Optional Health Insurance Benefits

Silver Gold Platinum
Maternity Benefits
IDR
IDR IDR
Normal Delivery (Physician), per pregnancy 3,000,000 5,000,000 7,500,000
Normal Delivery (Midwife), per pregnancy 900,000 1,500,000 2,250,000
Cesarean Section, per pregnancy 6,000,000 10,000,000 15,000,000
Abortion, per pregnancy 2,000,000 3,350,000 5,000,000
Outpatient Benefits
Outpatient Physician's visit, per day 25,000 40,000 60,000
Outpatient Specialist Consultation, per day 75,000 120,000 180,000
Outpatient diagnostic laboratory services, per policy year 450,000 675,000 975,000
Outpatient prescription drugs, per policy year 750,000 1,200,000 1,800,000
Reimbursement Percentage 80% 80% 80%
Overall Limit after deductible of 20%,
per policy year
2,000,000 3,200,000 4,800,000
Dental Benefits
Basic treatments, per policy year 150,000 300,000 1,500,000
Preventive treatments, per policy year 40,000 75,000 375,000
Rehabilitative treatment, per tooth 75,000 150,000 750,000
Complex treatments per tooth 75,000 150,000 750,000
Gum treatments, per policy year 35,000 75,000 375,000
Prosthetic treatments, per policy year 175,000 350,000 1,750,000
Reimbursement Percentage 80% 80% 80%
Overall Limit after deductible of 20%,
per policy year
450,000 900,000 4,500,000
Non Medical Benefit
Glasses every two years 500,000 750,000 1,500,000