AIA Health Insurance Review: Products, Advantages and Disadvantages and 10 Important Policy Points

The AIA health insurance review discusses whether it is safe insurance, the products and benefits it offers, and the advantages and disadvantages of this health insurance. AIA health insurance excels in terms of the wide age range of the insured. In terms of benefits, AIA also offers a nominal sum assured (UP) and competitive coverage. Apart from bancassurance health insurance, there are at least 5 types of health insurance products at AIA. Regarding benefits, premiums, and how to claim AIA health insurance, see more in this article. 

AIA Health Insurance Product Summary Product Hospital & Surgical Protection Premier Hospital & Surgical Protection Hospital & Surgical Plus Benefit Inpatient + outpatient + surgery coverage Treatment coverage covers the entire territory of Indonesia + overseas (except the US) Coverage for outpatient + inpatient costs at the hospital Is AIA Insurance Safe? AIA health insurance is safe and legal. In Indonesia, AIA is under PT AIA Financial. All AIA products, including health insurance, are safe insurance options. PT AIA Financial itself has been registered and supervised by OJK (Financial Services Authority) since April 3, 1997, Business License Number KEP-156/KMK.017/1997. Types of AIA Health Insurance AIA has at least 5 health insurance options. This amount is divided into three main categories, namely basic insurance and additional insurance (rider). The following is a list of AIA's health insurance: 

1. AIA PowerPro Life AIA PowerPro Life is a traditional term life insurance from AIA that guarantees benefits for death, ICU care and terminal illness. Judging from the coverage of benefits, AIA PowerPro Life can be said to be a combination of life insurance and health insurance. 

2. Hospital & Surgical Protection Hospital & Surgical Protection is an additional insurance from AIA that provides health insurance in the form of inpatient, surgical, medical and outpatient benefits at partner hospitals in Indonesia. 

3. Hospital & Surgical Plus Hospital & Surgical Plus is an additional insurance from AIA that covers inpatient, surgical, medical and outpatient expenses. However, unlike Hospital & Surgical Protection, this insurance product guarantee is not only available in Indonesia, but throughout the world. 

4. Premier Hospital & Surgical Plus Premier Hospital & Surgical Plus is an additional insurance from AIA that provides health benefits for unit-linked basic insurance products. This AIA health insurance product is available as a guarantee in Indonesia and throughout the world. The Premier Hospital & Surgical Plus specific protection benefits are adjusted to the chosen plan. 

5. Premier Hospital & Surgical Extra Premier Hospital & Surgical Plus is AIA's health insurance product designed as additional insurance for unit-linked basic insurance products with periodic premium payments. This AIA health insurance provides a guarantee for reimbursement of hospital costs with a standard service of 1 bed and an en-suite bathroom. There are five plans to choose from, including: Classic (Indonesian) Executive (Asia, except Singapore, Japan, Hong Kong) Elite (Asia) Prestige (worldwide, except United States) Ultimate (worldwide) AIA Health Insurance Benefits Benefits of AIA health insurance: 

UP Insurance Product Main Benefits Insurance Entry Age Insured Insurance Period AIA PowerPro Life Min. IDR 200 million The benefit of dying from any cause at the age of <4 years is 20%, 40%, 60%, or 80% UP The benefit of dying from any cause at the age of ?4 years is 100% UP ICU offer benefits of 50% UP or a maximum of IDR 250 million The benefit of a terminal illness diagnosis is 100% UP 15 days - 65 years 10 years. 

Hospital & Surgical Protection According to the policy Inpatient, surgical, medical and outpatient benefits at partner hospitals in Indonesia Cashless payment facility by swiping the membership card at the hospital cashier's EDC machine Guaranteed treatment room in the lowest price 2 or 4 bed room 0-70 years Up to 80 or 88 years old. 

Hospital & Surgical Plus According to the annual limit of the chosen plan Hospitalization, surgery, and medical and outpatient benefits worldwide There are 6 protection plans Cashless payment facility by swiping the membership card at the hospital cashier's EDC machine 0-65 years Up to 80 years old.

Premier Hospital & Surgical Plus According to the annual limit of the chosen plan Medical benefits including hospitalization and surgery (depending on the plan) in Indonesia to the whole world Cashless payment facility by swiping the membership card at the hospital cashier's EDC machine There is a family plan for a maximum of 4 additional insureds in 1 policy 0-70 years Up to 88 years old.

Premier Hospital & Surgical Extra According to the annual limit of the chosen plan Medical benefits (depending on the plan) throughout Indonesia to the whole world Daily benefits min. IDR 1.5 million and max. IDR 8 million 5 plan options available Cashless payment facility by swiping the membership card at the hospital cashier's EDC machine There is a family plan for a maximum of 4 additional insureds in 1 policy 0-70 years Up to 99 years old Advantages of AIA Health Insurance The main advantage of AIA insurance is the broad terms of entry age for the insured, so that customers can be more flexible. 

In terms of benefits, the minimum Sum Assured (UP) is also quite competitive at the level of Rp. 200 million for AIA PowerPro Life basic insurance products. On the other hand, AIA lacks basic insurance products that are purely designed as health protection. As previously explained, AIA PowerPro Life itself is basically life insurance that also provides health benefits. 

In addition to AIA PowerPro Life, AIA offers 4 additional insurance products to complement other basic insurance products. Apart from bancassurance insurance, AIA is still limited in terms of providing a variety of health insurance products compared to its competitors. Weaknesses of AIA Health Insurance There is no pure health insurance option. This is a type of health insurance that only provides pure health protection without an investment element. AIA Health Insurance Premiums and Fees Table The amount of AIA health insurance premium is a minimum of IDR 300,000 per month, especially for AIA PowerPro Life insurance products. 

AIA health insurance premiums are shown in the following table: 

AIA health insurance Premium (Minimum) Premium Payment Period Premium Payment Period AIA PowerPro Life IDR 300,000/month; IDR 300,000/quarter IDR 600,000/semester; IDR 1.2 million/year Annual, semi-annual, quarterly, monthly 10 years Hospital & Surgical Protection According to the policy (rupiah currency) Annual, semi-annual, quarterly, monthly Until the insured is 80 or 88 years old.

Hospital & Surgical Plus According to the policy (in rupiah currency) Annual, semi-annual, quarterly, monthly Until the insured is 80 years old.

Premier Hospital & Surgical Plus Policy (dollar or rupiah currency) Annual, semi-annual, quarterly, monthly Until the insured is 88 years old.

Premier Hospital & Surgical Extra According to the policy (currency in rupiah) Annual, semi-annual, quarterly, monthly Until the insured is 99 years old.

How do I claim AIA health insurance? The claim requirements documents are: Stamped power of attorney from the Policy Holder for payment of health benefits by submitting an authorized insurance claim Original receipts for treatment costs, purchase of drugs, laboratories, and other related receipts (specially for transactions above Rp. 1 million must use 6000 stamp duty) Certificate of Co Insurance Supporting documents in the form of laboratory examination results, ECG, Anatomical Pathology, or other diagnostic results Photocopy of purchase details of medicines/prescription drugs Photocopy of the active identity of the policyholder Photocopy of the insured's active identity Photocopy of AIA participant card Photocopy of savings account book Other relevant documents deemed necessary by PT AIA Financial. 

The stages for submitting AIA health insurance claims are as follows: Download the health insurance claim form on the official AIA website Fill out the form completely and correctly. Prepare the required documents for submitting AIA health insurance claims. Submit a claim filing using one of the following methods: AIA head office AIA authorized agent Bancassurance Officer AIA customer service AIA will check the completeness of the application file. If it is not complete, AIA will send an SMS to inform you of any missing files that need to be filled within 30 days. The AIA team will analyze the claim submission if the documents are complete. Confirmation of claim approval status will be sent by AIA via SMS or postal mail. If the claim is approved, the AIA health insurance money will be disbursed to the insured's account number. How Long is AIA Liquid Insurance Money? Disbursement of AIA insurance claims takes 8 working days for health claims and 11 working days for death claims. This period is calculated from the time the claim submission documents have been completed as required by AIA.

10+ Important Points of AIA Health Insurance Policy :

10 crucial points in AIA health insurance that participants must read and know. 

1. Pre-Existing Condition in AIA Health Insurance Policy Pre - Existing condition is a pre-existing condition. This is important because AIA health insurance applies this condition. This means that the AIA insurance company will not replace claims for pre-existing illnesses, ie before participants take out health insurance. The AIA health insurance policy defines the Pre-Existing condition as: Any kind of Illness, Condition, Injury or Disability: existing or existing; or where the cause exists or has existed; or where the Insured and/or Dependent have known, there have been signs or symptoms or disease; or indicated by the results of laboratory tests or other investigations indicating the possibility of certain conditions or diseases; before the Policy Issuance Date or the date of its amendment (Addendum), whichever is the latest. From this definition, we can see that the pre-existing insured does not have to know about the disease, may not know, but the disease already existed before the issuance of the health insurance policy. This shows the importance of taking insurance from a young age when health conditions are still excellent. 

2. Double-Claim (Can't) Policyholders can have two insurance policies. For example, someone joins BPJS Health and Health Insurance. Can participants double-claim? Double claim is the process of claiming twice for one event in one insurance and another. The AIA health insurance policy regulates this double-claim issue in the terms of the coordination of benefits. The provisions for the coordination of benefits in the policy are: The total amount of benefits received by the Policy Holder, both from this Policy and from policies issued by the Insurer and/or other companies, is a maximum of 100% (one hundred percent) of the treatment costs that have been paid by the Policy Holder. With this provision, it means that AIA health insurance participants cannot make double-claims with, for example, the most common, BPJS Health or other health insurance. 

3. Data Authenticity When Filling In The Form Honesty in filling out AIA health insurance data is crucial. Errors in data entry or dishonesty have serious consequences, such as policy cancellation. In fact, if fraud or data falsification is found, AIA insurance has the right to cancel the policy and not pay claims. In this regard, the AIA health insurance policy stipulates the following: In the event that the provision of incorrect information, statement, or explanation in the Life/Health Insurance Request Letter and/or Insurance Request Form for Dependent Candidate Data and/or amendments submitted by the Policy Holder, the Insurer has the right to refute the truth of the Policy so that it has the right to cancel as of the initial period, except after a period of 2 (two) years from the Policy Issuance Date or the policy change date (Addendum) which results in the latest risk selection or the latest Policy Recovery start date (whichever occurs last). In the event that the provision of information, statement, or explanation in the Life/Health Insurance Request Letter and/or Insurance Request Form for Data of Potential Dependents and/or amendments thereto submitted by the Policy Holder, there is an element of fraud and/or forgery, the Insurer has the right to refute the truth of the Policy. at any time thus entitled to cancel the Coverage. If there is a claim submission that occurs within a period of 2 (two) years which causes the need for re-selection of risk, the Insurer has the right to cancel the Coverage at any time without any time limit due to the untruth. 

4. Free - Look Period (Learning Rights) AIA health insurance provides policyholders with the right to study the policy (free - look period), as specifically regulated, namely: The Policy Holder has the right to study the Policy within 14 (fourteen) calendar days from the Policy Issuance Date. If the Policy Holder does not agree with the Terms of Insurance, the Policy Holder must notify in writing and return the Policy to the Insurer. The Insurer will return the Premium that has been paid by the Policy Holder after deducting administrative costs (not limited to medical costs, policy fees, and other costs if any) and the Coverage will be canceled from the start. On the other hand, if there is no written notification or objection submitted by the Policy Holder within that period, the Policy Holder is deemed to have agreed with the entire contents of this Policy Provision. Free Look Period provides an opportunity for health insurance participants to cancel and get a premium refund, within 14 days of receiving the policy. 

5. Waiting Period (Elimination Period) After the issuance of the policy, the insured cannot directly claim to AIA health insurance. Because in the policy there are provisions regarding the Elimination Period for 30 days and 1 year for certain diseases. 

a. 30 days waiting period The provisions of the health insurance policy regarding the elimination period are: There is no Insured Benefit that can be paid under this Insurance, if the Insured and/or Dependent undergoes Hospitalization due to illness within 30 (thirty) days from the Policy Issuance Date or Policy change (Addendum) which results in risk selection or the date of entry into force Policy Recovery (whichever happened last). 

b. Waiting Period 1 Year (Certain Disease) The AIA health insurance policy stipulates that certain diseases have a longer waiting period of 1 year. This means that if the insured suffers from this disease within 1 year from the issuance of the policy, the participant cannot claim hospital costs for the disease to health insurance. The policy provisions state that: There is no Insured Benefit that can be paid under this Insurance, if the Insured and/or Dependent undergoes Hospitalization due to a Specific Disease (17 Special Diseases) as of the Policy Issuance Date or the policy change date (Addendum) resulting in risk selection or the commencement date of Recovery Policy (whichever happened last). Details of this specific disease list are attached to the policy. 

6. Excess Fees and Over Claims Events that are often experienced by participants are excess costs and excess claims. This usually happens when the insured goes up to a hospital room class, which is a higher class than the insurance plan. How does AIA's health insurance policy deal with overcharges and claims? The police determined that: If the class of room in accordance with the Inpatient Guarantee Letter is not available at the Partner Hospital, the Policy Holder or Patient is obliged to pay for any Excess Costs incurred. Any Excess Costs that arise are the full responsibility of the Policy Holder or Patient, cannot be transferred and/or billed to the Insurer unless otherwise agreed by the Insurer. Any rejection of the submitted claim will be an Excess Claim and must be paid by the Policy Holder or Patient to the Insurer. 

7. AIA Health Insurance Exceptions This is something that must be read, understood and internalized by all insurance participants. 'Exception' conditions in the policy. Because, all things that fall into the exclusion category, then health insurance claims will not be paid by AIA. The health insurance policy specifies the Exceptions, as follows: Pre-Existing Conditions (Pre-Existing Conditions) Outpatient care that has no relationship with Inpatient Medical treatment costs incurred during the elimination period, except due to Accidents; Cost of routine medical check-up (medical check-up), cost of examination and prevention or treatment that is not related to the disease the Insured and/or Dependent knows, rehabilitation costs without a doctor's recommendation, preventive costs (prevention of disease) including immunizations and vaccinations, food supplements, costs rest, telecommunications costs, television rental costs and channels, refrigerator costs including contents and other costs not related to medical treatment; 

Treatment/treatment arising in connection with or resulting from congenital disorders, congenital defects, or hereditary diseases, whether known or not; Injury or illness caused by work or hazardous activities, or professional sports, racing of any kind, scuba diving, activities related to hang gliding, ballooning, parachuting, skydiving, boxing, wrestling, bungee jumping and other hazardous activities or sports; AIDS (Acquired Immune Deficiency Syndrome), ARC (AIDS Related Complex), or HIV positive (Human Immunodeficiency Virus) related to critical illness or complications from AIDS, ARC and/or HIV, where AIDS, ARC and/or HIV are Conditions Pre-Existing Condition, previously tested positive for HIV, and/or HIV infection prior to the policy coming into effect or resulting from sexual activity and/or drug abuse;

8. Ensure Policy Data is Correct and Accurate Health insurance participants must check the Policy Summary at the beginning of the policy book. This summary is important because it includes data about participants and the insured. The contents of the policy summary are: Police Number Insured Age Insurance Effective Date Insurance Plan taken. Determine the coverage ceiling Total insurance premium Ensure that the data - the data is correct. Incorrect data can complicate claims. 

9. Definition of Hospitalization In order for AIA health insurance participants to make claims for hospitalization, the participant's conditions must meet the provisions regarding hospitalization, namely: Hospitalization: Entry of the Insured and/or Dependent as an inpatient to receive Medically Necessary Treatment and treatment at the recommendation of a Doctor, where the Insured and/or Dependent must stay in a Treatment room with inpatient facilities at the Hospital, thereby incurring costs for the day of treatment in accordance with the details of the cost bill issued by the Hospital. 

10. AIA Insurance Rights to Change Premiums During Annual Renewal The insurance policy gives AIA the RIGHT to change the insurance premium when there is an extension or policy anniversary, which is as follows: The Insurer has the right to change the Premium based on certain conditions but is not limited to the experience of claims and inflation of medical costs. The change will take effect on the next Policy Anniversary and will be notified in writing to the Policy Holder. 

11. AIA Insurance Rights Not to Renew Insurance The insurance policy gives AIA the RIGHT not to extend the policy at the time of renewal, which are as follows: The Insurer has the right to review and/or refuse the extension and/or terminate the Policy on each Policy Anniversary by notifying in writing to the Policy Holder's last address as recorded at the Insurer.

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