Proteksi Prima Medika Plus

Product Information

Proteksi Prima Medika Plus (PPMe Plus) is a health insurance product issued by PT Asuransi Jiwa Manulife Indonesia that provides comprehensive Daily Hospitalization Benefits, a Death Benefit, and a Wellness Benefit in the form of a premium refund of up to 108%, subject to the terms and conditions stipulated in the Policy.

Product's Advantages

  • 8 Years of Protection for a more optimal calm
  • Healthy Living Bonus (Wellness Benefit) of 108% of the total premiums paid if no claims are made over 8 years
  • For claims of up to 8 days, you are still eligible for a Wellness Benefit of 50% of the total premiums paid

Advantages

  1. Hospital Cash Benefit
    Insurance Benefit with total amount 100% (one hundred percent) of the Daily Hospital Cash Benefit with benefit amount based on the selected premium package, with the following provisions:
    • Maximum 90 days per Policy Year for illness
    • Maximum 365 days per Policy Year for injury due to accident
    • If the Insured undergoes Hospitalization due to Illness and Injury occurring simultaneously, the maximum number of Hospitalization days shall be based on the number of Hospitalization days due to Injury.
  2. Additional Hospital Cash Benefit Due to ICU
    An additional benefit with amount 200% (two hundred percent) of the Daily Hospital Cash Benefit, with maximum 15 (fifteen) calendar days per Policy Year.
  3. Hospital Cash Benefit Due To Surgery
    If the Insured undergoes Inpatient Treatment and Surgery, the Insurer will pay a Surgery Benefit amounting to 500% (five hundred percent) of the Daily Hospital Cash Benefit.
  4. Death Benefit
    If the Insured passes away during the Period of Insurance, the Insurer will refund the entire Premium paid to the Appointed Beneficiary.
  5. Additional Death Benefit During Surgery
    If the Insured passes away while undergoing a surgical procedure or within 1 (one) day after undergoing a surgical procedure, the Insurer shall also pay an additional coverage benefit with amount to 500 (five hundred) times the Daily Hospital Cash Benefit to the Appointed Beneficiary.
  6. Wellness Benefit
    The Insurer shall pay the Wellness Benefit to the Policyholder with a percentage of the total Premiums paid, with conditions as follows:
  7. Total Days of Claim Wellness Benefit Value
    0 Days (no claim) 108% of the total premiums paid
    ≤ 8 days (less than or equal to 8 days) 50% of the total premiums pait
    > 8 days (More than 8 days Not eligible for the wellness benefit

Benefit Table for PPMe Plu

Product Specifications

Product Type Health Insurance
Entry Age 18-65 years old
Currency Rupiah (IDR)
Premium Payment Period 8 years
Coverage Period 8 years
Premium Payment Monthly
Underwriting Method Simplified Issuance Offer (SIO)

Illustration

Scenario 1: Hospitalized Due To Sickness
Daily Hospitalization Benefit = 3 days x Rp500,000 = Rp1,500,000 Total benefit received = Rp1,500,000

Skenario 2: Rawat Inap karena Kecelakaan + ICU + Tindakan Pembedahan

  • Surgery Benefit = Rp2,500,000
  • Daily Hospital Cash Benefit = 5 days x Rp500,000 = Rp2,500,000
  • Additional Daily Hospital Cash Benefit for Intensive Care = 2 Days x Rp1,000,000 = Rp2,000,000
Total insurance benefits received = Rp7,000,000

Scenario 3: Death in the 3rd year of Policy
Death Benefit = 100% of total premiums = 100% x 3 x 12 months x Rp420,000 = Rp15,120,000
Total Premiums Paid = Rp15,120,000

The total insurance benefits received by Mr. Anton and the designated beneficiary during the coverage period with amount: Rp1.500.000 + Rp7.000.000 + Rp15.120.000 = Rp23.620.000

However, if Mr. Anton makes no claims during the coverage period (8 years), he is entitled to a Wellness Benefit amounting to 108% of the Total Premium.

Wellness Benefit = 108% x (8x12xRp420.000) = Rp43.545.600



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