Table 2. Health protection schemes for foreign workers in Malaysia.

Insurance/Protection Scheme	Established	Provision	Basic Mechanism	Strengths	Weaknesses
SPIKPA: Foreign Workers' Insurance Protection Scheme	January 2011	Immigration (Department of Labour, MOHA) & Health Policy (MOH)*	• Private Insurance from 25 providers	• Cashless	• Low awareness of entitlements
			• Covers hospitalisation and surgical charges at Public Hospitals (MOH)	• No deposit required upon checking into the hospital (E-System)	• Does not cover outpatient services
			• RM 120 (USD 30) per annum; paid by the worker	• Designed to reduce the financial burden of the employers	• Does not cover plantation and domestic workers
			• Annual limit of up to RM 10,000 (RM 20,000 from end 2016) (increased from USD 2500 to USD 5000 in 2016)		• Although there was an increase in annual limit, this is insufficient for management of severe cases or those requiring long-term care
FWCS: Foreign Worker Compensation Scheme	1998–2019**	Section 26 (2) of Workmen’s Compensation Act 1952 (Amended Aug 1996)	• 26 private insurers	• ‘No fault’ compensation	• Relies on the employer to make the claims
			• RM 72 (USD 18) per annum; paid by the employer, without any salary deduction	• Covers injuries, occupation diseases and fatalities related to employment	• Claim process can take time and delay access to the funds required for emergencies
			• Lump-sum compensation, no more than RM 23,000 (USD 5,700) for injuries and RM 25,000 (USD 6,196) for death	• It is an offence for employers to deduct FWCS premium from workers’ salary	• If employers advanced payment of medical bills, then the amount will be deducted from compensation received
			• Labour Commissioner will assess all compensation payable		•
SOCSO: Social Security Organisation	1971-1993/ January 2019***	Employees’ Social Security Act 1969 (Act 4)	• Employment Injury Scheme (EIS)	• ‘No fault’ compensation	• Does not cover domestic workers
			• 2019 is a ‘cooling-off period’ for the switch from FWCS to SOCSO	• Aims to achieve near equal coverage as citizens	• Migrant workers not covered under the Invalidity Pension Scheme
			• Contribution rate is the same as citizens: 1.25% of the insured monthly wages; paid by the employer	• Workers to receive support until full recovery, including rehabilitation and disablement benefits	• Workers are not entitled to education loan benefit, vocational training, dialysis treatment or return to work programme (citizen only)
				• Dependents to receive benefits	• Exact implementation is yet to be made known
				• Onus is on the employer to contribute, but SOCSO claims can be made even if employer fails to contribute

* There is no legal provision for SPIKPA. SPIKPA provision is written in policy documents [15].

** Migrant workers were included in SOCSO between 1971 to 1993. In 1996 the Workmen’s Compensation Act was amended to specify coverage of migrant workers. In 1998, the FWCS, a private insurance scheme was established to provide social security insurance coverage for migrant works.

***Since January 2019, migrant workers were re-included in SOCSO on near parity terms with citizens.