Having Health Insurance is Crucial. But First, What Exactly is Health Insurance?

 

Human life cannot be free from uncertainty, as is the case when the burden of three diseases appears simultaneously (triple burden disease) in Indonesia today, which requires us to be more alert in maintaining the health of ourselves and our families. The three burdens of disease in question are the rapid prevalence (number of case growth) of non-communicable diseases, the number of classic infectious diseases which are still relatively high (for example: dengue hemorrhagic fever, diarrhea, etc.), as well as COVID-19 as a new type of infectious disease that evolved from other diseases. long.

All the facts above make managing a healthy life, treatment when sick, and health recovery increasingly complex and require quite a lot of money. If in the end this condition shakes up one’s own and family’s finances, several of these risks may occur: (a) dreams will be dashed because savings funds will be drained for treatment, (b) becoming a burden on the family or parents, or even (c) losing a source of income to survive.

None of us is immune from the threat of disease, so we need more than just savings and emergency funds to maintain financial resilience when facing risks related to uncertainty. This is where insurance comes in as a protection instrument, including providing health protection benefits through health insurance.

In contrast to life insurance which provides insurance benefits to the family/heirs of the insured, if the insured dies due to health problems, illness or accident, health insurance will usually cover the costs of medical treatment, hospitalization and surgery based on the terms and conditions agreed in the policy.

What is Health Insurance?

According to Investopedia, health insurance is a type of insurance protection that covers medical, surgical, drug and similar costs for the insured or policy holder.

For example, you have a fever and go to the hospital. After being examined by a doctor, it turns out that you need to check the laboratory and also buy medicines for the healing process. Well, the costs you incur during the treatment process can be partially or fully reimbursed if you have health insurance.

However, the amount of costs covered and the services provided by health insurance will vary depending on the benefits stated in your insurance policy. So make sure to read the insurance policy carefully before deciding to buy it.

Why is Health Insurance Important in Today’s Times?

Having health insurance is a wise step in maintaining financial and physical well-being. Here are several things that can help convince you to get health insurance.

1. Financial Protection

Quality health care often involves significant costs. By having health insurance, individuals do not need to worry about too heavy a financial burden when facing illness or injury. Health insurance helps protect against the costs of hospitalization, medical examinations, operations, and expensive medications.

2. Access to Quality Health Care

Health insurance provides easier access to quality healthcare services without having to worry about high costs. This allows individuals to receive early diagnosis, timely treatment, and necessary medical interventions to maintain their health.

3. Prevention and Preventive Maintenance

Many health insurance plans also cover preventative services and preventative care, such as annual health exams, vaccinations, and screening for certain diseases. This helps in detecting the disease early and prevents the development of more serious medical conditions.

4. Peace of Mind

Having health insurance provides invaluable peace of mind. In a health emergency situation, individuals and families do not need to worry about how they will pay for large medical bills. They can focus completely on their recovery and health.

5. Protection from Future Uncertainty

No one can predict when someone will fall ill or have an accident. By having health insurance, individuals can protect themselves from the uncertainty of the future. They have a financial security network that can help them deal with unexpected situations.

After reading the things above, if you are interested in having health insurance, you must understand the types of health insurance. The following are several types of health insurance in terms of benefits, type of treatment, organizing body, and parties covered:

1. The types of health insurance are divided based on their benefits, namely:
2. Health insurance with inpatient benefits

Inpatient insurance focuses on providing protection to policy holders if they have to undergo treatment or hospitalization in hospital, such as treatment for illnesses that are deemed to require special treatment or the recovery process after undergoing surgery or surgery.

1. Health insurance with critical illness protection benefits

Critical illness insurance generally takes the form of additional benefits from life insurance, which provides coverage for medical treatment costs when a customer is diagnosed with a critical illness.

1. Health insurance with accident protection benefits

Personal accident insurance is insurance that covers the risk of total permanent disability or death due to an accident. This type of insurance is designed to cover treatment costs due to risks experienced by the insured when experiencing an accident, either at work or on the road while driving.

1. Insurance linked to investment

This insurance is basically not health insurance, but health benefits are an additional benefit (rider). This type of insurance is officially referred to by the Indonesian Financial Services Authority (OJK) as Investment Linked Insurance Products (PAYDI), namely a protection service that combines whole life insurance with investment products.

2. Based on the type of treatment

Health insurance based on the type of treatment is divided into 3, including:

1. Inpatient Insurance

This type of insurance covers treatment costs that arise when the insured party is hospitalized, such as room costs, laboratory tests and surgical procedures. This insurance provides financial protection when the insured person requires intensive care and hospital stay.

1. Outpatient Insurance

This insurance covers treatment costs that do not require hospitalization, such as visits to the doctor, periodic health checks, dental treatment, and purchasing medication. This type of insurance focuses more on preventive care and non-urgent medical treatment.

1. Combined Care Insurance

This type of insurance combines coverage for inpatient and outpatient treatment. Through this insurance, the insured party will get the benefits of both types of treatment by paying a single premium.

3. Based on the Organizing Body

Health insurance based on the type of treatment is divided into 2, including:

1. Private Health Insurance

Managed by a private company, this health insurance offers various types of policies with a number of benefits and premiums that can be adjusted. This insurance company can adjust protection coverage and choice of health service providers according to individual or family needs.

1. Government Health Insurance

Administered by the government, this insurance is often called the national health insurance program. Countries with government health insurance systems generally have mandatory policies for residents to participate in this program by paying contributions.

4. Based on the Insured Party

Health insurance based on the type of treatment is divided into 3, including:

1. Individual health insurance.

Individual health insurance provides financial protection to individuals to overcome the risk of health costs that may arise due to illness or accident.

In this context, you as a policy holder will pay insurance costs (premiums) to the insurance company in exchange for the coverage or health benefits provided. The premium amount also varies, depending on several factors such as age, health history, and the type of coverage you choose.

Individual health insurance not only provides financial protection and easier access to healthcare, but also provides peace of mind. Apart from that, health insurance can also help you as a policy holder to be more aware of improving the quality of life through routine health checks and early treatment when sick.

1. Family health insurance.

Family health insurance is a form of health protection that covers all family members in one policy. With family health insurance, policy holders can get health protection benefits for themselves, their partners and their children.

Family health insurance premiums tend to be lower or more economical than purchasing individual policies for each family member, thus providing an efficient and affordable solution to meet the family’s health needs.

Family health insurance coverage is almost the same as private health insurance in general, namely coverage or benefits for inpatient care, outpatient care, birth benefits, dental benefits, glasses benefits and general examination benefits.

1. Group/employee health insurance.

Group/employee health insurance is usually provided by a company for their employees, where the health insurance aims to provide health protection that covers a group of people in one policy.

Group/employee health insurance usually covers a wide range of health services, including routine check-ups, hospitalization, and provision of medications. In addition, this insurance program can also cover additional services such as eyeglasses, dental care and mental health services.

In some companies, group/employee health insurance can also cover the spouse and two children of employees who are insured in the insurance policy. Employees who benefit from group/employee health insurance can feel more valued and protected, while companies can leverage this as a way to increase employee satisfaction and retention.

Health Insurance Benefits.

The benefits of health insurance are extensive and cover various aspects that affect an individual’s daily life, financial stability, and physical and mental health. Below, I will discuss in detail some of the main benefits of having health insurance.

1. Access To Necessary Medical Care: One of the greatest benefits of having health insurance is the ability to access necessary medical care without having to worry about high costs. With adequate health insurance, individuals can get the health care they need without having to delay or avoid it for financial reasons. This allows for early diagnosis and timely treatment, which in turn can increase the chances of cure and reduce the risk of more serious complications.
2. Financial Protection: Health care costs can be very expensive, especially for complex medical procedures or long-term conditions. Without health insurance, a person may have to use their savings or even go into debt to pay for large medical bills. Health insurance provides financial protection against these risks, by paying some or all of the costs of needed medical care. This helps maintain individual and family financial stability, as well as avoid the detrimental financial impact of unexpected medical bills.
3. Prevention and Early Detection: Many health insurance programs offer coverage for preventive health examinations, such as blood tests, routine health examinations, and vaccinations. It helps in the prevention of preventable diseases and health conditions. Apart from that, health insurance also facilitates early detection of existing diseases, such as cancer or heart disease. By detecting the disease early, individuals can begin treatment more quickly, increasing the chance of recovery, and reducing long-term care costs.
4. Chronic Disease Management: For individuals living with chronic health conditions such as diabetes, asthma, or hypertension, health insurance provides access to the care they need to manage their conditions. This may include consultation with a specialist, medication, or physical therapy. By having access to appropriate care, individuals with chronic illnesses can better manage their conditions, prevent complications, and maintain an optimal quality of life.
5. Family Protection: Health insurance also provides financial protection for the family in the event of an accident or serious illness that requires long-term care. In such situations, medical costs and loss of income can burden families financially. Health insurance helps reduce this financial burden by paying some or all of the costs of medical care and providing income replacement if an individual is unable to work due to illness or injury.
6. Mental Well-Being: Worrying about the high costs of medical care can cause significant stress and anxiety. By having adequate health insurance, individuals can have peace of mind in knowing that they are protected from the financial risks associated with unexpected illness or injury. This can reduce stress and anxiety levels, as well as improve overall mental well-being.
7. Encourages Preventive Care: Health insurance often covers the costs of preventive health check-ups and vaccinations, which encourages individuals to pay regular attention to their health. By encouraging preventive care, health insurance can help reduce the rate of preventable diseases and lead to a healthier population overall.
8. Contribution to the Health System: By providing easier access to health services and encouraging the prevention and management of chronic diseases, health insurance helps reduce the burden on the health system as a whole. This can lead to increased efficiency, reduced health care costs, and improved quality of health care for everyone.

Tips for Choosing Health Insurance

So, after knowing the various information needed to apply for health insurance, you can start looking for insurance products and providers that are right for you! However, sometimes there are too many health insurance providers offering attractive benefits and premium prices, making us confused about which one to choose. Following are tips for choosing health insurance to suit your needs and abilities.

1. Determine your health needs.

Before choosing a health insurance provider, it’s a good idea to know the health needs of you and your family. Consider factors such as medical history, type of healthcare services desired, and additional needs such as dental or eye care.

2. Compare the premiums and benefits offered.

Compare the premium costs and benefits offered by several insurance companies on your list of choices. Carefully consider what is covered in the policy, including coverage limits.

3. Check the health service network.

Make sure that the health service provider you choose is within the insurance provider’s network. This can help reduce maintenance costs and ensure easier access.

4. Consult an insurance agent.

If you need it and it is possible, look for a trusted insurance agent. They can help you understand your options and choose a policy that suits your needs.

5. Consider the budget you have.

Adjust insurance choices to suit your budget. Choose a policy that provides an optimal balance between costs and benefits you will get.

Before making a decision to buy a health insurance product, consider all these factors and tips, and make sure you fully understand the terms and conditions of the health insurance policy you choose.

How to Register for Health Insurance

Signing up for health insurance can differ depending on the country you live in, the type of insurance you choose, and the insurance provider you choose. However, generally, the steps are similar in most places. Here are the general steps for signing up for health insurance:

1. Research and Evaluate Your Needs:

Before you sign up for health insurance, consider the health needs of you and your family. Review the type of coverage you need, including whether you need coverage for preventative health care, chronic medications, or emergency care.

2. Research Insurance Providers:

Do your research to find an insurance provider that suits your needs. You can do this by searching online, comparing coverage, costs, and customer reviews of multiple insurance providers.

3. Contact an Insurance Agent or Representative:

Once you have selected an insurance provider, contact an insurance agent or representative to discuss the available options and get more information about the plans offered. They can help you understand coverage details, premiums, and the enrollment process.

4. Choose a Suitable Plan:

Once you have a good understanding of the plans available, choose a plan that suits your health and financial needs. Consider factors such as coverage, monthly premiums, deductibles, and maximum limits.

5. Filling Out the Application:

Once you choose the right plan, you need to fill out a health insurance application. This application usually includes your personal information, financial information, as well as the medical history of you and family members who will be covered by insurance.

6. Submit Supporting Documents:

In addition to filling out the application, you may need to submit supporting documents such as a copy of your identity, proof of address, and additional financial information. This may vary depending on the insurance provider’s requirements and the type of plan you choose.

7. Waiting for Approval:

Once you have submitted your application and supporting documents, you need to wait for approval from the insurance provider. The approval process usually involves reviewing the application and verifying the information provided.

8. Premium Payment:

If your application is approved, you will be asked to pay the insurance premium. These premiums are usually paid monthly or at other intervals determined by the insurance provider.

9. Accept Insurance Cards:

After premium payment, you will receive your health insurance card. This card contains important information such as the policy number, insurance provider name, and coverage start date.

10. Understand Coverage and Benefits:

Lastly, be sure to fully understand the coverage and benefits provided by your insurance plan. Know the network of covered health care providers, claims procedures, and your plan’s limitations.

11. Using Health Services:

Once you are enrolled in health insurance, you can start using the health services available under your plan. Make sure to take advantage of your coverage by following the guidelines and procedures established by your insurance provider.

In Conclusion, health insurance is an important financial instrument in protecting individuals and families from the financial risks associated with high medical care costs. With adequate health insurance coverage, individuals can access the health care they need without having to worry about exorbitant costs. The main benefit of health insurance is access to necessary medical care whether on a normal day, related to chronic illness or when an accident occurs. In signing up for health insurance, individuals need to do research to determine their health needs and choose a plan that suits their needs and budget and they can also consult with an insurance agent so that the insurance they purchase fits their needs.

Health insurance plays a crucial role in increasing access to medical care, protecting individual and family finances, and promoting overall health and well-being. By understanding the benefits, types and process of enrolling in health insurance, individuals can take steps to protect themselves and their families from unexpected health risks.