Jamsostek expands medical services to cover fatal diseases | Health Insurance

Jamsostek expands medical services to cover fatal diseases

State-owned insurance company PT Jamsostek said that as of Dec. 1, its services would cover dialysis, cardiovascular surgery and treatment of cancer and HIV/AIDS, to bring benefits for workers taking part in its healthcare program.Director of Jamsostek’s Service Affairs Djoko Sungkono said on Wednesday that the company would provide up to Rp 600,000 per visit, with a maximum of three visits per week, for dialysis services, Rp 80 million annually for cardiovascular surgery, Rp 25 million per year for cancer treatment and Rp 10 million per year for HIV/AIDS treatment.“Only workers meeting all administrative requirements will receive additional health benefits. Patients seeking additional health services will need a letter of reference and recommendations from their employers and a public health center to receive the service,” he said on Wednesday.As a main requirement, recipients of additional benefits must have been registered with Jamsostek and have paid regular contributions for at least one year, while their employers must have participated in social security programs at least for one year.he said Jamsostek had disseminated circulars to all public health centers and hospitals that were partners in its healthcare program, in order to facilitate additional healthcare benefits for potential recipients.Asked for the reasoning behind the move, Djoko, recently appointed to his current role, said Jamsostek would be transformed into a public company in July 2015 and had an obligation to improve its service to all participants in accordance with its financial capability.“Jamsostek makes the new move in observance of its 34th anniversary on Dec. 5 and to compete with state-owned PT Askes, which gives a similar service to civil servants, despite the lower contribution paid by workers for the program,” he said.Workers and their employers have paid up to 11 percent of their gross monthly salaries to the four social security programs, including 0.7 percent for the healthcare scheme.according to the newly endorsed law on social security providers, the healthcare program will be integrated into the national healthcare program, which will be handled by Askes as of January 2014, while occupational accident, old-age risk, pension and death programs will be handled by Jamsostek as of July 2015. Djoko said that Jamsostek would provide equipment to workers and companies, mainly construction firms, to reduce the risks of occupational accidents. “The fewer occupational accidents occur, the less Jamsostek will pay in compensation,” he said, adding that companies claiming the least would be given priority.he said Jamsostek would also cover medical checkups for workers aged 40 years old or more and give Rp 2 million in burial assistance to any workers killed in occupational accidents.For almost 34 years, Jamsostek, which has collected around Rp 105 trillion in contributions from 9.5 million workers, has paid out Rp 45.1 trillion in compensation under its five current programs, including Rp 37.1 trillion in healthcare claims for 10.5 million cases.

Jamsostek expands medical services to cover fatal diseases | Health Insurance.


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