What is the Statutory Definition of Health Insurance? Here's the Explanation

Health insurance is a form of financial protection to protect someone from unexpected medical expenses or medical care. According to the law, health insurance is defined as a form of insurance that provides protection to insurance participants against the risk of unexpected medical expenses or medical care.

Health insurance can be provided by insurance companies, government agencies, or non-profit organizations. Health insurance participants usually pay a monthly or annual premium to the insurance provider, and the insurance provider will pay part or all of the medical expenses or medical care needed by the participant.

In law, there are several definitions related to health insurance, including:

1. Social health insurance: Health insurance organized by the state or local government to provide health protection to the public.

2. Commercial health insurance: Health insurance provided by private insurance companies to provide health protection to insurance participants.

3. National Health Insurance Program: A program organized by the government to provide health protection to the public by providing access to affordable and quality health services.

These definitions illustrate that health insurance is an important form of financial protection for the community in facing the risk of unexpected medical expenses or medical care. Therefore, having health insurance can provide financial security and reduce the burden of medical expenses or medical care for insurance participants.

In Law no. 24 of 2011 concerning the Social Security Administering Body (BPJS), health insurance is specifically regulated in Article 1 point 3 and Article 3. Article 1 point 3 explains that health insurance is a form of financial protection for participants or participants' dependents in order to obtain the necessary health services and worth it.

Whereas Article 3 explains that the Health Social Security Administrative Body (BPJS) is a legal entity established and organized to provide health insurance to participants, their dependents, and their families, by applying the principles of social insurance.

With the Law no. 24 of 2011, health insurance has become more structured and well organized by the government. The Social Security Administering Body (BPJS) for Health is the health insurance provider most widely used by Indonesian people.

In its implementation, BPJS Health provides health insurance covering first level health services (public health centers, clinics, and practicing doctors), advanced level health (hospitals), dental health, mental health, and medicines.

In addition, BPJS Health also provides health programs such as family planning programs, stunting prevention programs, and other health programs as an effort to improve overall public health.

In terms of health insurance claims, BPJS Health has provisions and procedures that must be followed by participants or parties submitting claims. This aims to ensure that claims submitted are in accordance with the provisions and do not cause harm or misuse of the health insurance system.

Overall, health insurance is an important form of financial protection for the community in facing the risk of unexpected medical expenses or medical care. In Law no. 24 of 2011, health insurance is specifically regulated and BPJS Health is a health insurance provider that is widely used by Indonesian people.

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