Updated Framework on Medical Bill Coverage Differences: Additional Health Insurers Responsible for up to 175% of the JKN Tariff

In an effort to ensure that health insurance participants (“Participants”) are financially protected if they seek treatment above the classes that they are covered by under health insurance schemes, as well as to improve the implementation of differential cost payments that are completed by additional health insurance providers, the Minister of Health (“Minister”) has issued Decree No. HK.01.07/MENKES/1117/2025 of 2025 (“Decree 1117/2025”) on Guidelines for the Payment of Cost Differences by Additional Health Insurance Providers Through Coordination Between Insurance Providers (“Inter-Insurer Coordination”).[1] Decree 1117/2025 has been in force since 11 November 2025 and has simultaneously repealed and replaced the previous framework of Decree of the Minister No. HK.01.07/MENKES/1366/2024 (“Decree 1366/2024”), which addressed similar matters to Decree 1117/2025.[2]