A problem with a healthcare insurance company

[Samoerai]

Residing in Indonesia, opting for BPJS is a no brainer due to its incredibly low cost.
The monthly fees are as follows:

• 1st Class: Rp 150,000 (less than US$10)
• 2nd Class: Rp 100,000 (less than US$6.5)
• 3rd Class: Rp 35,000 (less than US$2.5)

Considering that the cost of particular treatment can reach hundreds of millions or even billions of rupiah in case of an accident, BPJS coverage proves highly valuable. It extends to regular medication as well, and the expense for such medication alone could surpass Rp.150,000 per month. Even if one never utilizes the coverage, paying of less than US$10 is akin to making a donation to the system helping reasonable number of individuals. A good cause for donation as it will help the disadvantage people who otherwise will not be able to cover their basic healthcare.

Unless they are very wealthy people were money is not an issue, a person will need to be very thick not to recognize this significant benefit of BPJS. However, a reported issue arises for some expats, even those with spouse sponsored ITAP as they are reportedly unable to access BPJS.

Still cannot apply for BPJS .. still in process of KK with both our names

 

[Samoerai]

So, unless you have an accident that requires hospitalization, how often will a person need a treatment that costs over IDR155m in Indonesia?

In some cases, major surgery and hospitalization, requires large sums of money to be paid. Just recently, my uncle in The Netherlands, had colon cancer surgery. Surgery was succesfull but he had to stay in the hospital for 30 days, because his colon wouldn't start up (lack of other expression). In The Netherlands all is covered by insurance. So, imagine that one has to undergo something like this in Indonesia.

 

[gemima]

I am still contemplating on this. Asking advice on this forum. Shall I do it, or not? Pros and cons?

I would say no. I pay 170 euro a month (well my company does) for my expat insurance from my home country (Ireland - I've had insurance cover with the same company my entire life...). There is nowhere near as high an excess (in fact there is practically no excess..its 45 euro per medical condition) and they add in travel insurance as part of the cover. The only issue is I've never claimed anything so I'm not 100% sure how helpful they will be in the event I do end up hospitalized. I recently watched a friend die here without any attempt to medivac her from her insurance and it has woken me up to the reality of what can happen if you are suddenly incapacitated (the care she got at the hospital was covered by the insurance and it was very good so the lack of medivac was linked to her inability to survive the journey).

 

[Samoerai]

It's per claim (the deductible) so you got screwed

As said before, it is per year. However you are screwed if you need surgery and are hospitalized -let's say in December. You have to pay the deductible (in my case 7400 euro) and the next year you need 'after-surgery', then you pay the deductible again

 

[harryopal1]

Residing in Indonesia, opting for BPJS is a no brainer due to its incredibly low cost..........
However, a reported issue arises for some expats, even those with spouse sponsored ITAP as they are reportedly unable to access BPJS.

I have a spouse sponsored KITAP (permanent) and just recently successfully applied for BPJS although some while ago we were told that was not possible.

 

[Samoerai]

Some of you are saying not to go ahead with Cigna. Still "bingung dan ragu-ragu", because

(1) I cannot (yet) apply for BPJS (KK still only with my name, called KK WNA).
(2) At my age the premium for health insurance is minimum around 4 juta per month, unless one opt for a large deductible, which is not always an option because most insurance don't have this option.
(3) Cigna is worldwide (ex. USA). So not only coverage in Indonesia. Also, when I travel I don't need a travel insurance.
(4) Hospitalization with VIP is covered, without rules (so called pro rate rule), like with Allianz and Prudential: if VIP rooms are all full you can upgrade to Super VIP room for 2 days and when normal VIP room is available you have to move. Or something in that order. Be carefull if you are in this situation, because if you stay in the Super VIP room you end up paying for a portion of the total(!) hospital bill.
(5) Also no lists, saying you are not covered for 6 month for these illnesses and 1 year for those critical illnesses.

What to do?

 

[snpark]

Seems you've made your mind up despite already everyone saying NO

So good luck then with Cigna

 

[Wisnu]

I do agree Bupa is top class. We had Bupa for more than 10 years under company health benefits, before change to Cigna.
Cigna is not bad. The only issue, in Indonesia, it take more time to get approval for in-patient procedure. Time difference with UK could be issue too.
However, never get problem for reimbursement in case of we have to pay first.

 

[Samoerai]

Seems you've made your mind up despite already everyone saying NO

So good luck then with Cigna

Hmm, it's that I don't have another option that's reasonable ..

 

[snpark]

Hmm, it's that I don't have another option that's reasonable ..

Did you try Allianz? Mine is worldwide and direct billing, not sure why you said you can't get global, its cheaper if you do Indo only
Worldwide always excludes USA but thats what travel insurance is for, for the 28 days when you are in USA etc

 

[Samoerai]

Did you try Allianz? Mine is worldwide and direct billing, not sure why you said you can't get global, its cheaper if you do Indo only
Worldwide always excludes USA but thats what travel insurance is for, for the 28 days when you are in USA etc

The underwriter didn't give me much confidence .. confidence in future requests for hospital treatments assessments.

 

[pantaiema]

Still cannot apply for BPJS .. still in process of KK with both our names

From What I read. You will get a more success rate when your name is registered in the Family registration card (KK) with an Indonesian who already have access to BPJS such your other half. But not all people have the same circumstances.

 

[Samoerai]

From What I read. You will get a more success rate when your name is registered in the Family registration card (KK) with an Indonesian who already have access to BPJS such your other half. But not all people have the same circumstances.

I know .. I am in the middle of that process. But the head (or what ever it is called) of that Dukcatpil is not very cooperative.

 

[Hawk256]

I know .. I am in the middle of that process. But the head (or what ever it is called) of that Dukcatpil is not very cooperative.

Surely making him happy is cheaper than the montly fee and high deductible of the policy you are looking at.

 

[Samoerai]

Surely making him happy is cheaper than the montly fee and high deductible of the policy you are looking at.

Yeah. That's what I am thinking too. My wife is not so happy about it. That day he was talking how difficult it is to put a WNI and WNA on one KK, because the databases are seperated (blocked was the word he used). She knew what he was after.

 

[Hawk256]

Yeah. That's what I am thinking too. My wife is not so happy about it. That day he was talking how difficult it is to put a WNI and WNA on one KK, because the databases are deperate (blocked was the word he used). She knew what he was after.

My wife and I didn't have that problem and I have never heard anyone claim anything similar. I think it's clear where the "problem" is. I guess the only question now is how much it costs to fix.

 

[pantaiema]

I know .. I am in the middle of that process. But the head (or what ever it is called) of that Dukcatpil is not very cooperative.

In many instances you can not change the system alone. You might need to do it with Indonesian way of doing that.

 

[Samoerai]

it's clear where the "problem" is

Yes, clear. It's the culture here. Already discussed - and on going - in the thread "wonders & curiosities" - and even in this thread.

Bules pay a different price than locals. In Bali this is a well known fact. Bules are "walking jompets" .. not my expression, btw. Ambil taxi in Bali on a Saturday evening and asking "pasang argo"? Tidak bisa, pak.

Corruption .. even in hospitals, where doctors perform unnecessay assesments .. "Oh, we have to do the ct scan again, but now with contrast, because this ct-scan is not clear". After that "Oh we better do a mri-scan, because that is the best".

Visa agents only can arrange a kitas-retirement. Why? Because the agent will be your sponsor. Really? So if I cannot pay my hospital bill, the agent should? The procedure for the kitas takes 2 months, but there is also an "express"-procedure. Cost you a arm and a leg, though.

Upgrade one's listrik power to 5500 Watt in the rumah? Bisa, tapi harus tunggu 2 months, but if you pay someone inside PLN, bisa cepat!

And I can go on and on and on.

 

[Pak Tani]

Yeah. That's what I am thinking too. My wife is not so happy about it. That day he was talking how difficult it is to put a WNI and WNA on one KK, because the databases are seperated (blocked was the word he used). She knew what he was after.

Don't do it. If you start paying, they will try it again on you whenever you need them and also on other bules.

They must be under another department, Menkanham or whatever. Just play dumb, don't pay, and tell them you want to find a solution for the 'blocked-problem' there.

And, when you go there, don't make that your only destination. Find something nice to do in that area when you're done at HAM (mall?) and a nice place to eat.

It's going to be fun!

 

[Samoerai]

Don't do it. If you start paying, they will try it again on you whenever you need them and also on other bules.

They must be under another department, Menkanham or whatever. Just play dumb, don't pay, and tell them you want to find a solution for the 'blocked-problem' there.

And, when you go there, don't make that your only destination. Find something nice to do in that area when you're done at HAM (mall?) and a nice place to eat.

It's going to be fun!

I like your respond
I will check who is his boss and try to talk to him.

My position would be stronger if it's really true that a KK-WNA can be joined with the KK of the spouse. Where does it say this?

Would it be this article? https://www.hukumonline.com/klinik/...i-wna-yang-menikah-dengan-wni-lt59648d2c92064