Health Insurance

Since the topic of this thread is health insurance for expats on Bali I fail to understand how comments about what Indonesians, other than those in Bali, do regarding their medical care choices relate to the issue being discussed.

But, since it's been raised, allow me to correct some of the prior comments.

True enough, wealthy Indonesians may well choose to head off to Kuala Lumpur, Singapore or Bangkok for serious medical issues, but they are a small minority.  I guess you would have to have lived here for many years to understand that the vast majority of Indonesians, when in need of medical care, are more than happy to rely on local medical care as provided by a myriad of excellent medical facilities, as well as local healers which are found in a number of indigenous Indonesian cultures far beyond Bali, and its famed Balians.

As for the quality of medical care available in Indonesia, again, I guess one would have to be a user of local medical care to understand that it's actually pretty good.  In fact, in a year 2000 WHO report about the quality of medical care for each world country, Indonesian ranked right in the middle, and that was way back in 2000…or 14 years ago.*  Today, if such a study were done, Indonesia would surely rank even higher.  It's a pity that the WHO hasn't conducted a more recent study to verify what anyone who has been living here for many years already knows.

Back in the 1980's and even to the late 1990's it used to be fair game to knock the quality of medical care available in Indonesia…but things change, and here in Indonesia, things generally change for the better…once again, as anyone who has lived here for past decade and one half, already knows.

*Source:  http://en.wikipedia.org/wiki/World_Heal … ms_in_2000

Good informative information.

Richard Flax wrote:

After reading your comments you are effectively saying that you pay $1923 a year for top level cover including pregnancy ( that would be interesting ) and dental cover. 

With the greatest respect for someone over 60 this is amazing !


I've been rather lucky so far in Indonesia as I have yet to have serious injury or medical problem, but I will sooner of later.
That in mind, I have been reading this thread, looking at options.
Going out of the country for anything less than a very specialised illness seems more than a bit OTT and not something I'd consider otherwise.
The insurance companies I've looked at were all aimed at expats and all absolutely stupid as far as costs went.
After a trip to a hospital for a minor injury, I took a peek at a few local companies, asking advice as to the best value for money and least hassle.
A couple of the more well known brands were said to be great at getting premiums but lousy at paying out for anything; others were said to be far better, not arguing with what the doctors suggest.
So, why expat insurance, why not local insurance?
I do have one aversion here, I dislike anything priced in dollars.

MikeWallace77 wrote:

Indonesian medical care is not all that good. .


There is little argument; some Indonesian medical services are rubbish, others middle of the road at best.
However, your statement is untrue as there are many top class medical facilities available here.
Sweeping statements, especially false ones, are unhelpful.

“Assuming that expats are more wealthy than the average indonesian, it would still seem to be extremely reasonable for expats to seek better medical treatment overseas (if within our budget) and certainly for serious illnesses.”

For serious illness, that's obvious.  Or, as my oldest son Bima would say, “a no brainer.”  That is precisely why most medical insurance policies for expats in Indonesia include coverage for emergency medical evacuation. 

“Indonesian medical care is not all that good.”

According to who?  You?  In my last post I just cited the 2000 WHO report which puts Indonesia at the 48 percentile in ranking.  That means that as of the year 2000 Indonesia was ranked as average in quality of medical care.  By all accounts if the WHO did another current study, Indonesia would rank higher.  But of course, if you want to dispute that finding by the World Health Organization, be my guest. 

There are plenty of Indonesian medical students who study abroad, and moreover, there are many foreign students studying medicine in Indonesia…the International Medicine Program at Gadjah Mada University in Yogyakarta as just one example.  Surprise, surprise, foreign medical students coming to Indonesia to study medicine. 

“…you are not aware of this but rich indoensian families can pay to have their sons or daughters go through medical college and become practising doctors.” 

No question that medical schools cost money, but if you're inferring that one can “buy” a medical degree in Indonesia you are very mistaken. 

Making sweeping and exaggerated statements do nothing to benefit the readers of this forum.  Moreover, one misdiagnosis that you have personal knowledge of is no indication of anything aside from one misdiagnosis.  It happens everywhere, thus the term “second opinion.”

Fred, have you tried getting a quote from William Russell?

Keep in mind that in order to get the lowest premium cost, you should use the highest deductible you can afford.  The deductible is of course that amount of the total medical bills per year, or per occurrence, that you can afford. 

In a pinch, if you could come up with $2,000, then ask for a quote with a $2,000 deductible.  Unless you have a history of medical issues, you should find the premiums to be very reasonable. 

Medical insurance should be for catastrophic occurrences…disasters that will bankrupt you if you have to pay for all the care out of pocket.

I haven't tried WR as yet, but it has to be worth a phone call.
I did take a look at a couple of local ones, one looking very promising.

I, as with most of my family, have no history of illnesses before death.
The latter not tending to matter as you're past caring.
More seriously, our lot tend to get to 80+ and snuff it of something quick. My dad went with a burst artery at well over 80. Luckily, he'd got out of the car and was on his way into the bridge club. Still active right up to his demise.
Quite a handy place to go as it was the place he most loved.
Seems like the best way to me. A quick, "what the hell was that?" and gone.

It sounds like you're a medical insurance underwriter's dream.  Family medical history and your medical history all factor into rating your premiums. 

There are probably some good local companies to consider.  For me, it's all about the insurance company's reserve base and how much of their risk they have to pool out to other carriers.  In other words, a company with a long history and a solid track record for paying claims on time and without pulling some mysterious small print out of a hat like a rabbit is what is of most concern to me.

As we age, our priorities normally change from estate building to estate preservation.  When kids are involved, this only becomes more crucial.  Everyone's situation is different, and for certain, these situations change over time.

I'll be curious what you hear from WR.

Cheers!

It's worth taking note of that...!

I totally agree with your corrected statement, but to it I would add that it's one thing to get into the medical college, (using daddy's money or not), but it's quite another to maintain the required grades to continue. 

Also, I for one appreciate your willingness to correct your prior statement, but why would you have made such an outlandish and completely wrong statement, (which you presented as totally factual), in the first place?

This is how you originally made that statement:

“…and probably you are not aware of this but rich indoensian families can pay to have their sons or daughters go through medical college and become practising doctors. This may be untrue in Bali but for Java it is certainly true.”

It seems to me, and others too with whom I've discussed this, that you are often prone to present Indonesia and any of its problems, failures and shortcomings in the most unfavorable light possible, and sometimes even to make totally false statements which unfairly disparage Indonesia (as in the case of the quoted statement above).

A great quote by the American writer Harlan Ellison comes to mind:

“You are not entitled to your opinion. You are entitled to your informed opinion. No one is entitled to be ignorant.”  ;)

Good night.

.

“Hello Ubudian, yes you are most welcome to have your own opinion, but let's face it, from a tiny village outside Ubud you don't really know much about what goes on in Jakarta and West Java except from what you see on TV .”

It's precisely that sort of presumptive comment from you that often gets you into trouble.  And moreover, that comment presumes that you would know more, living in Kuala Lumpur until very recently. 

Firstly, my wife's older sister is married to a long time member of the Bali Provincial DPRD and a key member of his political party.  He is in Jakarta a lot, is well connected and serves on several national committees.  We speak very often, almost daily, and I suspect that my insight into what is going on concerning the political climate in Jakarta is likely better than if I actually lived there, and didn't have that family connection.

My Balinese wife holds a masters in business administration, and up until 1998, worked in Jakarta in a managerial position.  Another brother in law is a national artist of Indonesia, I Made Djirna, and through him I have personally met a number of the heavy hitting Jakarta tycoons, as many of them are avid art collectors, as I am.  And, in the conduct of family business, I am not without my own trips to, and time spent in Jakarta, although in the past five years, I haven't been there as often as I once was. 

My wife's family is prominent and well known.  As typical with Balinese families, her family is quite large, and also, it is very close.  Within her family there are high level police officers, immigration and customs officials, business persons, priests, and as already mentioned, high level political figures.  I know these people.  I have been living with them 24/7 for more than the past 15 years.   

And then of course I have my own considerable contacts here on Bali, and they start with his Excellency, the Governor of Bali, I Made Mangku Pastika on down.  My association with Mangku Pastika is through his personal Balian, who has been my own Balian, even before I met my wife.  Of course my personal contacts go well beyond his Excellency, but I surmise that a long list of “who is who on Bali” isn't necessary.  However, I am totally confident “Mike” that if we played a game of “who is better known” running your real name around Bali would produce little in the way of confirmation of what you claim as your contacts (heretofore nameless), and my contacts.   

This particular topic thread is about medical insurance and health related matters on Bali…not Jakarta or western Java.  So in reality, all of this discussion about Jakarta and western Java, which you introduced to this thread, is off topic anyway.  Nonetheless, it might be that we can accomplish something here, so I'll continue. 

As a side note, I was originally solicited by the forum founder to accept the designation “Indonesian expert” and not simply “Bali expert.”  I turned that designation down because while I believe my knowledge of Indonesia as a whole is pretty good, it is indeed Bali where I have the greatest amount of expertise and experience.   And moreover, that experience is recent and continuous for more than the past 15 years. 

“Whereas you have chosen to speak the opposite and say there is almost no corruption and that Indonesia is so wonderful.”

This is another area which also often gets you into trouble…your annoying tendency to put words in other mouths.  I have never said, nor could you ever find anything I've ever written, either here or on numerous other forums or blogs where I participate, that states “there is almost no corruption in Indonesia.”  What I have accurately stated, over and over, is that great progress has been made here in Indonesia regarding corruption, and that today with immigration and customs officials, one does not find anywhere near the levels of corruption that used to plague this great country.  That truism has been supported numerous times by other long time permanent residents and regular participants on this forum.  More importantly, it's the truth. 

Am I an optimist when it comes to Indonesia?  Absolutely yes, and my respect and profound appreciation for this great country made my decision to take full Indonesian citizenship all that more easy.  However, my optimism does not cloud my objectivity, and once again, I challenge you to produce anything written by me that would lead anyone to logically conclude otherwise. 

And yes, Indonesia is wonderful, and again, as most anyone who has lived here for as long as I have will agree, it keeps getting better, albeit there is still room for improvement.  No doubt there will always be room for improvement here.  That is the message that I continuously relay on this forum, and it's also the same message conveyed by those other long time permanent expats who regularly post here. 

And seriously, if you are more reliant on the comments of one particular Balinese driver as opposed to the balanced and more comprehensive comments you can read here by numerous sources, both Indonesian as well as expats, then I suggest you re-think just how it is you formulate your own opinions.

“But the way I see it is that so many Asian countries have the same problems, and Indonesia is no better than the others, and in many cases much worse.”

And this is a third area which often gets you into trouble…your tendency to make broad sweeping comments which are not offered as opinion, but rather as fact, and without any sort of documentation.

So, let's take that last comment and dissect it a bit by two simple questions…what counties in Asia is Indonesia “much worse” than?  And, how is “much worse” to be defined?  What possible useful purpose do such broad sweeping comments have?  The question is of course rhetorical, because the obvious answer is “none.”

“You should also remember that I too am married into an Indonesian family and have chosen Indonesia as my home.”

According to you, your move to Bandung is very recent…recent as in just this past month.  Also according to you, you lived here in Bali sometime during the 1980's and into the 1990's.  None of this is verifiable, and none of it is documented.  On the other hand I offer a direct link on every post I make here to my section on Virtual Tourist which provides a huge amount of documentation as well as many photos which only someone who is living here, and deeply immersed in the local culture, could have ever possibly taken.  Sorry to be blunt, but we have only your word on your experience in Indonesia, whereas I can offer members on this forum who have known me for many years, have been to my compound outside of Ubud, and know me and my family very well.  This is a matter of credibility, and in that regard I must be honest and simply say, you don't have any credibility, because all we have is your word, and a slew of postcard like photos of Bali on the Bali photo images segment of this forum…photos which are typically taken by any visiting tourist to Bali.

I don't know if we can reconcile or not.  I'm still trying to put aside another comment you made on this thread (now removed) where you stated, (and in direct support of that now banned troll) “half of what Ubudian says is utter nonsense but there are some who will blindly follow anything he says.” 

Nobody “blindly follows me” on this forum, but I have earned the respect of many long term expats who also regularly participate on this forum.  Thus your condescending comment (also now removed) to lukerege was particularly nasty, “well it's not often I see hero worship.” 

If we are going to reconcile and find a way to mutually co-exist on this forum, then you are going to have to make some considerable changes to the way you post, keeping in mind the various comments I've just made.  It really is up to you. 

Since you already admit that you get a lot of your information about Indonesia from your Indonesian wife, I might also suggest that you let her read this particular post and listen to what I strongly suspect she will say.

Hmmm...too much information I think.

Reminder to all: This thread has been created to provide information and advice on health insurance in Bali. So, it would be much appreciated if you could all stick to the original title in order to provide useful feedback to the initator of the discussion. Off topic posts are not welcomed on the forum as they do not bring anything constructive.

Thank you,

Hasnaa

Thanks!

As a postscript to the conversation above:

On July 17th 2015 The Indonesian authorities activated their decisions made in the previous years (2008 on) governing Insurance.

This is a new law.

International Health Insurance polices can only be sold by local brokers and agents if the policies they are marketing are compliant to the requirement.
See below

“Insurance objects located in Indonesia can only be insured by insurance companies licensed with the Financial Services Authority (Otoritas Jasa Keuangan) (OJK),   
Financial Services Authority (Otoritas Jasa Keuangan) (OJK).

Very few International policies on the market here comply with this law. 

It is strongly recommended that you obtain written confirmation from your Insurance representative that the policy they are selling is compliant, as this is now a consideration in the issuance of visa's for people resident over 6 months here on KITS. KITP. Retirement visas etc.

NB: The BPJS National Insurance system is valid for Indonesian citizens and foreigners holding a KITS. KITP  visa who hold a Work Permit, a Tax number and are enrolled in the National Social Security Program for manpower (SJSN)

There is a PDF document available with a summary of changes in Visa, work permits, Insurance and other details that affect Expats in Indonesia as of July 15 th 2015 , I cannot find a way to attach it, if you would like a copy please provide your email to ***

Moderated by Priscilla 8 years ago
Reason : Do not post your personal contact details on a public forum for your own security

It is correct. There are many great hospitals in Indonesia that provide professional medical services, with international standard equipment, and  practiced by professional doctors

As for medical insurance, There are also many International Insurance companies with FSA licence in Indonesia that provide good health cover, with emergency evacuation and cashless system, AND, they charge reasonable premium that doesn't burn our pockets.

As discussed at length above Indonesian law requires all foreign Insurance companies to be formally associated with an Indonesian Insurance company. Very few of the foreign companies on the local market comply, in order to clarify the legal position once and for all please read this :

Below is a document explaining the requirements of the Ministry explaining the requirements of the law announced on July 17th 2015

Of particular interest for KIT S holders, or those applying for KIT S,  in this conversation thread, is the stipulation that any Health Insurance policy must be issued by an Insurer that is compliant with Indonesian law.
Under the heading "Individual Requirements for Foreign Workers"  point (v) below

In the case of foreign Insurance companies a formal written agreement with a local Insurer is required.  Apparently many/most of the overseas Insurers do not have this arrangement in place. It would be wise to request a formal confirmation from the broker or Insurance company that is selling the Policy that the foreign insurance company has this agreement in place 

WORK PERMIT IN ACCORDANCE WITH INDONESIAN LAW (UPDATE)
(Minister of Manpower Regulation No. 16 Year 2015 re The Procedures To Employ Foreign Worker)

I.    GENERAL REQUIREMENTS
(i)    The ratio foreign worker to Indonesian worker is 1:10.
(ii)    Employer that has the form of: persekutuan perdata, Persekutuan Firma (Fa), Persekutuan Komanditer (Commanditaire Vennootschap or CV), Usaha Bersama/Associate (UB), Usaha Dagang (UD) and Koperasi is not allowed to employ a foreign worker unless regulated otherwise under specific laws.
(iii)    The employer is required to appoint an Indonesian co-worker as associate (pendamping) who will succeed the foreign worker in the future.
(iv)    Obligation to pay the Foreign Worker Employment Compensation Fund (DPK-TKA) in the amount of US$ 100 per month in advance (except for government institutions, international agencies, diplomats, social and religious institutions).
(v)    A foreign worker can only work in one (1) position in a company (except for members of BOD and BOC of a PT or the Trustees, the Management and the Supervisors of a Yayasan).
Remarks

•    Points (i) and (iii) do not apply to:

a.    Members of the Board of Directors (BOD) or Board of Commissioners (BOC) of an Indonesian limited liability company (PT).
b.    Members  of  the  Trustees,  the  Management  and  the  Supervisors  of Indonesian Foundation (Yayasan).
c.    Employee for a job that is an “emergency” and “urgent” in nature.
d.    Employee    for    the    temporary    employment.    Types    of    temporary employment:

1)    Providing guidance, counseling, and training in the application and innovation of industrial technology for improving the quality and design of industrial products as well as overseas  marketing cooperation for Indonesia;
2)    Filming of a commercial nature that has obtained permission from the competent authority;
3)    Giving lectures;
4)    Attending a meeting that is held by the head office or representatives in Indonesia;
5)    Conducting audits, production quality control, or inspection at the company's branch in Indonesia;
6)    Foreign worker in training program for his/her working capabilities; and
7)    Works to be performed and completed at once; and
8)    A work related to the installation of machinery, electrical, after-sales service, or product during the exploratory time for the business.

Employee for impresario services (entertainment services or workers in the field of arts and sports).


II.    INDIVIDUAL REQUIREMENTS (FOREIGN WORKER)
(i)    Having   formal   education   to   hold   work   position   (formal   academic certificate).
(ii)    Having certificate of competence or experiences of at least 5 (five) years in relation to the work position that shall be held.
(iii)    Statement Letter by employee to transfer his/her skills to the appointed Indonesian co-worker (pendamping).
(iv)    Having Indonesian Taxpayer Number (NPWP), if the foreigner works in Indonesia for more than six (6) months.
(v)    Having    insurance   policy   from   the   insurance    company    that incorporated in Indonesia.Registration  in  the  Indonesian  Social  Security  Program  (BPJS), if foreigner works in Indonesia for more than six (6) months.



Remarks

Points (i), (ii) and (iii) do not apply to:
a.    Members of the BOD or BOC of PT.
b.    Members  of  the  Trustees,  the  Management  and  the  Supervisors  of Yayasan.
c.    Employee for a job that is an “emergency” and “urgent” in nature.
d.    Employee for a temporary employment.
e.    Employee for impresario services.


III.    OTHER REQUIREMENTS (BASED ON THE WORK PERMITS)
No.    Permits
    Requirements
1    Manpower Utilization Plan    (Rencana Penggunaan Tenaga Kerja Asing or RPTKA).    a.    Should be applied online to the Director General of Manpower Placement Development (Direktur Jenderal Pembinaan Penempatan Tenaga Kerja).
b.    Duly completed RPTKA form.
c.    Points (i) to (vi) of the Individual Requirements.
d.    Deed of Incorporation and its ratification including the amendments.
e.    The employer's business permit  from the relevant Indonesian Government body.
f.    Recommendation of Position to be held by the foreign worker from technical institution if needed (particular positions).
g.    Company Domicile Letter.
h.    Company Taxpayer Registration Number (NPWP).
i.    Company's    organizational    structure
scheme.
j.    Assignment Letter of Indonesian co- worker (pendamping), who will succeed the foreign worker and its training plan program.
k.    Annual Manpower Report (Wajib Lapor Ketenagakerjaan)  in  accordance  with Law No. 7 Year 1981.


Remarks

•    Types of RPTKA:

1)    General RPTKA (maximum five (5) years and extendable);
2)    RPTKA for “emergency” and “urgent” works (maximum one (1) month and cannot be extended);
3)    RPTKA for temporary employment (maximum six (6) months and cannot be extended);
4)    RPTKA in Special Economic Area (KEK), Free Trade Area and Free Port (regulated in the specific regulation);
5)    RPTKA for Ocean Area (regulated in the specific regulation);
6)    RPTKA for impresario services; and
7)    RPTKA  for  karaoke  guide  (maximum  six  (6)  months  and  cannot  be extended).

•    RPTKA should be extended at the latest thirty (30) business days before its expiration.

•    Point (j) and some of the Individuals Requirements ((i),(ii) and (iii)) do not
apply to:

a.    Members of the BOD or BOC of PT.
b.    Members  of  the  Trustees,  the  Management  and  the  Supervisors  of Yayasan.
c.    Employee for a job that is “emergency” and “urgent” in nature.
d.    Employee for a temporary employment.
Employee for impresario services.









2    Permit    To    Employ Foreign  Worker  (Izin Mempekerjakan Tenaga  Kerja  Asing or IMTA)    a.    Should be applied online to the Director of Utilization Foreign Worker Control (Direktur Pengendalian Penggunaan Tenaga Kerja Asing).
b.    Proof of payment of DKP-TKA.
c.    Ratification of RPTKA decision.
d.    Passport of the foreign worker.
e.    4 x 6 cm color photograph.
f.    Points (i) to (vi) of the Individual Requirements;
g.    Employment agreement (draft or executed version).
h.    Assignment Letter of Indonesian co- worker (pendamping), who will succeed the foreign worker and its training plan program.
i.    Recommendation of Position to be held by the foreign worker from technical institution if needed (particular positions).
j.    Deed of Incorporation and its ratification including the amendments (apply only for BOD, BOC of PT or the Trustees, the Management and the Supervisors of Yayasan).


Remarks

•    IMTA is also applied for the BOD and BOC members of PT or Trustees, Managements and Supervisors members of Yayasan, who are domiciled abroad.

•    The members of BOD and BOC of PT or Trustees, Managements and Supervisors of Yayasan should obtain IMTA as of the issuance date of the ratification of his/her appointment.

•    The General IMTA is valid for a term of not more than one (1) year and maximum two (2) years for BOD and BOC members of the PT or Trustees, Managements and Supervisors members of the Yayasan (extendable).

•    IMTA shall be the basis for filing:

a.    Visa Approval Recommendation;
b.    Limited Stay Permit (ITAS);
c.    Conversion of the Visiting Stay Permit (ITK) to become ITAS;
d.    Conversion of the ITAS to become Permanent Stay Permit (ITAP); and
e.    Extension of ITAP.

•    IMTA should be extended at the latest thirty (30) business days before its expiration.

•    Point h and some of the Individuals Requirements ((i),(ii) and (iii)) do not apply to:

a.    Position of members of the BOD or BOC of PT.
b.    Position   of   members   of   the   Trustees,   the   Management   and   the Supervisors of Yayasan.
c.    Employed for a job that is “emergency” and “urgent” in nature.
d.    Employed for a temporary employment.
e.    Employed for impresario services.

The employer that has obtained the IMTA, should report to the Head of Manpower Department in the location of the foreign worker employed at the latest seven (7) days after the commencement of the employment.

•    The employer is obliged to make a report for utilization  of the foreign worker to the Head of Manpower Department in the location of the foreign worker employed, that contains:

a.    Realization  of  the  training  program  for  the  Indonesian  co-worker periodically once in six (6) months; and
b.    End of the utilization of the foreign worker.