Insurance as one type of expenditure that should not be trimmed even though it is saving is something that is currently provided by the company for its employees. Generally, the company currently provides Government insurance, which is often known as BPJS Kesehatan. Unmitigated, even in some companies also facilitate their employees with insurance from private companies at once. By having this facility, of course you can maximize health insurance from the company, in order to get multiple benefits. Check out more below here:
Know Exactly What Type of Health Insurance and Benefits You Can Get
When subscribing to BPJS Kesehatan, there are three types of classes that have their respective functions that can be used according to the fees paid, starting from services in the Class I, II, and III treatment rooms. Each of these types of insurance can certainly provide your own benefits. As with private insurance, usually you can get different benefits, according to the package registered by the company.
When getting a health insurance card and guidebook, read as much as possible so you can maximize health insurance from the company you work for. Pay attention to details such as how much the maximum number of outpatient claims you can get in a year. Do not miss, also pay attention to how much the maximum bill for claiming hospitalization & care facilities in class what you can get with the insurance.
When doing outpatient care, you also have to pay attention to whether there are types of drugs that cannot be claimed. For some types of health insurance from the company, for example, you can get all types of drugs or vitamins / supplements, but in other types of insurance you might not be able to get them. This can make you more anticipated when the doctor will prescribe vitamins, ask for the type of vitamin or generic drug, because the price is tilted the function is not much different. So, even though the drug cannot be claimed, you can still save money.
Pay attention to the location of a hospital or health facility that you can visit to make a claim
Do not miss, in order to maximize health insurance from the company, you also need to know exactly about where you can take advantage of the health insurance. There are several types of insurance that can be claimed at any hospital, but it is different from BPJS Kesehatan. Usually BPJS Kesehatan already has partners with several types of hospitals, clinics, health centers, or doctor practices that you can visit.
Make sure that these locations are close to where you live (both home and boarding). After that, find out where the hospital or health facility is. It is important to know these locations, so that when you fall ill no longer waste time just to find the location of health insurance claims. Of course when the body condition is not optimal, of course this will only make your body weaker.
Know the Process for Making Claims to Specialists
Again, different types of health insurance are also different ways to use it. For BPJS itself, of course you have to really understand about where the health facilities are located that can help you make claims. If indeed the general practitioner who works then recommends that you see a general practitioner at a particular hospital or specialist, of course you must get a referral letter first.
Unlike private health insurance, you can usually go directly to a general practitioner or specialist who you want to meet. You only need to register to be a patient in a partner hospital, then you can immediately process it to the doctor in question.
Right now, precisely since 2014, the government already has a new program that can be used by employees who also get two types of health insurance: Government and Private. This program is called Coordination of Benefit (COB).
What is Coordination of Benefit (COB)?
Reporting from BPJS Kesehatan, COB is a program carried out by BPJS Kesehatan with the Indonesian Life Insurance Association / Indonesian General Insurance. COB is a process in which two underwriters who bear the same person to take advantage of the same health insurance benefits, limiting the total benefits in a certain amount which does not exceed the amount of health services that are expended. This is indeed intended to improve services for participants who want and are able to pay more, but at a sloping price.
With this program, you can take care classes and get benefits that are not covered by the JKN rules, and get advanced treatment that is exclusive and can be treated at a private hospital that has not collaborated with BPJS Kesehatan, if in an emergency. BPJS Health will continue to guarantee fees according to the tariffs applicable to the program, while the difference will be the responsibility of private insurance, as long as it is in accordance with applicable provisions & procedures.
This certainly can be a distinct advantage, because if you visit a hospital that is not yet a BPJS Health partner, but already a private insurance partner, you can take the reimbursement option to private insurance. Later, the private insurance company will collect money from BPJS Kesehatan, according to rules that have been determined by BPJS Kesehatan.
Check here to find out what private insurance works with BPJS Kesehatan in the COB program.
Examples of simulations in utilizing the COB program:
Budi is an employee of PT XYZ, which facilitates himself with health insurance from BPJS Health and ABC Insurance, which is also a partner of BPJS Kesehatan. One time, Budi fell ill, so he approached the health facilities that sheltered him in the BPJS Health program, where the doctor gave a referral letter to be hospitalized. After visiting the partner hospital, the local doctor finally decided that Budi would be hospitalized for several days, using class I care facilities, such as those paid by the company where he worked.
Because he wanted to maximize health insurance from the company where he worked through the COB program, Budi finally informed the hospital to take advantage of the COB program. So, instead of just staying in a class I room, Budi made a request to be moved to the VIP class. He shows the BPJS Health card and private insurance. After that, the hospital will process the process, and process all the steps that need to be done so that Budi can be treated in the VIP class. Later, the difference between VIP and class I fees will be claimed by ABC insurance to BPJS Kesehatan, in accordance with applicable regulations.