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1970/01/01 00:00:00Limited Offer10% Off
 

Indonesia Best Health Insurance – Lifepal [2021]

There are hundreds of health insurance policies available in Indonesia. Choosing the best one can be tricky, even for the experts! 

Therefore our team has concluded 7 best plans based on various criterias, such as seamlessness of claim process, number of hospital network coverages, total sum insured, and premium prices.

1. AXA Mandiri International Exclusive Worldwide

  • Premium starts at Rp3 million per month
  • Cover the ICU expenses according to the hospital bill
  • Cover hospitalization expenses according to the hospital bill
  • Cover the visit for general and specialist practitioners according to the hospital bill
  • Daily sum insured for hospital stay: US$100 to US$230
  • Annual limit: US$1,8 million to US$2,9 million

2. Lippo Insurance Health Protection

  • Premium starts at Rp400.000 per month
  • Sum insured according to hospital bills (as charged)
  • Covers vitamins and medicines, without the need for in or outpatient care.
  • Cashless claim method
  • Easy access for policy details, claim records, and hospital network from mobile application
  • Coverage region: Worldwide

3. Chubb Life Health Protection

  • Cashless claim method
  • No-Medical Check-Up Required
  • Cover daily hospitalization and ICU expenses
  • Entry age for main insured: 6 to 70 years old
  • Coverage extension is valid until 90 years old
  • Covering 108 medical conditions and 50 critical illnesses

4. Cigna Premium Health Protection

  • Premium starts at Rp300.000 per month
  • Entry age for the main insured: 18 to 70 y.o
  • Entry age for the insured children: 6 months to 17 y.o
  • Coverage extension is valid until 80 y.o
  • Coverage region: Indonesia, Singapore, Malaysia, Thailand
  • Cover hospitalization and ICU expenses
  • Cover pre and post hospitalization expenses
  • Cover medical check up 2x a year

5. Manulife MiUltimate HealthCare

  • Entry age for the main insured: 18 to 70 y.o
  • Entry age for the insured children: 30 days to 17 y.o
  • Coverage region: worldwide
  • Daily sum insured for hospital stay: Rp500.000 to Rp3 million (Indonesia & Malaysia)
  • Daily sum insured for hospital stay: Rp3 to 9 million (outside Indonesia & Malaysia) 
  • Daily sum insured for ICU expenses according to hospital bills 
  • Daily visit for general and specialist practitioners according to hospital bills
  • Sum insured for surgery according to hospital bills
  • Daily hospital accommodation: Rp500.000 to Rp1,2 million 
  • Psychological counseling: Rp1 million to Rp2,3 million per year

6. Pacific Cross Comprehensive International Plan

  • Entry age: 23 to 90 y.o
  • Cover the inpatient expenses
  • Cover emergency room treatment expenses
  • Cover dental care expenses due to personal accident
  • Cover ambulance expenses
  • Cover repatriation/medical evacuation insurance
  • Maternal care and free newborn coverage

7. PRUPrime HealthCare

  • Entry age: 1 to 65 y.o
  • Policy extend coverage until the age of 85 y.o
  • Daily sum insured for hospital stay up to Rp8 million
  • Cover the visit for specialist practitioners
  • Annual limit: Rp1,5 billion
  • Return of premium 50% if no claim in the first year
  • Policy can be used worldwide (except United States)
Click here to get the best health insurance offers for your needs or continue reading to understand more about health insurance in Indonesia. 
 

What Is Health Insurance? 

Health insurance offers financial protection through medical expenses coverage when in case of health emergencies. The main benefits include the costs of hospitalization, outpatient care, surgery and medical check-up. Meanwhile, additional benefits or riders include maternity, dental, and eye care.

On the other hand, insurance premiums vary depending on your age, lifestyle, type of coverage, and other factors. The premium can increase each time you renew the policy.

 

Types of Health Insurance Plans in Indonesia

Based on its function, health insurance plans in Indonesia are divided into six categories. 

1. Insurance Care

There are two types of care that can be obtained by insureds, which are inpatient and outpatient. 

  • Inpatient care means the insurer only covers the expenses that require admission to hospital. 
  • Outpatient care means the insurer covers the medical expenses without being admitted to hospital. 

2. Participation

Health insurance in Indonesia has two different types of participation, which are BPJS Kesehatan and private insurance.

  • BPJS Kesehatan is Indonesian national health insurance that is provided by the government. 
  • Private insurance offers the most convenient option for medical care in Indonesia. 

3. Coverage

There are two types of health insurance coverage that you can choose, which are full coverage and highest coverage. 

  • Full coverage means the insurer covers all your medical expenses (refer to annual limit).
  • Highest coverage means the insurer only covers the highest expenses from your hospital bills.

4. Insurance Plan

Based on insurance participants, insurance plan can be divided into two categories, individual and employee benefit plans. 

  • Individual plan means the insurer only covers one individual and their family members (max 4-5 members) based on their personal needs and budget. 
  • Employee benefit plan means the insurer covers the medical expenses of the insured employee. 

5. Claim Method

Private health insurance companies in Indonesia offer two ways of claim plan, which are cashless plan and reimbursement plan. 

  • Cashless claim plan allows you to get medical care just by submitting your insurance card or insurance ID. This method is only available in hospitals within the insurance company’s network.
  • Reimbursement claim plan requires you to pay your medical bills in advance and to process the claim by yourself afterward to get repayment from the insurance company. This claim plan is available in hospitals within and outside the insurance company’s network.

6. Traditional and Unit Link

Health insurance is divided into two categories, which are traditional and unit link. 

  • Traditional insurance focuses only on the benefit of medical care expenses coverage.
  • Unit link insurance focuses on giving the benefit of medical care expenses coverage plus investment benefits.
 

How to Claim Health Insurance in Indonesia? 

Health insurance claim can be settled through cashless or reimbursement methods. Cashless methods are preferable as it is easier to process claims without involving any documentation and no need to pay the bills in advance. 

However, if your medical expenses go beyond the sub insured or annual limit, then you will have to settle the payment personally to the hospital. 

Cashless  Reimbursement 
Submit your insurance card or insurance ID to the hospital → hospital confirms to the insurer → once approved, claim is success and you get medical treatment.  Clear your hospital bills → report your claim to the insurer → make sure to submit all claim documents →  the insurance company will do the claim survey → once approved, the reimbursement claim is success.

Claim documents for reimbursement:

  • Hospital bills
  • Pharmacy bills (if any)
  • Valid ID proof 
  • Doctor’s report
  • Claim form
 

Reasons Why Your Claim Could be Rejected

There are reasons why your health insurance claim might get rejected. It may be caused by misperception concerning the insurance policy. 

We have elaborated seven possibilities that should be considered to avoid claim rejection.

Claim included in the exclusions

There are conditions that are not included or covered by the health insurance plans, such as if you have pre-existing conditions, self harm, and others. Exclusions vary to each insurance company and should be discussed carefully with your agent or broker to avoid having your claims rejected.

Inactive insurance policy

Your health insurance policy will be suspended if you don’t pay the premium on time (sometimes referred to as lapse). If this happens, you should ask for advice from your insurance agent.

Exceeding the claim time limit

Some of the health policies provide a certain period of time for an emergency admission after a patient has been admitted to the hospital. If you don’t apply within the time specified, then your claim might be rejected.

Inadequate claim documents

You need to complete all the required documents to confirm the validity of the claim. Therefore, make sure to not miss any of the requested claim documents.

Illegal claim

If the insured is found as an illegal immigrant or anything that is against Indonesian law, then the claim will be rejected.

In waiting period

After registering for insurance, you have to wait for some time until your insurance policy is all set and activated. During this waiting period, you cannot file claims.

Claim region is not covered

Make sure to read and understand your region policy coverage. For instance, PRUPrime HealthCare covers insurance claims worldwide, except the United States region.

Excessing the sum insure or annual limit

Sum insured is the amount of coverage available for your medical expenses. If you go beyond the sum insured, then your claim will be rejected.

 

Tips for Choosing The Best Health Insurance in Indonesia

With many choices of insurance policies and brands, you need to be more selective when it comes to buying the best health insurance benefits. If you are looking for the ideal health plan to meet your needs, here are some guides to help you out. 

1. Cashless Claim Plan

Cashless claim plan gives you a more convenient way to file a claim. All you need to do is to submit your insurance card so that the hospital administration can confirm your insurance ID. Make sure the hospital is within the insurance company network.

There are many private health insurance companies that offer cashless claim plans, such as Cigna, AXA Mandiri, Prudential, BCA, BNI Life and many others. 

2. Cover Outpatient Expenses

General practice consultation in Indonesia can be very costly, depending on the complexity of the consultation. For that reason it’s better to choose a policy that also covers outpatient expenses. Some of our best recommendations are AXA Mandiri, Cigna, and Manulife. 

3. Return of Premium 

Several health insurance companies offer a return of premium, also known as no claim bonus. This means that if the insured does not file a claim during the term of policy, the insurer grants a return from some of the paid premium (mostly starts from 20%).

4. Coordination of Benefit (CoB)

Coordination of Benefit (CoB) can be an ideal solution if you are facing a case of excess claim. For instance, the first insurance policy will cover your hospital bills. If there’s an excess of claim, it will be billed to the second underwriter.

5. Cover Pre Existing Condition

Pre-existing condition means a health problem that you have had before covered by insurance. Most health insurance in Indonesia exclude this in the policy. Even so, there are several options for insurance companies that cover pre existing conditions. The most popular one is Maestro Optima Care from AXA.

6. Sum Insured According to Hospital Bills

The sum insured or annual limit that is offered by health insurance might seem big at glance. To put that in a perspective, the sum insured of Rp50 million might seem a lot for now. However, in the coming years along with the rising health inflation, which is around 7% to 15%, the current Rp50 million sum insured may end up as inadequate later on. 

For that reason it’s better to choose insurance that covers medical expenses according to hospital bills, also known as as charged, such as health insurance from Manulife, Prudential, and BNI Life.

7. Premium 3% to 5% from Income

We all can agree that health insurance is very important. However, you still have to ensure that your cash flow is ideal. To do so, make sure the premium doesn’t exceed your financial capability. The ideal is to allocate 3% to 5% from your monthly income for paying your premium.

8. Consider to Buy From Insurance Brokers

Insurance brokers can help you file claims in the easiest way possible. Lifepal truly understands that in an emergency situation, it can be very difficult to file a claim on your own. Especially if your claim submission is rejected for certain reasons. 

Lifepal offers assistance in overcoming these claims problems. 

 

Health Insurance FAQ

Here are some frequently asked questions about health insurance in Indonesia. 

What is health insurance?

Health insurance is a financial management product that offers coverage for your medical care expenses, such as hospitalization, surgical, prescription drug, dental, eye care, and maternity bills.

Why do I need health insurance?

Health insurance is not cheap. That’s why it can be so tempting to go without coverage, especially if you’re in foreign country and barely get sick. 

However, you need to consider that medical emergencies in Indonesia are quite expensive. In fact, Indonesia’s health inflation is one of the highest in Southeast Asia. You can see from the infographic above, the health inflation in 2018 alone increased by 11% (exceeding Singapore). That’s why health insurance has become an important necessity in Indonesia. 

Instead of spending savings or investment on medical expenses, insurance will help your cash flow always on the right track. Find out the best health insurance plans from Lifepal!

What is health insurance coverage?

The insurance coverage is divided into two categories, which are the key benefits and rider. 

  • Key benefits: inpatient and surgical
  • Rider: outpatient, dental, eye care, maternity, medical check-up

What is the entry age of health insurance in Indonesia?

The entry age for health insurance varies from 6 months to 17 y.o for children, 17 to 70 y.o for adults, and maternity benefits range from 20 to 43 y.o. The premium cost of health insurance will be greatly affected by the insured’s age.

What is BPJS, and how is it different with regular health insurance?

BPJS Kesehatan is national health insurance, provided by the government. Private health insurance comes with added benefits and more convenient medical care. BPJS is only available for Indonesian citizen and provides basic healthcare protection and guarantee.

Health insurance terms

  • Insurance actuary: professional that works for insurance to help the company calculate the premium amount of potential participants.
  • Copayment: the fee that you must pay when you file a claim (generally 10% of the total medical bill).
  • Premium: the amount of money that must be paid by the insured to the insurance company. 
  • Policy: a written agreement between the insured  and the insurance company regarding their respective rights and obligations.
  • Insurance claim: a formal request from the insured to the insurance company in order to get medical services according to the policy. 
  • Grace period: time period after the due date of premium payment but the insurance policy is still valid.
  • Waiting period: the period of time after the policy is issued by the insurer. During this period, insurance benefits are temporarily unavailable for the insurer. 
  • Insurer: The legal party written on the policy as the company who provides insurance coverage. 
  • Insured: legitimate party written on the policy as an individual(s) or company who gets benefits from the insurer.
  • Rider: additional benefits to the basic plan that can be obtained by insured by paying extra premium.
  • Coordination of Benefit (COB): COB applies when you are covered by more than one health insurance policy. The purpose of COB is to determine which one of those policies has the primary responsibility to pay/process a claim and the other one to contribute.

 

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