BANDAR SERI BEGAWAN – Foreign permanent residents and the foreign spouses of Brunei citizens must now pay for their own medical treatment following a major policy shift by the Ministry of Health (MoH) that came into effect on July 1.
The policy change will end free healthcare for thousands in Brunei, requiring them to secure personal health insurance for medical costs previously shouldered by the government.
The new regulations do not apply to stateless permanent residents, who will continue to receive free healthcare similar to Brunei citizens.
Responding to public concern and to clarify the changes, the health ministry held a press conference on Thursday, led by Health Minister Dato Dr Hj Mohd Isham Hj Jaafar and Home Affairs Minister Dato Hj Ahmaddin Hj Abd Rahman.
Who is affected by the new policy?
The new charges will affect:
• Permanent residents with foreign nationality.
• Foreign spouses of Bruneian citizens.
• Foreign spouses of stateless permanent residents.
They are now required to bear the full cost of treatment at government hospitals and the Pantai Jerudong Specialist Centre (PJSC).
Who is exempt?
Not everyone will have to pay for healthcare. The following groups are still eligible for free treatment:
• Brunei citizens.
• Stateless permanent residents.
• Those who were already receiving care at PJSC or government hospitals before July 1. Their costs will continue to be covered until discharge or completion of treatment.
• Mental health patients as defined under the Mental Health Order.
• Patients with infectious diseases listed under the Infectious Diseases Order.
Health insurance now a must
MoH is now encouraging those affected to take up personal health insurance to protect themselves and their families from financial strain, especially for hospitalisation, medication and specialist treatment.
Health Minister Dato Dr Hj Mohd Isham said for every hospital admission, patients will be required to pay a portion of the treatment fee upfront, starting from as little as 10%, which can then be reimbursed by their insurance provider. Health insurance from overseas providers will also be accepted.
He stressed that people needing emergency care or immediate medical attention will not be turned away or be required to pay upfront.
Minister of Home Affairs Dato Hj Ahmaddin added that Takaful Brunei, the country’s largest takaful operator, plans to expand medical coverage to individuals up to 95 years old. However, people with pre-existing health conditions will incur higher premiums.
Home Affairs Minister Dato Hj Ahmaddin Hj Abd Rahman. Photo: Rasidah Hj Abu Bakar/The Scoop
What happens to those who can’t afford to pay?
MoH reassured people that financial assistance is available. Those who face difficulty paying will be referred to medical social workers for a case assessment. Help may come in the form of:
• The Patients’ Relief Fund under the MoH
• Brunei Islamic Religious Council
• Sultan Haji Hassanal Bolkiah Foundation
• Installment plans
What prompted the policy shift?
MoH said health expenditure has skyrocketed over the past three years due to an ageing population and rising drug prices.
The health ministry’s annual budget has ballooned by 66%, increasing from $391 million in FY 2022/23 to over $652 million in FY 2025/26.
Dato Dr Hj Mohd Isham said in FY 2024/25 alone, the government spent close to $70 million on medical care for foreigners who were either permanent residents or married to Bruneians. This includes $28 million spent at PJSC, a private hospital that provides cancer and stroke treatment.
“In most other countries, permanent residents and foreigners are responsible for their own medical costs, often through mandatory health insurance. Even citizens pay part of their medical bills,” the minister said.
He added that there have been cases of people abusing the system by marrying Brunei citizens to obtain cancer treatment, or permanent residents living abroad but returning to Brunei to access free medical care.
Health Minister Dato Dr Hj Mohd Isham Hj Jaafar. Photo: Rasidah Hj Abu Bakar/The Scoop
The new policy has caused widespread dismay among permanent residents. Many of them, who were born and raised in Brunei but unable to become citizens under the current criteria, are now deeply concerned about affording healthcare for their families.
The minister urged anyone facing financial hardship to speak with MoH medical social workers about obtaining financial assistance for healthcare costs.
“It shouldn’t affect their ability to access care. For those with other nationalities, they can always go back to their own countries, for those that can afford it. But for the rest that can’t afford it, let us know and our medical social workers will do the appropriate assessment.”
He added that despite the policy change, medical fees remain “heavily subsidised” by the government and do not reflect the true cost of care provided.
Ultimately, he explained, this change aims to ensure the public health system’s financial sustainability for future generations.
Editor’s note: As of press time, The Scoop has reached out to the Ministry of Health and Ministry of Home Affairs to clarify the number of people affected by the new healthcare policy, as well as the number of permanent residents who are stateless, and those who hold foreign nationalities. According to the latest population census, there are 26,300 permanent residents in Brunei.
