The presence of the Social Security Agency (BPJS) Health is good news for us all. Not only serve the civil servants, retired civil servants, military / police, now everyone can enjoy BPJS this.
Since the beginning of 2014, health insurance and employment turn into the Social Security Agency (BPJS). Inside it is divided into two segments, namely BPJS Health and Employment.
BPJS card sorting officer of health of inmates Social (WBS) at the presentation card in Children's Social Health BPJS Bina Insan Bangun Daya 2, cipayung, Thursday (24/4).
Health BPJS derived from Health Insurance (Askes), while the Employment BPJS transition of Social Security Workers (Jamsostek). Health BPJS currently using the system of Indonesia Case Based Groups or INA CBG's, so it is more structured and has its own standards.
Actually, how big a role BPJS for society? For civil servants may indeed required to have BPJS. However, they as private employees are not necessarily thinking the same thing, especially those with deep pockets and have private health insurance.
Executive Director of the General Insurance Association of Indonesia Julian Noor still assessing BPJS weak to services. "Not suitable for the lifestyle of the elite," he said. Upper-middle income people still can not claim to be forced to follow the flow of BPJS. They are not used to queue or provide proof of the claim that is currently being used BPJS in his system. Bother when treatment is not in their perception.
As experienced Astrika Yuanita, assistant manager at one of the private companies. He admitted that currently do not have BPJS. "Have not had time to take care of it," said the woman who was familiarly called this Tika. He currently has health insurance from two private banks. The first insurance for outpatient and inpatient other. Both are given facility office where he worked. With two types of insurance is enough for him. Moreover, both are valid for up to two children personally.
Women who are still single is also not really know about BPJS Health. But his office has given Social Security before switching to BPJS. But he does intend to take care of BPJS Health as a good citizen.
In addition, 27-year-old woman was also always keep the pattern of life that are not easily fall ill. Moreover, pain is a calamity that could come at any time. Certainly have to prepare it.
While Yuyun Pramita who works as a civil servant (PNS) in one of the government agencies already have BPJS Health. "It used to wear Askes and direct Askes automatic switch," said Yuyun.
This shift was initially baffled when treatment but now is not. But long lines berlum still a problem that is resolved by the government.
Besides BPJS Health, Yuyun also use private insurance. This is to help patch that can not be handled Askes. There are several medications and medical procedures that can not be paid by Askes or BPJS Health. For that Yuyun and families use private insurance to cover it.
Insurance is used for emergency situations that are not too heavy when paying. For premium, Yuyun also not take too large amount in order not to burden the family finances. Because he still had to pay several installments and insurance education.
There Plus Minus
Financial planners from Tata Consulting Dana, Diana Sandjaja CFP, assess BPJS is an excellent program of government. Although still pegged premium, the amount will still be cheaper. "When compared with the premiums of private health insurance premiums BPJS certainly very cheap," he said.
What is interesting is people of all ages with a history of any disease can participate BPJS alias no selection. While private health insurance certainly adjust between age and disease history. Or might be rejected or excluded illness claim if there is already a history.
He added BPJS is a health protection program of the government that are made to people who have not able to have health insurance as a result of a weak economy or informal sector workers are now able to be a participant BPJS. "So who do not have health insurance, you should join BPJS," he advised.
According to Diana, BPJS could benefit the community, depending on the readiness of the government in facilitating this BPJS program. In that sense, competent clinicians, drugs and other enough. "This BPJS not harm the public," he added.
However, in addition to having advantages, BPJS also has its drawbacks. People who are accustomed directly to hospitals, clinics or health centers are required to advance. "Surely they felt having to commute. Not to mention if the drugs are prescribed only 10 days, not able to specialize more than one in a day and more. Now the rules of procedure that makes society more complicated, "said Diana.
While private health insurance is currently no stand-alone and no rider of life insurance. Existing forms of protection such as that created per item in terms of physicians, room, or the lab. Nothing can be directly billed according to hospital bills with a certain ceiling, there are just daily satunan only. Choose the appropriate needs. Ideally suitable hospital bills alone.
In addition, higher private insurance premiums, and no selection. If there is a new collection can take outpatient claims. If an individual, could not claim an outpatient. Private health insurance also depends on the program are taken. "Minus a fairly high premium, no selection, no limitations," he explained.
So it is more advantageous where, BPJS or private health insurance? "Depending on ability," said Diana.
If it is able, better grab the outpatient private but his own expense. Especially if the private health insurance premium class, which means scope of protection higher than BPJS. "But if less able or medium has the corresponding private BPJS and still better capabilities. Can there maanfaat coordination between private health insurance and BPJS, "he continued.
So, what is the ideal? BPJS course, private health insurance, or both? According to Diana, if private health insurance is already full cover, no longer need to have BPJS. Moreover, when the procedures and providers BPJS not liking. "But if they bear health insurance, plus BPJS better."
And, when choosing to wear BPJS course, we certainly have to be willing to stand in line and follow the procedure. "However, when viewed from premiums and benefits, BPJS is the best option," he added.
Do not be proof-texted
To determine health insurance that fits for us, private or government-owned, there are some things that should be considered. Choose carefully so as not to be disappointed later on:
- Be sure to know the limits warranties
- Choose the appropriate bill
- Choose the cashless
- Select hospital provider in accordance with the usual hospital we go or near home.