatment |
To receive treatment at Government hospitals or clinics; and
The required Specialist Treatment is unavailable at Government hospitals or clinics; and Confirmation by Government Medical Specialist; and:- Medical Form 1/09 with financial documents (bills, receipts, invoices, quotes, etc.) |
Cost incurred by the Government:
Costs incurred by pensioners:
|
| Emergency Treatment |
Emergency treatment at the closest private hospital or clinic as there is no hospital or clinic closer to the scene of the emergency; and
Immediate treatment is crucial as delay of treatment may lead to fatality (life- threatening); and Certification or validation of medical facility by private hospital or clinic physician; and Medical Form 2/09 with financial documents (bills, receipts, invoices, quotes, etc.). |
Immediate treatment in order to save a patient's life;
Certified by physician from private hospital / clinic that treats the patient. Cost incurred by the Government:
|
| Treatment at the National Heart Institute Sdn. Bhd (Institut Jantung Negara) |
Obtain treatment from Government or private hospital or clinic; and
Referred by General Physician/ Cardiologist at Government or private hospital / clinic to the National Heart Institute (IJN); and Medical Form 1/09 together with financial documents (bills, receipts, invoices, quotes, etc.) |
Patients have received treatment at the Government or private hospital / clinic; and
Referred by General Physician / Cardiologist at Government or private hospital / clinic to the National Heart Institute (IJN). |
| Infertility Treatment |
Obtain treatment from Government hospitals / clinics or Klinik Lembaga Penduduk & Pembangunan Keluarga Negara (LPPKN); and
Medical facilities cannot be supplied or provided by Government hospital or clinic or LPPKN; and Certification or validation of the needs for the medical facilities by a doctor or medical officer from the Government / LPPKN; and Medical Form 1/09 with financial documents (bills, receipts, invoices, quotes and etc.) |
To overcome the primary infertility only – first pregnancy and having difficulty in conceiving.
Not allowed: Unnatural Process of Pregnancy
|
| Treatment Abroad |
Obtain treatment from Government hospital; and
Special treatment needed by patient is not available within the country; and Approval by Medical Board; and Acknowledgement by the Director General of Health Malaysia that the treatment required is not being provided by any Government hospitals or clinic; and Form 3/09 needs to be submitted to the Remuneration Division of JPA with financial documents (bills, receipts, invoices, quotes, etc.); and Application is being approved by the Cabinet Officer (Jemaah Pegawai) for Abroad Treatment Abroad |
Reimbursement for expenses on companion can be considered subject to the recommendation of Medical Board.
Costs incurred by the Government: The cost of treatment:
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Financing Services for Medication and Medical Equipment Supplies to the Federal Public Pension and Eligible Dependent
The Government has appointed Oratis Services Sdn Bhd through an open tender to process the reimbursement for medicines and medical devices supplied to Federal Government Pensioners via the Electronic Medical Supply Automation System (e-MASS).
With e-MASS, Federal Government Pensioners can obtain medicines and medical devices that are not supplied by Government hospitals / clinics at registered pharmacies without any payment.
e-MASS Execution Method
With the implementation of e-MASS, Federal Government Pensioners can obtain medicine supplies and medical devices from any hospital / clinic / pharmacy / private agency registered with Oratis Services Sdn Bhd without making any payment (subject to terms & conditions).
Federal Government Pensioners must submit Medical Form 1/09 (complete with verification from a Government medical officer or physician) and a valid prescription from a Government hospital / clinic to obtain medicine supplies or medical devices through the following methods:
- Obtain directly from a hospital / clinic / pharmacy / private agency registered with Oratis Services Sdn Bhd. (The list of hospitals / clinics / pharmacies / private agencies registered with Oratis Services is available on its website at www.oratis.com.my.); or
- Contact the e-MASS Call Centre toll-free at 1-800-88-6627 and delivery will be made directly by Oratis Services Sdn. Bhd. to Federal Government Pensioners or hospital; or
- Place your order online via the e-MASS Portal at www.emass.com.my and delivery will be arranged by Oratis Services Sdn. Bhd.
