Family health insurance is a policy that provides coverage for the cost of care and treatment for all family members. So, the name of the insured in the policy does not only consist of one person but each family member.
Definition of Family health insurance
Table of Contents
Health insurance for the family is a policy that covers the cost of care or treatment at a hospital or clinic and the like for the insured family. That is, one policy applies to all family members (maximum 5 people) at once.
How Family health insurance Works
The way the policy works is quite simple. Even though you only use one policy, the amount of premium for each family member is different. For example, the amount of premiums for fathers and mothers will usually be higher than for children. Here are the conditions that need to be considered:
- The maximum number of members is five people (father, mother, and three children). More than five people will be charged an additional premium.
- The insurance policy will expire once the oldest family member reaches the maximum insurance coverage age.
- The insurance policy does not cover the age limit of the child specified in the insurance policy.
Benefits Provided by Family health insurance
The benefits are divided into two categories, namely basic benefits and additional benefits (rider). The basic benefit is the main coverage provided by the insurance company to its customers. While the rider is an additional benefit to complement the basic benefits and will be subject to additional premiums.
Health insurance: What Is It And Why Is It Important
Following are the benefits of each:
| Basic Benefits | Additional Benefits (Rider) |
| Inpatient, outpatient & surgery | Childbirth, teeth, and eyes, & medical check-ups |
Better Family or Individual Policy?
Basically, the benefits of family and individual plans are the same. The difference is only in the number of insured in the policy and the insurance premium.
Many think that family plan premiums are much more expensive than individuals. However, this assumption is not entirely true. Because, when compared to registering each family member into individual insurance, the total premium is actually much more expensive.
How to Claim Insurance
| Cashless (Non Tunai) |
| Submit the insurance card to the hospital → swipe the card → the hospital will confirm to the insurance company → insurance participants can immediately get medical services → done. |
| Reimbursement (Cash) |
| Paying hospital bills with personal funds → submit a claim to the insurance company → the insurance company will check the documents and perform analysis → the insurance company makes the claim payment → done. |
Types of Family Health Insurance
Based on the product, family health insurance is divided into two categories, namely conventional and sharia. Meanwhile, for the insurance benefits, customers can buy basic benefits or complement them with additional benefits (rider) .
Based on the type of product
As mentioned earlier, family health insurance products are divided into two categories, namely conventional and sharia. Here are reviews of the two:
Conventional family health insurance is health protection for families presented by conventional or non-Islamic insurance companies. The benefits provided are in the form of coverage for inpatient and outpatient costs if one of the family members falls ill.
Islamic health insurance has insurance benefits similar to conventional health insurance. The difference is that this insurance product follows sharia principles or according to Islamic law.
By Type of Benefits
Meanwhile, based on the benefits, family health insurance can also be divided into two types, namely basic and additional benefits (rider).
Here’s the difference:
The basic benefit in family health insurance is the main coverage provided by the insurance company (the insurer) to the insurance participant (the insured). The benefits provided generally include inpatient, outpatient, and surgery.
Additional benefits in family health insurance are extra coverage to complement the basic benefits of the policy and will incur additional premiums. Additional benefits provided generally include benefits for childbirth, dental and eye care, to medical check-ups.
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