Category
Purchase & Payment Claims Submission Endorsement & Cancellation TAMI Feature
/
/
/
What's the difference between Perlindungan Kesehatan Prima & HealthPlus Family?

Perlindungan Kesehatan Prima and HealthPlus+ Family are health insurance plans that offer inpatient/surgery and outpatient benefits for both individual and family members.

The differences between these two products are:

  1. Perlindungan Kesehatan Prima:
    • Inpatient benefit follows an inner-limit scheme, meaning consultation fees, room and board, and miscellaneous costs, has its own limit.
    • The waiting period applies during the first year of coverage as follows:
      • 270 days from the effective date of the policy specifically for pre-existing conditions and certain critical illnesses.
      • 15 days from the effective date of the policy for treatment due to illness (except for accidents and Saldo Prima).
    • Inpatient benefits will be reinstated in 30 days after previous medical treatment for the same diagnosis, including any complications.
  2. HealthPlus Family:
    • Inpatient benefit is an as-charged scheme, meaning coverage aligns with the actual bill from the clinic/hospital. The payment for this as-charged scheme benefit follows the terms and limits in your schedule of benefits.
    • The waiting period applies during the first year of coverage as follows:
      • 15 days from the effective date of the policy for treatment due to illness (except for accidents and Saldo Prima).
      • 12 months from the effective date of the policy specifically for pre-existing conditions and certain critical illnesses.
    • Inpatient benefits will be reinstated in 0 days after previous medical treatment for the same diagnosis, including any complications.
Was this article helpful?
Related Article
When does my policy coverage period start?
What’s the age limit to become member of HealthPlus Family?
Does HealthPlus Family cover pre-existing conditions?
Share MyPro on
facebook
twitter
instagram
contact-us-banner
Help Center
Have problems or questions regarding MyPro? You can contact us here
phone
0803-133-8888
 email
cs@myprotection.id
wa
0878-1321-7520
Help Center
Have problems or questions regarding MyPro? You can contact us here
phone
Call Center
email
Email us!
wa
WhatsApp