Needs and functions of health insurance

Health Insurance Needs It So
Health costs are now the only treatment to the doctor alone has cost a pretty expensive (to pay the doctor added with the purchase of drugs), especially if the need to seek treatment and stay in the hospital. The medical costs are growing by day resulted in a very heavy burden of the family when one family member is attacked from the disease.
Meanwhile, the unexpected, such as illness or accident is a common occurrence even though the timing is not predictable. Because it badly needed a plan to address the problem or the issue carefully and wisely.
Prepared Face Unexpected
Here's a true story that we write as an illustration. The husband, wife, call it Dicki and Dina already has a very beautiful baby with the name Alia.
Dicki and Dina are couples who live in metropolitan Jakarta, which requires them to work together in order to meet all needs of daily life. The couple lived in a residence on the outskirts of Jakarta.
Some time ago, the fruit of their heart disease that required him to stay in the hospital because they have to undergo several tests and treatments are quite internsif. Without realizing their child has been living in the hospital for 1 week.
Once they want to settle their hospital bills surprised, why it cost so expensive? Up to Rp. 12 million? They are setting up an emergency fund but the amount is insufficient to pay all hospital bills before, so in order to settle the hospital bills before they have to disburse funds for their future savings.
This kind of thing we often hear. Not only should take from future savings, but instead there is a need to borrow them first to the relatives because this form of expenditure is always ignored. How you can solve problems like this? There is a way which in our opinion can help you anticipate this at least in terms of availability of finance for things that are not unexpected. First to set aside the unexpected should you fill it out again when it is used and both with have health insurance. Both of these alternatives has advantages and disadvantages.
Unexpected Funds and Insurance
The first option is to set aside the unexpected should specify the amount of your own. Of the several books related to family finances in our opinion you should not unexpected tactical setting up funds ranging from 2 to 6 months of living expenses per month.
When the family monthly expenditure of Rp 5 million, then at least you should be set aside in savings amounting to between Rp 10 million to Rp 30 million. Because of this requirement is the need for the unexpected, where events can occur at any time, then placement in a product that high levels of liquidity into our suggestions. For example, in the form of savings in which the decision can be made at any time with the ease of ATM which is now almost all banks offer these advantages.
You've set the magnitude and have placed it in savings, when in the next month you should use it for unforeseen needs such as home repair Rp 2 million, then you should add back the amount of its original value. For example, USD 10 million represents funds set up for unforeseen circumstances. When you've spent $ 2 million, then you should have budgeted funds to replenish its total funds into USD unexpected. 10 million back.
The usefulness of these funds for a variety of unexpected expenses not only because of hurt, but for other needs such as, repair leaky home, car collisions and others. Limitations of this alternative to prepare for unforeseen expenses for family health is highly dependent of funds available with which you set aside to fund unforeseen.
Sometimes funds are not sufficient prepared with the increasing cost of medical treatment, be it only to the doctor and have to stay in the hospital. The advantage with this method is that you can determine the amount of money should you spend or set aside. If it does not happen things that are unwanted or unexpected so that you have set aside funds remain intact in number.
Alternatively you can do is to buy family health insurance. With this program you are transferring the risk of unexpected things (illness) to a third party (insurance company) and costs should you spend each year in the form of annual premiums that have no cash value or be lost or burned if not used in the current year.
Health Insurance
Indonesian people in general have not seen the insurance especially health insurance as a necessity. Another case with American or European people who have seen health insurance as a necessity. Not only higher costs for medical care in the U.S. or Europe, but if they do not have insurance it will be very difficult for them to get the best treatment as desired.
In general, the subject of health insurance is similar to the general Asurasi where the premium paid for one year can not be returned or burnt during the year despite no claims. Some insurance companies give a refund of premiums paid when no unfortunately for 1 year, although a small amount.
In Indonesia there are two categories of health insurance is health insurance collective (group) and individual health insurance. Individual insurance usually diperutukan for families in which only consists of a maximum of 5 individual, father, mother 3 children fund. Premiums must be paid relatively higher than the collective health insurance.
Meanwhile, the collective number of individuals who take part are larger and usually the premium paid is lighter because of the risk of claims on the average by all individuals in the group. The greater the number of groups or members within a set of lower premiums to be paid.
Insurance Benefits
Health insurance is a type of insurance that protect the availability of funds when an individual or a family member became ill. All the needs of the doctor to have to stay in the hospital with various needs such as, cost of medication in the hospital until all operations are covered by the insurance company. In general, the type of treatment or programs that are available are the benefits of ambulatory (outpatient), benefit-hospital (inpatient), labor benefits and dental benefits.
In general, the benefits of outpatient (Outpatient) incurred by the insurance company is: * GP Consultations * Providing referrals to doctors when necessary spesilis * Consult a medical specialist * The purchase of medicines in accordance with the list of drugs * Pemerikasaan diagnostic support
In the outpatient benefits have maximum limits use of funds each year. Of the total cost of expenditures for outpatient care, in general, in every insurance company requires the insured to pay 20 percent.
Benefits associated with the birth of the child labor, the cost of normal delivery, delivery with additional tools and operating S-caesacea. For there persalian benefit waiting period is usually up to 280 days. Each insurance company has a limit of the waiting period that is different.
As for the benefits of preventive dental care, basic dental care, dental care complex and the installation of dentures. For all treatments insurance companies typically limit the number of total costs that can be used per year. The dental benefits are an obligation for the insured to pay 20 percent of the cost of care (same as outpatient benefits.)
The three benefits of treatment as above, namely outpatient, maternity and dental benefits is an additional option you can take by following the basic program of hospitalization benefits. So you can not just take advantage of outpatient only, labor only, or dental treatment without following the basic program hospitalization benefits.
For the benefit of hospitalization in which the basic benefits that should be taken first, hospitalization benefits coverage in general is almost the same from various insurance companies that exist. The benefits are: * The cost of accommodation space * Fee Non-ICU accommodation * Consult your doctor * Consultation specialists * The cost of surgery, complex, major, intermediate and minor * Other expenses include hospital: drug cost, laboratory tests and diagnostic * Maintain the road 30 days before and after hospitalization * Nursing home * Local ambulance service * Maintain an emergency road accident * Treat dental emergency road accident * Compensation for death
The amount of coverage is very dependent on the program you take, the various insurance companies using the name or type of program is different. For inpatient amount of the premium to be paid annual visits from the cost of accommodation in the hospital room you choose, for example, you choose the cost of accommodation at a cost of Rp. 200 000 then the next following benefit program options specified. For these three additional programs, premium to be paid for outpatient care based on the size of the selected GP consultations, delivery based on the desired cost of natural childbirth and dental care in terms of basic care.
Insurance Claim
In the event there are claims that insurance companies use the reimbursement system (reimbursement) or the system provider. With the replacement system, the insured must first spend money to pay for medical expenses which you claim (requesting reimbursement) to the insurance company.
In this case the completeness of the letters of administration becomes imperative. Sometimes problems arise in the process claim because it did not complete the necessary requirements. The duration of the withdrawal of funds tertantung claims with insurance companies is generally around 7 working days.
As for the system provider you do not spend any money, you only provided health insurance membership card in order to obtain needed medical care. Surely in a hospital or clinic you have chosen previously.
With a replacement system you can go into any hospital. While with the system provider, you must specify the option you want a hospital based on hospital lists that work with the insurance company.
Perhaps the question arises, how much premium should we spend to have health insurance? Once again, the magnitude of the premium or fee should you spend each year depends on the program you choose. As the example above where you select the inpatient program with accommodation costs Rp.200, 000, then the premiums will be calculated based on the cost of accommodation and age of the insured. The younger the age of the insured will be increasingly expensive burden of premiums.
Importance of Insurance
After learning the basics or health insurance in general, it appears that health insurance is very important for a family plan. Why is that?
First, by following the health insurance program, for sure you know the burden of expenditure that should spend per year for premium payment without having to fear when one family member became ill.
Second, by choosing a health insurance program with the system provider, if one family member became ill then you do not have to bother with issues of money, because everything was already covered by insurance companies and you do not need to spend any money for hospitalization. With outpatient care you are required to spend 20 percent of the total cost.
While the shortcomings in terms of health insurance is still quite expensive for our society. Actually it is very expensive relative word, therefore we strongly recommend that you plan your family finances, so you can see the family's financial goals by priority.
When you participate with insurance companies who use the system provider, you can only choose a partner hospital of the insurance company. So that must be seen in this case is how many hospitals or clinics owned by a partner insurance company. The easiest option is to determine the nearest hospital with residential and certainly with the best quality.
So from our earlier explanation really expect you can see the importance of preparing or planning a fund unexpected or your health insurance program that protects families from financial hardship when a disease outbreak strikes. Begin immediately. The younger you are the easier to follow and the premium must be paid for also relatively cheaper. Hopefully useful.