Compare Health Insurance (part 3 – final)

9 May

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When you are looking for a health insurance company, you are looking for a partner that you can trust.  PT Asuransi Jiwa Sequislife, in 2010 was awarded as one of Top 50 Indonesia Corporate Brands by Swa magazine. It is a fully owned Indonesian Insurance company who has been serving in the industry since 1984 and has a track record of acquiring 2 Multinational Life Insurance Companies who was running business in Indonesia, i.e. New York Life and Met Life Indonesia which main office are in USA.  Its good running management is lead by Mr. Tatang Widjaja, who was also acknowledge by Warta Ekonomi magazine as one of “Indonesia Most Admired CEO 2011” for the insurance category.  More details regarding the company check its website http://www.sequislife.com .

As an insurance agent we are in a binding contract with the company which we represent to only sell that company products. In this case, I am only allowed to talk about Sequislife products, not other insurance company products. Thus when I said compare health insurance, you readers have to do your homework in comparing the proposals that you have in hand.  For the same price you paid, what benefits will you get?

Let’s start the comparison of proposals you have in hand with Sequislife Health Platinum Rider :

1. Plan based on the daily hospital room and board rate

-> Sequislife plan based on the daily hospital room and board rate in rupiah :

Plan A – 200,000 (taken out from the market in 2012), Plan B – 300,000, Plan C – 500,000, Plan D – 600,000, Plan E – 800,000, Plan F – 1,000,000, Plan F1 – 1,250,000, Plan G – 1,500,000, Plan H – 2,000,000.

One person is entitle to take multiple policy with health platinum riders benefit up to a maximum daily room and board rate benefit of 4,000,000 rupiahs per day, per person.

Admission of an Insured Person as an inpatient into a Hospital for a period of not less than 12 (twelve) hours is taken as 1 day stay. Maximum 150 days per policy year.

2. Lodger Fees for parents / relatives if the person insured is under 15 years old.

Plan B – 100,000, Plan C – 150,000, Plan D – 200,000, Plan E – 250,000, Plan F – 300,000, Plan F1 – 350,000, Plan G – 400,000, Plan H – 500,000.

Maximum 14 days per policy year, benefit above is maximum per day.

3. Medical Report Fees

Maximum 1 medical report per disability, maximum per medical report is 200,000 rupiah.

4. As charged benefits :

I. In-patient Benefits

a. Daily Intensive Care Unit (Maximum 45 days per policy year, maximum per day)

b. Hospital Miscellaneous Services such as :

– general nursing, prescribed and consumed drugs and medicines

– splints and plaster casts

– laboratory and X-ray examinations

– intravenous injections and solutions

– basal metabolism tests

– administration of blood and blood plasma, including the cost of blood and plasma.

c. Surgical Fees

d. In-Hospital Consultation (Includes Doctor and Specialists)

Maximum 2 visits per day, 150 days per policy year.

II. Out-patient Benefits

a. Day surgery/ out-patient surgery

b. Pre-hospitalisation/ pre-surgical Specialist Consultation

Maximum 30 days prior to hospitalisation.

c. Pre-hospitalisation diagnostic services and laboratory tests

Maximum 30 days prior to hospitalisation.

d. Post-hospitalisation treatment

Maximum 90 days post hospitalisation.

e. Emergency accident out-patient treatment

Received medically necessary treatment as an out-patient in Hospital within 24 (twenty-four) hours of the accident causing injury. Follow-up treatment by the same doctor or hospital for the same covered body injury will be provided up to the maximum amount and up to 30 (thirty) days from the date of the accident.

f. Emergency accident dental treatment

Accidental injury occurred to sound natural teeth, provided the medical attention is sought within 24 (twenty-four) hours of the occurrence of the accident.  All follow-up treatment costs by the same physician/doctor thereafter will be reimbursed up to 30 (thirty) days from the date of the accident.

g. Ambulance services

Maximum per policy per year is 500,000 rupiahs for all plan purchased.

Note : As charged benefit is subject to reasonable customary charges according to the plan purchased. As charged benefit is subjected to an Annual Overall Limit and Lifetime Overall Limit, whichever is reached first.

5. Special Benefits :

I. Out-patient kidney dialysis treatment

Plan B – 20,000,000, Plan C – 30,000,000, Plan D – 30,000,000, Plan E – 40,000,000, Plan F – 55,000,000, Plan F1 – 55,000,000, Plan G – 60,000,000, Plan H – 70,000,000.

Maximum per policy year.

II. Out-patient cancer treatment

Plan B – 20,000,000, Plan C – 30,000,000, Plan D – 30,000,000, Plan E – 40,000,000, Plan F – 55,000,000, Plan F1 – 55,000,000, Plan G – 60,000,000, Plan H – 70,000,000.

Maximum per policy year.

III. Prosthesis and Implant

Plan B – 1,500,000, Plan C – 3,000,000, Plan D – 3,500,000, Plan E – 5,000,000, Plan F – 6,500,000, Plan F1 – 7,000,000, Plan G – 7,500,000, Plan H – 9,000,000.

Maximum per policy year.

IV. Out-patient physiotherapy treatment

Plan B – 200,000, Plan C – 300,000, Plan D – 350,000, Plan E – 450,000, Plan F – 500,000, Plan F1 – 550,000, Plan G – 600,000, Plan H – 700,000.

Maximum benefit above is per treatment, maximum 60 days post hospitalisation; maximum 60 days per policy year.

V. Home Nursing

Plan B – 150,000, Plan C – 250,000, Plan D – 300,000, Plan E – 350,000, Plan F – 450,000, Plan F1 – 500,000, Plan G – 550,000, Plan H – 600,000.

Maximum benefit above is per day, maximum 120 days per policy year.

6. Annual Overall Limit

Plan B – 165,000,000, Plan C – 275,000,000, Plan D – 330,000,000, Plan E – 440,000,000, Plan F – 550,000,000, Plan F1 – 687,500,000, Plan G – 825,000,000, Plan H – 1,100,000,000.

Multiple policy with health platinum riders has a maximum annual overall limit of Rp.2.200.000.000,00 (two billion and two hundred million rupiahs) per year.

Benefits, except Accidental Death Benefit, payable in respect of expenses incurred for treatment provided to the Insured Person during the period of insurance shall be limited to the Annual Overall Limit irrespective of the type/types of disability.

In the event of the Annual Overall Limit having been paid, all insurance for the Insured Person shall immediately cease to be payable for the rest of the Policy Year.

7. Lifetime Overall Limit 

Plan B – 825,000,000, Plan C – 1,375,000,000, Plan D – 1,650,000,000, Plan E – 2,200,000,000, Plan F –  2,750,000,000, Plan F1 – 3,437,500,000, Plan G – 4,125,000,000, Plan H – 5,500,000,000.

Multiple policy with health platinum riders has a maximum Lifetime Overall Limit of Rp.11.000.000.000,00 (eleven billion rupiahs).

This limit applies to the total of all benefits that have been paid under this Rider, including all past renewals, during the entire lifetime of the Insured Person (or maximum until 75 years of age).

8. Accidental Death Benefit

Plan B – 60,000,000, Plan C – 100,000,000, Plan D – 120,000,000, Plan E – 160,000,000, Plan F – 200,000,000, Plan F1 – 250,000,000, Plan G – 300,000,000, Plan H – 400,000,000.

In the event of death of the Insured Person which occurs within 90 (ninety) days and from occurrence of a covered accident, the lump sum accidental death benefit is payable in accordance with the Plan the Insured Person is covered under, as specified in the benefit above.

9. International SOS Travel and Emergency Medical Assistance

In accordance with benefit provision in International SOS agreement for International Travel and Medical Assistance, Domestic Medical Assistance.

Important information : Sequislife Health Platinum medical cover is valid for All countries hospital medical treatment and special for heart surgery, the cost of stents and all heart surgery related cost is fully covered As charged, subject to the platinum plan limit purchased.

That is only the benefits, I’m sure everyone is more interested on How Much do we need to pay to get all of those benefits of Sequislife Health Platinum Riders. Below I will provide a rough estimate of the cost based on age range :

Age Range

1 to 20 (+WPDD)

21 to 35(+WPDD)

36 to 50

51 to 60

Platinum B

Rp.4.200.000,00

Rp.6.500.000,00

Rp.10.500.000,00

Rp.12.000.000,00

Platinum C

Rp.6.200.000,00

Rp.8.500.000,00

Rp.15.000.000,00

Rp.17.000.000,00

Platinum D

Rp.7.200.000,00

Rp.9.500.000,00

Rp.17.000.000,00

Rp.19.000.000,00

Platinum E

Rp.9.200.000,00

Rp.11.500.000,00

Rp.22.000.000,00

Rp.24.000.000,00

Platinum F

Rp.10.400.000,00

Rp.14.000.000,00

Rp.26.000.000,00

Rp.29.000.000,00

Platinum F1

Rp.13.500.000,00

Rp.18.000.000,00

Rp.35.000.000,00

Rp.39.000.000,00

Platinum G

Rp.15.500.000,00

Rp.21.000.000,00

Rp.39.000.000,00

Rp.43.000.000,00

Platinum H

Rp.17.800.000,00

Rp.24.000.000,00

Rp.46.000.000,00

Rp.53.000.000,00

Age

     

51 to 60

Platinum B      

Rp.12.000.000,00

Platinum C

     

Rp.17.000.000,00

Platinum D

     

Rp.19.000.000,00

Platinum E

     

Rp.24.000.000,00

Platinum F

     

Rp.29.000.000,00

Platinum F1

     

Rp.39.000.000,00

Platinum G

     

Rp.43.000.000,00

Platinum H

 

 

   

Rp.53.000.000,00

Note : For age range 1 to 35, the premium has include an additional rider called Sequis Waiver of Premium due to Disability or Dread Disease (WPDD). The premium above is an annual premium with a unit link based product with a minimum of 10 years premium payment period.

There are waiting period and exclusions applies. Make sure you check with the agents to know the details before you decided to buy the products. The younger you are the cheaper the premium, the more benefit you can get.

No one knows whats going to happen tomorrow, so ask yourself, if you are hospitalised, for whatever reason and the cost is reaching up to say 150 million rupiahs, who is going to pay the bill? Will your boss/company pay for it? Do you have enough savings to cover it? Will your family future affected if you have to pay for it? Health Insurance is just one way to get that peace of mind when the event come to life.

If you are unsure, try to do some financial planning ahead.  As a financial planner I can assure you that Financial Planning is more than just about securing your future, it is about making your dreams come true.

Thank you for reading and any request for personalised proposal of the product please contact me by email on steviani@gmail.com or tweet @steviani29 .

Steviani, CPA, CFP®, 2013 Sequislife ICON, MDRT.

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