Why Buy Outpatient Insurance at Roojai?

With Roojai’s outpatient insurance, you can customize your policy benefits to match your needs. This way, you only pay for what you really need—no unnecessary extras. Discover the best cashless outpatient rider options at Roojai!

Coverage starts from Rp10 million, up to the actual bill amount

Coverage starts from Rp10 million, up to the actual bill amount

Flexible benefits tailored to your budget

Flexible benefits tailored to your budget

Cashless claims at 2,000+ trusted partner hospitals

Cashless claims at 2,000+ trusted partner hospitals

Convenient online purchase process

Convenient online purchase process

Outpatient Health Insurance Benefits at Roojai

Outpatient insurance can only be added if you already have a primary health insurance policy from Roojai. It cannot stand alone and must be attached to an active main policy.

Benefits

Details

Annual Limit

General practitioner consultation

Medical treatment within 24 hours without hospitalization by a general practitioner

Limit :

From Rp10 million – as per actual bill

Specialist Consultation

Medical treatment within 24 hours without hospitalization by a specialist

Limit :

From Rp10 million – as per actual bill

Medications

Coverage for doctor-prescribed medications

Limit :

From Rp10 million – as per actual bill

Laboratory Test

Includes X-rays, diagnostic & pathology tests

Limit :

From Rp10 million – as per actual bill

Advanced Medical Imaging

Includes CT Scan, MRI, PET Scan, Ultrasound Doppler

Limit :

From Rp10 million – as per actual bill

Partner Hospitals

2000+ List of hospitals accepting cashless claims

Affordable Outpatient Insurance Premiums with Copayment

One of the advantages of getting outpatient health insurance at Roojai is the flexibility to choose your own copayment scheme, allowing you to enjoy more affordable premiums.

Copayment refers to the percentage of medical expenses you need to pay out of pocket when making a claim. For example, if you select a 10% copayment, you only need to cover 10% of the outpatient treatment cost, while the rest will be covered by the insurance company.

As per Indonesian regulation, all outpatient benefits come with an automatic 10% copayment. Beyond that, if you are seeking for options on how to lower your premium, at Roojai, you're free to choose a higher copayment amount. This option is ideal if you're on a budget but still want essential outpatient coverage.

Terms and Conditions of Roojai Outpatient Insurance

T&C

Spesifications

Primary health insurance policy

Required

Entry age for adults

18 – 65 years

Entry age for dependent children

15 days – 18 years *

Maximum renewal age

80 years

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

Do You Still Need Outpatient Insurance If You Already Have BPJS?

BPJS Kesehatan provides basic healthcare protection for Indonesian citizens, including outpatient services at primary healthcare facilities (FKTP) such as community health centers (Puskesmas) or affiliated clinics. However, despite BPJS covering most medical needs, additional outpatient insurance is still beneficial for several reasons:

Flexibility in choosing hospitals and doctors

BPJS Kesehatan follows a tiered referral system, meaning patients must visit FKTP before getting specialist care in hospitals. With outpatient insurance, you can:

  • Consult a specialist doctor directly without a referral
  • Choose private hospitals or clinics as per your preference
  • Get faster treatment without long queues

Broader coverage for medications and treatments

BPJS only covers medicines listed in the National Formulary (Fornas), which is often limited to generic drugs. If you need branded medicines or non-covered drugs, you must pay out of pocket.

With outpatient insurance, you can:

  • Cover the cost of prescribed medications, including branded drugs
  • Include advanced medical tests such as MRI, CT scans, or complex laboratory tests

Avoid long queues and BPJS administrative processes

BPJS patients often face long waits just for a consultation or medical check-up. With outpatient insurance, you can enjoy a range of benefits, such as:

  • Enjoy faster claims processing (cashless service at partner hospitals).
  • Skip long queues for medical services

Although BPJS Kesehatan provides basic coverage for a range of medical services, there are still limitations—especially when it comes to outpatient care. By having this additional insurance, you can access outpatient services more quickly, with greater flexibility, and tailored to your medical needs—whether for individual coverage or as a complement to your family health insurance.

How to Buy Health Insurance Online at Roojai

Roojai's Outpatient Health Insurance is coming soon! Stay tuned for the latest updates on how to get the best health coverage for you and your family.

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