Health Insurance: Definition, Types and Benefits

His human name is certainly not free from the name of the disease. No matter the age, the disease can attack your body at any time. There are various causes of disease, from diet, even to accidents.
 

Given the increasingly expensive medical costs, it is better for us to use health insurance products. By using health insurance products, our finances will not automatically be drained for medical expenses. We recommend that all our families regardless of age are given health insurance products with the aim of guarding the future.

A wide selection of health insurance products are available but you should pay attention to before buying because there are many types and each type of course has insurance benefits as well. 

Definition of health insurance

Quoting from Investopedia (2019) Health insurance is a type of insurance coverage that pays for medical, surgical or other things related to health costs listed on the policy. The insurance company that issues the policy can reimburse the health costs that are listed on the policy.

Usually every company already has its own program for its employees in terms of health insurance. Usually the costs billed by the insurance company will be paid using the employee's salary that has been deducted, but there are also companies that prepare special funds to pay for employee insurance.

This insurance is not Indemnity which does not restore the financial position immediately before the loss occurs. Insurance companies replace according to their ability, who can afford to pay more will get greater benefits and vice versa.


Who should have health insurance?

Everyone who is more than 15 days old and does not pass the age of 60 years should have health insurance to avoid expensive medical expenses and also so that we are safe from the abyss of bankruptcy. With insurance, we don't have to sell our valuable assets for medical expenses.

For those who have been insured under this guarantee continuously until the end of the policy year where the insured reaches the age of 70 years is allowed as long as there has never been a previous policy cancellation.


Here are some types of health insurance in Indonesia:


1. By organizer

  • Government, health insurance issued by the government for example is BPJS Health or Healthy Indonesia Card
  • Private, many kinds of insurance issued by the private sector such as AXA, ACA and so on. There are investment insurance (Unit Link) and Pure Health Insurance


2. By type of treatment

  • Hospitalization, finance the cost of treating patients who must be hospitalized or hospitalized
  • Outpatient, paying for patients who do not have to carry out hospitalization at the hospital, usually the costs incurred are medical diagnoses, laboratory checks, drug costs and others.


3. Subjects borne

  • Personal, which means that 1 person is borne or per individual
  • Groups, can be in the form of a family or an organization in the company


Health insurance benefits

Citing the official website of the OJK regarding Health Insurance, here are the benefits that you will get by having health insurance.


Rawat Inap (In Patient)

Replace medical expenses due to illness and require treatment or stay at the hospital in accordance with the provisions that apply to the conditions of the insurance company's policy.


Out Patient

Reimbursement of medical expenses due to illnesses that do not require hospitalization or overnight stay but only outpatient treatment or outpatient treatment.


Maternity

Maternity insurance reimburses the cost of childbirth or childbirth in accordance with the program taken and guaranteed in the policy.


Glasses (Glasses)

Reimburses the cost of eyeglass lenses and frames or frames with a cover letter from an ophthalmologist.


Teeth (Dental)

Dental Insurance covers medical expenses due to basic care, gum care, complex dental care, repair of teeth and dentures in dental care.


General chek up

Reimburses the cost of health checks according to the program taken and guaranteed in the policy
How health insurance works

First of all, you are required to pay a monthly fee so that your health insurance will continue to be active. The amount of fees to be paid depends on the initial agreement between you and the organizer. Usually for the costs that are borne only for outpatient costs, the costs are not too big, it's a different thing if we choose a package for inpatient costs which tend to be more expensive.

Second, if you are sick and require outpatient or inpatient care, you can contact the organizer to disburse the costs for all your treatment. Each organizer has their own procedures


How to choose health insurance 

Here are tips and how to choose health insurance so you can get maximum protection.


Medical history

Consider your entire medical history and that of those closest to you. If one of them or you yourself have a history of serious diseases such as heart disease, then you must take insurance that has an inpatient program. Unlike the case if the individual who wants to be included is still healthy, then you should choose insurance that covers outpatient costs.
Job risk

If you or someone close to you has a risky job such as always traveling out of town or work related to construction, then it's a good idea to choose an insurance product that has a more complete package. The goal is to minimize all events that are beyond our control.


Company reputation

The first thing you should consider is the track record of the company. You can find out by looking at the company profile, client testimonials or even asking directly to people who have used the insurance product you want.


Understand and read carefully the contents of the policy

The most important thing before you make an appointment is to check and understand what your policy contains. If you understand correctly, it will minimize miscommunication about what will be covered and what will not be covered.


How to buy health insurance

Health insurance can be obtained through:

  • Certified Insurance Agent.
  • Insurance Broker especially for complete risk
  • Directly contact the insurance company that guarantees the risk either through the call center, the internet or visiting directly.

How to close a health insurance policy

For closures over the age of 55, insurance companies usually apply:

Men for the diseases below will not be guaranteed forever, namely:

  • Hypertrophy Prostat
  • Cataract
  • Hypertension and all its complications
  • Heart
  • Mellitus diabetes

Women for the diseases below will not be guaranteed forever, namely:

  • Cataract
  • Mellitus diabetes
  • Hypertension
  • Heart

When it turns out that the police do not comply with what has been previously agreed, in the settlement of disputes, and actions that can be taken include:

  • Request clarification from the company either through agents or directly to the company for the peace process or deliberation between the parties.
  • Complain to the Indonesian Insurance Mediation Agency for the value of a problematic claim of up to Rp. 750,000,000,-
  • If you still haven't found a common ground, you can choose dispute resolution through arbitration or dispute resolution through the courts.

Are you looking for cheap health insurance from a trusted provider? TheNewbie provides a wide selection of health insurance products that you can choose from! The process is easy, the application for disbursement assisted by a professional team is one of the many benefits that you will get!

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