Table Manfaat | M-Protect

Benefits Schedule


MANFAAT RAWAT INAP (INPATIENT BENEFITS) PLAN A
Tanpa Co-Share 750,000 Co-Share 10% 750,000 Co-Share 20% 750,000
Biaya Kamar dan Menginap - per hari, maks. 365 hari (Room rates - per day, 365 days (max.)) 750,000 750,000 750,000
Unit Perawatan Intensif per hari, maks. 20 hari (Intensive care unit - per day, 20 days (max.)) 1,500,000 1,500,000 1,500,000
Biaya Dokter Bedah - per kasus rawat inap (Cost of Surgery - per case)

Sesuai

tagihan

penggantian

penuh

(Full as charged)

Sesuai

tagihan

penggantian

90 %

(90% reimbursement)

Sesuai

tagihan

penggantian

80 %

(80% reimbursement)

Biaya Anastesi - per kasus rawat inap (Anesthetic costs - per case)
Biaya Kamar Bedah - per kasus rawat inap(Cost of the surgery room - per case)
Biaya Aneka Perawatan per kasus (Anaesthetist’s Fee - per case)
Biaya Kunjungan Dokter di Rumah Sakit - per hari, maks. 365 hari (Doctor’s visit at the hospital - per day, 365 days (max.))
Biaya Konsultasi Dokter Ahli - per hari, maks. 365 hari (Specialist consulting fee - per day, 365 days (max.))
Perawatan Gigi Darurat Akibat Kecelakaan - per tahun (Accidental damage to teeth - per year)
Perawatan Rawat Jalan Darurat Akibat Kecelakaan - per tahun (Accidental emergency outpatient - per year)
Juru rawat pribadi - per hari, maks. 30 hari (Private nurse - per day, 30 days (max.))
Ambulan lokal - per kasus (Local ambulance - per case)
Biaya Alat Bantu Tanam - per tahun (Costs of inplant - per year)
Haemodialisa, Kemoterapi & Radioterapi - per tahun (Hemodialysis, chemotherapy & radiotherapy - per year) 5,000,000 5,000,000 5,000,000
Manfaat HIV/AIDS - per tahun (Benefits of HIV / AIDS treatment - per year) 5,000,000 5,000,000 5,000,000
Biaya Sebelum & Setelah Rawat Inap - 30 hari sebelum & 30 hari setelah rawat inap, per kasus rawat inap (Pre & post hospitalization Expenses - 30 days pre & post hospitalization, per case) 2,000,000 2,000,000 2,000,000
Biaya Rawat Jalan - per tahun (Outpatient costs - per year) 2,000,000 2,000,000 2,000,000
Biaya Non Medis - per kasus (Non-medical costs - per case) 150,000 150,000 150,000
Santunan Tunai Rumah Sakit - per hari, maks. 14 hari (Hospital cash compensation per day, 14 days (maximum) 750,000 750,000 750,000
Evakuasi Medis & bantuan darurat lokal - (Medical evacuation & local emergency assistance) Termasuk (included) Termasuk (included) Termasuk (included)
Opini Medis Kedua - (Medical second opinion) Termasuk (included) Termasuk (included) Termasuk (included)
Batas Manfaat Tahunan Untuk Individu - (Annual benefit limit for individuals) 75,000,000
Batas Manfaat Tahunan Untuk Keluarga - (Annual benefit limit for families) 150,000,000
Santunan Kematian Oleh Sebab Apapun - (Death Compensation by any cause) 10,000,000
Individu - Batasan top up - (Individual - Top up limit) 150,000,000
Santunan Kematian Oleh Sebab Apapun - (Family - Top Up Limit) 225,000,000