MiCare

What MiCare does

MiCare Sdn Bhd is a Malaysia-incorporated Third Party Administrator (TPA) founded in 2006 that builds connectivity applications and infrastructure for exchanging healthcare transaction information among doctors, patients, government organizations, corporates, and insurers. Its core products include the MiCare platform (claims processing and administration), a consumer-facing MiCare mobile application (entitlement tracking, claims submission, panel provider search, and outpatient Guarantee Letter requests), and the MyMed application (personal health tracking including vaccination records, blood pressure, and physical activity). The business serves 15M+ members through 7,000+ healthcare partners and 5,500+ panel providers across Malaysia, Thailand, the Philippines, and Vietnam, with a planned regional headquarters in Singapore and expansion into Indonesia.

MiCare's go-to-market is B2B sales-led, targeting health insurers, corporate employers, and insurance brokers/agents with three primary revenue streams: TPA services (claims administration, medical audits, panel provider management), Fee-For-Service (FFS) administration, and Business Process Outsourcing (BPO) for healthcare administration. Pricing is quote-based on multi-year enterprise contracts with no public tiered pricing. The company's core differentiator is a "no hidden cost" model — zero fee splitting, no panel joining fees, and no commissions to panel providers — which combined with a deep panel network and claims data across 15M+ members forms the basis of its competitive position.

The company is privately held, with US$60M in disclosed equity raised in 2020–2021 from IFC (International Finance Corporation, World Bank Group) and Mitsui & Co. to fund Southeast Asia expansion. It operates regional subsidiary entities in Thailand (Health Benefit Consultants Co., Ltd.) and the Philippines (Micare Philippines, Inc.), plus a Vietnam office, and is led by founder Moses Hee. Headcount is reported at 501–1,000 employees, concentrated in operations and claims administration roles.

Name

MiCare

Legal name

MiCare Sdn Bhd

Website

https://eclaims.micaresvc.com

Company type

Private

Founded year

2006

Operating status

Operating

Headcount range

501–1,000 employees

Short description

MiCare is a Malaysia-headquartered healthcare Third Party Administrator (TPA) that connects insurers, employers, providers, and patients for medical claims administration, cost management, and BPO services across Southeast Asia, serving 15M+ members via 7,000+ healthcare partners.

Ownership category

akta.pro rank

Product category

Healthcare Third Party Administration

NAICS

Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds (524292)

SIC

Hospital & Medical Service Plans (6324)

akta.pro primary industry

Individual Health Insurance Administration (TPA/ASO) (FSAIAEAK)

akta.pro secondary industry

Member Services & Contact Center Operations (TPA) (HLAEALAI)

Keywords

• Healthcare claims administration
• Third party administration
• Medical claims processing
• Healthcare benefits management
• Health insurance administration

Headquarters

HQ city

Selangor

HQ country

Malaysia

HQ region

Asia

Offices7 records

Markets served

GTM type

B2B

Offering type

Services

Cost components

Personnel, Operations, Technology or R&D, Marketing or Sales, Infrastructure

Revenue model

1. Third Party Administration (TPA) Services: Core revenue from providing TPA services including claims processing, administration management for insurers, brokers, agents and corporates. Services include medical audits, panel provider management, and patient flow optimization.
2. Fee-For-Service (FFS): Fee-based services for healthcare administration and claims processing
3. Business Process Outsourcing (BPO): Outsourced healthcare administration services for payors including cost management and administrative work reduction

Pricing tiers

Go-to-market motion2 records

Distribution channels2 records

Marketing channels2 records

Core offering

MiCare is a Third Party Administrator (TPA) that builds connectivity applications and infrastructure for the exchange of healthcare transaction information, linking doctors, patients, government organizations, corporates, and insurers. The company delivers TPA services, Fee-For-Service (FFS) administration, and Business Process Outsourcing (BPO) for healthcare claims processing, cost management, medical audits, and guarantee letter issuance, supported by member-facing mobile applications.

Product overview

MiCare offers a unified healthcare Third Party Administration (TPA) platform that combines connectivity infrastructure with mobile application solutions. The core MiCare platform processes medical claims and links healthcare stakeholders including insurers, employers, doctors, and patients. The MiCare Mobile Application and MyMed Application serve as member-facing interfaces enabling benefit tracking, claims submission, panel provider search, and health record management. The platform also encompasses TPA services, Fee For Service (FFS) administration, and Business Process Outsourcing (BPO) capabilities for insurers, brokers, agents, and corporates.

Differentiator

Problem solved

Functional benefit

Brands

• MyMed: Mobile application allowing members to track entitlement benefits, submit claims, search panel clinics, hospitals, and pharmacies, and request outpatient Guarantee Letters.

Products and services

• MiCare Platform (Third Party Administration Services) Core Third Party Administrator (TPA) platform that builds connectivity applications and infrastructure for exchanging healthcare transaction information linking doctors, patients, government organizations, corporates, and insurers. Delivers TPA services, Fee-For-Service (FFS) administration, and Business Process Outsourcing (BPO) for insurers, brokers, agents, and corporates.
• MiCare Mobile Application Mobile application allowing members to track entitlement benefits, personal claims, search and view panel clinics, hospitals, and pharmacies, submit claims, and request outpatient Guarantee Letters (GL). Available to MiCare's 15M+ members.
• MyMed Application Health application used by MiCare for tracking vaccination progress, health goals, and personal health data including blood pressure, blood sugar levels, and physical activity. Sub-brand of MiCare.

Quantifiable outcome

• Supporting over 15,000,000 members
• +2 more outcomes

Named customers3 records

Segments5 records

Ideal customer profiles4 records

Technology focussed Yes

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature3 records

Scale indicators5 records

Recent moves6 records

Expansion highlights5 records

Broad incumbents

• Allianz Care: Allianz's international health insurance and assistance division, providing group health benefits, claims administration, and provider networks to multinational employers across Asia Pacific. Overlaps with MiCare on TPA services for cross-border employer health plans in SE Asia.
• International SOS: Global leader in medical and travel security assistance with deep SE Asia operations. Provides healthcare administration, provider network management, and medical advisory services to insurers and corporates — overlapping with MiCare's TPA and panel network offerings, but with a broader global footprint.
• FWD Group: Pan-Asian insurance company operating across Hong Kong, Thailand, Indonesia, Philippines, Vietnam, Singapore, Malaysia, and Japan. Provides group health benefits and claims administration comparable to MiCare's TPA services, though with greater capital backing and an in-house insurance underwriting model.
• Aetna International (CVS Health): International health benefits arm of CVS Health serving multinational employers and individuals in SE Asia. Provides claims administration, provider networks, and integrated health management directly comparable to MiCare's core offering, but bundled with insurance underwriting at global scale.
• Sedgwick: Global claims management and TPA serving group health, workers' compensation, and absence in APAC. Comparable to MiCare on claims administration and cost containment, but with a much broader portfolio (workers comp, property, auto) and predominantly US/global presence rather than SE Asia specialization.
• Bupa Global: International health insurance division of Bupa, offering group health benefits and claims management for corporate and individual clients in Asia Pacific. Comparable to MiCare on employer-sponsored health plan administration in SE Asia, but bundled with insurance underwriting rather than pure TPA.
• Cigna Healthcare International: One of the world's largest international health insurers, offering group health benefits and TPA-style administration across SE Asia. Competes with MiCare for the same multinational corporate employer accounts, though at much greater scale and with insurance underwriting capability MiCare does not have.

Regional players

• Etiqa Insurance & Takaful: Leading Malaysian insurance and takaful provider (part of Maybank Group) with its own administration arm and panel network in Malaysia and SE Asia. Competes with MiCare for Malaysian insurer and corporate clients, with strong domestic advantages but less regional TPA breadth than MiCare.

Emerging players

• Doctor Anywhere: Singapore-headquartered health-tech platform operating telemedicine, corporate wellness, and digital health services across SE Asia. Competes with MiCare MyMed/MiCare App for digital engagement of insured members and corporate health benefit management, but is more consumer/telehealth focused.

Direct peers

• Asia Assistance Network: Thailand-headquartered pan-Asian Third Party Administrator and assistance provider offering medical claims administration, network management, and cost containment services — directly competing with MiCare in the regional TPA market and serving overlapping insurer and corporate clients.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat5 records

Key risks6 records

Key highlights7 records

Customer concentration

Revenue estimate

Valuation estimate

Number of profiles

Profiles1 record

Subsidiaries2 records

Funding overview

Funding rounds2 records

Investors2 records

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about MiCare