"I was healthy and never sick over this. Why do I have to take health insurance? "
Many people think so and we may be one of them. However, ever occurred to us, what will happen if the accident and illness comes on suddenly and we had to be hospitalized? We may have to pay costly medical expenses up to savings drained away, and this of course is not a situation we expect to happen. Instead, would not it be helpful if we already have health insurance that can help us in paying medical expenses? More so for us now that the cost of healthcare is increasingly costly. Paying doctors, buy drugs, hospitalizations are some examples of costs that must be paid when you or a family member stricken with the disease.
Fortunately for working in a company or agency that already has health insurance program, so at least, partly due to impaired health risks can be assisted by the health insurance program. What if companies do not provide such facilities? Or you an entrepreneur? Let's not hesitate and start planning to buy health insurance. With the purchase of health insurance, the amount of expenditures for health care costs will be relatively stable because of the cost or the annual premium can be calculated with certainty, so easier for us to manage expenses and reduce costs is not unexpected.
In Indonesia there are two types of health insurance is health insurance collective (group) and individual health insurance. Insurance is usually reserved for private individuals or families, while insurers collectively as found in many companies already provide health coverage to their employees. Individual insurance premiums to be paid relatively higher than the collective health insurance. Why is that? Because of the collective, then the number of participants who took part individually or bigger so the risk of a claim can be evenly by all the individual within the group. The greater the number of groups or members within a single institution or company, it will lower the premium to be paid.
Benefit
Health insurance is a type of insurance that helps the availability of health insurance funds if participants develop health problems or illnesses. All the needs of seeing a doctor, stay (care) in hospitals, drug costs in the hospital until the operation, all that can be covered by insurance companies. Generally this type of treatment or programs that are available are the benefits of ambulatory (outpatient), benefit of inpatient care (inpatient), labor benefits and dental benefits.
In general, the benefits of ambulatory (outpatient) are covered by insurance companies is as consulting fees or general practitioner and specialists, prescription medication costs, costs of preventive measures, the cost of assistive devices required by doctors, and others. In the outpatient benefits have maximum limits use of funds each year. While hospitalization benefits that can be enjoyed by participants of health insurance is like the hospital costs, lab fees, delivery fees, the cost of emergency service (emergency). The benefits of preventive dental care, basic dental care, dental care complex, and the installation of dentures.
Third-care benefits, namely outpatient, maternity and dental benefits is an additional option that we can take the following basic program, which benefits of hospitalization. So, we are not allowed to just take advantage of outpatient care, childbirth or dental work alone without following the basic program of hospitalization benefits.
The amount of premium to be paid and the amount of value in health insurance is dependent on the health insurance program that we choose. Various insurance companies have the types of programs and premiums vary by the details of benefits also varies. Typically, insurance companies limit the amount of the total cost that can be used per year.
The system claims / insurance
The system used by health insurance companies there are 2 ie the reimbursement system (reimbursement) or the system provider. With the reimbursement system, insurance participants have to spend money first to pay for treatment then can we claim or request a replacement to the insurer in which we become participants of insurance. With this system we are then free to choose a hospital anywhere, but certainly the maximum reimbursement has been determined in advance. That need to be our primary concern in making the claim is the completeness of letters of administration that became the main requirement for the reimbursement of expenses that we can be paid out by insurance companies. How quickly depends on the disbursement of claims services provided by insurance companies, but generally ranges from 7 working days.
For those who embrace the system provider, we do not need to spend money first. We only provided with health insurance membership card in order to obtain needed health care in a hospital or health clinic that we selected earlier based on a list of hospitals that work with the insurance company.
