Some people may choose health insurance to help us in the process of treatment during illness and insurance that will bear any hospital treatment costs. The government is now actively holding an insurance program that can help the community, especially the community can not afford to be able to perform treatment. Health insurance is considered to have several benefits that really help us in performing treatment, especially those that require large costs such as surgery. Not a few of them are difficult to find treatment funds at a high enough cost. Therefore, the public is now switching to join the government health insurance program that can help to do any treatment. Although today many have insurance but some of them even less know or understand about the procedure claiming insurance. Although the procedure has been described by the agent and clearly written in the policy book. For that we need to re-understand the ways and procedures to claim our insurance. Below are some ways you can follow to claim insurance.
1. Be sure to Always Pay Premium
When we decide to have health insurance, it’s good to consider the premium to be paid each month. Make sure that our monthly income can be sufficient to pay health insurance deposits. Taking into account beforehand so we can pay the monthly premium and made it as a compulsory spending every month. If we do not pay premiums regularly every month then someday it will be a burden of high enough bills and will incriminate us. That way, make sure that our policy is not hollow or forget to pay monthly premiums.
2. Make sure the Insurance Period Has Been Over 30 Days
Many of the insurance companies determine the active period of the insurance after 30 days. For that, if less than 30 days, then if we are going to conduct treatment to the hospital most likely will not be accepted or rejected, unless in urgent conditions such as accidents. So beforehand we must ensure that the active period or policy life has been more than 30 days since filed to follow the health insurance.
3. Be sure to Read the Exclusion Clause
After we officially have health insurance and get a policy, then there are some things that must be considered. For example, read the policy in the clause clause of exceptions. Here are some examples of the contents of the exception clause listed on the policy.
For critical illnesses such as coronary heart disease and 34 other critical illnesses, it can only be claimed at least after 6 months. That way if we had previously had heart disease should not rush to claim it, try waiting for 6 months to 1 new year we can claim.
For a disease that already exists before, whether we know or not then the insurance company will not bear it. For example for congenital disease of birth.
After that make sure to check the insurance ceiling that has been provided for us. This ceiling contains the maximum amount of medical costs that will be covered by the insurance as long as we are treated. If using the cost of care more than set then we have to pay back for the shortcomings.
4. What If We Sudden Pain?
If the insurance card is an international SOS number then call to ask the nearest hospital we can refer.
After getting a hospital referral, usually the hospital will ask whether the room will be in accordance with the ceiling or higher. If we can add to the shortage is not a problem if you choose higher than our ceiling.
Generally hospital insurance using the card and with the card so that we do treatment inpatient for free alias not issued sepersenpun because everything has been covered by insurance.
5. Pay Later (Reimbursement)
In health insurance, there is a method of reimbursement or pay later. So when doing treatment, we have to pay for the medical expenses themselves first, but the cost will be replaced at the end by the insurance. Below is the procedure of reimbursement.
In the method of reimbursment, there are 2 types of forms of claims, namely the form of customer claims against insurance companies, and the second form of Doctor’s Certificate of care
When going to the hospital make sure to bring both the form and give to the nurse then those who will fill with accompanied by the hospital stamp.
Upon completion, we will get bill receipt for our treatment from the hospital, be sure to photocopy the receipt and ask the hospital to legalize it, because the original receipt will be requested by the insurer.
After returning from the hospital, we will have 3 documents, two claim forms and one receipt. After that we can then complete it with a copy of ID card and photocopy of account book. Document documents are then given to the relevant department of insurance claims. We can monitor the process by phone and after a maximum of 14 days we will receive the change of money as stated on the receipt from the insurer.
Notice the Claim Method
For some people, the steps above are still considered a bit confusing. But make sure to come back to understand it so we can benefit from our health insurance. In essence, regardless of the type of insurance you use, try to be sure by asking in advance about the mechanism of insurance claims.