Best Personal and Family Health Insurance

Roojai Health Insurance Benefits Summary

Roojai Indonesia offers a wider range of health insurance plans from domestic to health insurance international coverage. The options include:

Indonesia
Asia excluding Singapore, Hong Kong, China, Japan
Worldwide excluding the United States

This product is designed to evolve over time, with continuous improvements and new features introduced on an ongoing basis.

Annual inpatient limit

The maximum benefit limit received in a year

Limit:

From Rp200 million – Rp900 million

Room type

Choose a room type that matches your preferred comfort level.

Limit:

Semi-private (2 beds)

Partner Hospitals

Choose Preferred hospital network (20% co-payment required at certain hospitals) or Comprehensive

Limit:

2000+ partner hospitals

Outpatient Insurance Benefits (optional)

Cover consultation, diagnostic tests, and medications costs that do not require hospitalization

Limit:

From Rp10 million – Rp40 million

Co-payment (optional)

Choose an additional co-payment option for outpatient care to make premiums more affordable

Limit:

10% – 30% of the bill paid by the insured

Deductible (optional)

Choose an additional deductible option for inpatient care to make premiums more affordable

Limit:

Rp5 million – Rp500 million paid by the insured

Companion accommodation

Accommodation cost provided for companions of inpatients

Limit:

From Rp500.000/day

ICU treatment

Costs incurred during patient treatment in the ICU

Limit:

As billed

Daycare treatment

Medical treatments completed within 20 hours without hospitalization. E.g. chemotherapy, minor surgeries, dialysis, etc.

Limit:

As billed

Pre & hospitalisation (30 days)

Medical cost related to treatment before and after hospitalisation

Limit:

As billed

Ambulance fees

Cost of transporting patients to the hospital due to accidents, illness, or other critical conditions

Limit :

As billed

International Emergency Medical Assistance (IEMA)

Emergency medical assistance if the insured experiences a medical emergency abroad^*

Limit:

As billed

^* in compliance with terms of coverage

Terms & Conditions of Roojai Personal and Family Health Insurance

Entry age for primary insured

18 – 65 years

Entry age for spouse

18 – 65 years

Entry age for dependent children

15 days – 18 years ^*

Maximum renewal age for primary insured & spouse

80 years

^* can be extended up to 25 years if the child is still a student.

Why Are Roojai Health Insurance Premiums Affordable?

One of the key advantages of Roojai health insurance is the flexibility to design your own policy benefits. You can adjust the coverage based on your needs and budget, ensuring that premiums remain affordable without sacrificing essential protection.

Deductible Options for Inpatient Benefits

With Roojai, you can choose inpatient benefits with a deductible scheme to make your premiums more budget friendly. A deductible is a fixed amount you must pay out-of-pocket before the insurance covers the rest of the claim. It is paid once per year.

Example: If your deductible is Rp1.000.000 and your hospital bill is Rp3.000.000, you pay Rp1.000.000 while the remaining Rp2.000.000 is covered by the insurer.

This option is ideal for those who want to reduce premiums while still maintaining essential inpatient protection.

Copayment Options for Outpatient Benefits

Roojai allows you to customize your outpatient benefits with several flexible options:

Exclude outpatient benefits to save on premiums
Include outpatient benefits with an annual limit adjusted to your needs
Include outpatient benefits with an annual limit combined with a copayment scheme

A copayment is the percentage of medical costs that you pay yourself.

Contoh: jika memilih copayment 20% dan biaya rawat jalan Rp1 juta, kamu hanya perlu membayar Rp200 ribu, sementara Rp800 ribu dibayar oleh perusahaan asuransi.

This way, you can still enjoy outpatient benefits with more affordable premium.

Flexibility in Choosing Hospital Networks

Roojai also provides two hospital network options:

Full Network: You’re covered when you visit any hospital within our network. As long as the hospital is part of our network, you're eligible for coverage.
Preferred Network: You’re covered when you visit hospitals in our network, but if you choose one of our premium hospitals, you’ll need to pay 20% of the bill.

If you choose the Preferred Network, you’ll have access to all hospitals in our network, including premium hospitals. However, when using a premium hospital, you’ll need to cover 20% of the total bill.
Example: If the inpatient cost at a premium hospital is Rp10.000.000, you pay 20% (Rp2.000.000) while the remaining Rp8.000.000 is covered by the insurer.

This option is ideal if you want access to top-quality services while keeping your premiums affordable.

Check the full list of Roojai Network hospitals!

Flexibility in Choosing Coverage Area

Roojai gives you the freedom to choose your coverage area, whether limited to Indonesia or extended internationally. If you choose for protection in Indonesia only, your premium will be more affordable compared to global coverage. For emergency situations (life-threatening or risk of serious harm), your insurance covers inpatient treatment for up to 90 days per year, wherever you are in the world.

How to Claim Personal Health Insurance at Roojai

There are two ways to claim your health insurance with Roojai: cashless and reimbursement. Both methods can be done at Roojai’s partner hospitals. Here’s how each works:

Cashless claim
Cashless claims can only be made at partner hospitals. The process is simple: the insured shows their insurance card to the hospital administration, which then contacts the insurer to verify that the claim matches the policy agreement. If it aligns with the approved policy benefits, the claim is settled immediately.

Reimbursement claim
Reimbursement claims apply to treatments at partner hospitals (and in emergency cases, also at non-partner hospitals), both domestically and abroad. The insured must first pay the medical expenses out of pocket, then submit a claim for reimbursement.