HEALTH INSURANCE - MyHEALTH

APRIL International is part of the APRIL group which was founded in France more than 35 years ago. The APRIL group has grown steadily to the point where we now look after close to 6 million policyholders worldwide who, at the last count, represent some 86 different nationalities and are located in more than 120 countries around the globe.

MyHEALTH is underwritten by PT. Asuransi Artarindo, PT. Asuransi Artarindo was established in 1979 and serves its customers both individual and corporate with wide range of general insurance products such as motor vehicles, property, engineering, casualty, marine cargo and other types of insurance including international health insurance. PT. Asuransi Artarindo has good financial statement and operates in major cities throughout Indonesia.

The strong partnership of APRIL International and PT. Asuransi Artarindo ensures that you receive the benefits of our combined international and regional experience; and our financial strength. Together we place trust at the centre of our relationships and rely on 3 core principles: transparency, reliability and sustainability.

MyHEALTH is designed for global citizens and expatriates who want reliable international health coverage. MyHEALTH is extremely flexible, allowing you to mix and match modules to design the ideal health insurance plan you desire.

WE OFFER 4 LEVELS OF MODULAR COVER, WHICH YOU CAN MIX AND MATCH TO SUIT YOUR NEEDS

CORE and ESSENTIAL
Basic and affordable
Full cover for hospital and surgery with an annual limit on outpatient
Ideal for someone who wants general protection for accidents & serious medical conditions

EXTENSIVE
Bestseller
Offers stronger coverage to manage chronic conditions
Ideal protection for families

ELITE
Comprehensive plan
Designed to bring you top end coverage without being excessive
Elite benefits

Worldwide Assistance included in all plans

Area of cover
Worldwide / Worldwide Excluding USA / ASEAN Excluding Singapore
Core plan : ASEAN Excluding Singapore

OPTIONAL TO MIX & MATCH
Outpatient
Maternity
Dental
Optical

COMMUNITY DISCOUNTS

Whether you are a couple, a family with kids or an extended family, you can benefit from our discounts starting with two insured persons. The discount is based on the number of persons insured at the start of the policy. All members must have the same policy start and
end date.

2 PERSONS = 5% DISCOUNT
3 PERSONS = 7.5%DISCOUNT
4 PERSONS = 10% DISCOUNT
5 PERSONS OR MORE = 15% DISCOUNT

DEDUCTIBLE
Looking for a premium saving or already have local coverage but need a top up? Annual deductibles are a way for you to reduce your premium.

A deductible is the amount you are responsible for before the insurance plan starts to pay for medical expenses. For instance, if your deductible is $1,000, you must pay that amount, out of your own pocket before we begin paying your medical expenses.

The annual deductible is per person per year and only applies to your hospital and surgery plan.

CHOOSE FROM 6 LEVELS OF DEDUCTIBLES
$0 $500 $1,000 $2,500 $5,000 $10,000

OUTPATIENT CO-INSURANCE
On our outpatient plans, we offer a 20% co-insurance. This means that you will be responsible for 20% of each of your outpatient expenses and we will cover the remaining 80%. The coinsurance only applies to your outpatient expenses.

UNDERWRITING AND APPLICATION PROCESS
Underwriting is the process of assessing risk in order to offer insurance and set the premium you pay. Medical insurance underwriting considers your medical history and whether pre-existing conditions will be covered or excluded.

Health insurance is all about covering the unexpected costs of healthcare. If you have been sick or treated in the past this changes your risk profile and we have three ways of underwriting to address this.

Full Medical Underwriting
01 We ask you detailed questions about your medical history when you apply
Complete the Full Medical Underwriting Application Form.
You must be 65 years or below to apply.
You will receive an offer from us or we may request additional information. Please provide the additional information quickly as this can delay your cover. Coverage can start as soon as you accept our offer

Once you accept the underwriting offer, your cover will start immediately after payment. You will then receive by email your member pack. Should you require a printed member pack, please email This email address is being protected from spambots. You need JavaScript enabled to view it.

We will review your application and let you know whether it has been accepted or not.
You will receive your member pack that contains your policy terms and conditions and benefits schedule.
You will be able to access your electronic insurance card on your Easy Claim app.
Your policy documents and forms will be available on your Online Portal.

FREQUENTLY ASKED QUESTIONS

Who can apply for insurance?
Anyone residing in a country acceptable to us at the time of application and not older than 65 years for fully underwritten. Children may be covered as dependants in a policy.

Is there a maximum renewable age?
No.

Can you tell me more about the application method?
We offer Full Medical Underwriting. Its requires you to complete a medical questionnaire for each person to be insured. Full disclosure of your medical history must be provided. The answers you give will form the basis of any insurance policy issued. Declared conditions may be accepted as standard, excluded and/or covered with a premium loading. An offer will be made based on the declarations provided in the form. In some cases, we may have to decline the application.

Any pre-existing conditions not declared during the underwriting process can jeopardise your coverage. Subsequent to the policy being issued, if a non-disclosure is discovered, the insurer may impose an exclusion or in more serious cases, void policy in its entirety from the start. If you are uncertain about whether any particular fact needs to be disclosed, you should disclose it.

Would it be possible for a family to have different plan levels under the same policy?
Certainly!

My spouse and I have insurance coverage through work but it does not extend to our children. Can I apply for a plan for just my children?
Yes, but we will name you, the parent, as the policyholder.

When can coverage begin?
Coverage begins when you accept our underwriting offer and the premiums are paid.

I plan to remain in Indonesia for some time but if I move from Indonesia or return to my home country. Can I take my plan with me?
Provided there are no regulatory restrictions in the country that you move to, we will continue to offer renewals. The premiums however may change depending on the country you move to.

Am I allowed to make changes to my plan over time?
Yes, you can make changes to your plan at renewal. Just let us know in writing as soon as you receive your renewal offer. Changes to your coverage will likely result in a change in premium and any upgrades in coverage will be subject to underwriting.

How do I add my newborn to my plan?
Children born to a parent who has been covered under our Extensive or Elite Plan for at least 366 days, can be added from birth without underwriting. A Newborn Additions form must be submitted within 28 days of birth.

For the case of adoptions, surrogacy and assisted conception, children must undergo our full medical underwriting process.

Can I choose my own medical provider/doctor?
Yes, you have the freedom to choose your own provider

Will I be penalised if I incur a big claim?
Never! Our plans are community rated which means no matter how large your claims may be during any policy year, you will always have the opportunity to renew your policy at prevailing rates. You will not be rated individually.

How are my premiums determined at renewal?
On an annual basis, we may adjust premiums to ensure the plan keeps up with medical costs. Your renewal premium is affected by the annual adjustments that we make and we will inform you at renewal what was the base increase applied.

In addition to the annual adjustment that we make, the following factors contribute to the overall determination of your renewal premiums.

• The published rates in effect at the time of your renewal for your plan selection and your age on the first day of your renewed policy
• Any underwriting premium loadings that you accepted at the start of the policy
• Community discounts based on the headcount at renewal (if applicable)
• Any changes that you make to your plan at renewal

MyHEALTH's premium structure is on an age-band basis which means that the premiums within that age band are the same. If you move from one age band to another, there will be in increase in premiums associated with that age-band jump. When that occurs, this can be another contributing factor in your overall premium increase.

If you have any questions about how your premium is computed, do not hesitate to contact us.

How do I renew my policy?
A few weeks prior to your policy expiring, you will receive a renewal notice from us. If you decide to renew, we must receive your premium and renewal confirmation on or before the start date of your renewed policy. Otherwise, it will be deemed that you have not decided to renew your policy with us.

FREQUENTLY ASKED QUESTIONS
What doesn't the plan cover?
There are certain circumstances that the policy will not cover. These are stated as exclusions in the contract. Here is an extract of some of the exclusions but you are advised to read the policy terms and conditions for the full list of exclusions.

a. Services which are not medically necessary to treat illness or injury or to diagnose symptoms that suggest you may have illness or injury.

b. Pre-existing conditions and any related, associated or consequential disabilities which were not disclosed to us before the period of insurance and which we have not agreed in writing to cover under this policy.
c. Treatment which is covered by insurance or a source of indemnity other than this policy.

d. Emergency Dental Treatment related directly or indirectly to biting, chewing or teeth grinding.

e. Treatment, care or tests directly or indirectly related to :

• Major assisted conception, contraception, sterilisation, fertility or infertility, prior history of miscarriages, hypogonadism or testosterone deficiency, sexual dysfunction, or abortion other than for therapeutic reasons;
• pregnancy or childbirth, or complications of pregnancy following major assisted conception, other than services claimed under Maternity
Benefits where specifically provided on the benefits schedule;
• elective caesarian section prior to the 38th week of term;
• sexually transmitted disease;
• cosmetic treatment or gender reassignment surgery or therapy;
• sleep disorders or behavioural or developmental disorders;

f. The following services, whether or not recommended or prescribed by a physician :

• Experimental or unproven treatment;
• House calls, delivery of medicine or other items, or any service rendered at a person’s home, office, hotel room, or similar place;
• Non-prescription drugs, vitamins, nutritional supplements, chelation therapy, bioresonance therapy or diagnosis, or colonic hydrotherapy;
and other complementary medicine services not specifically listed on the benefits schedule.

g. The following services, whether or not recommended or prescribed by a physician :

• which are not reasonable and customary;
• for medical certificates or administrative fees such as a charge for providing a claim form or medical records;
• incurred outside the period of insurance or in any period for which the appropriate premium has not been paid;
• incurred during the period of insurance for drugs and/or medical services consumed or provided once the period of insurance has ended; or
• charges which are not reasonable and customary charges, meaning any charges for medical treatment which exceeds the general level of fees and charges made by other similar professional standing in the same locality where the charges are incurred, without regard to ability to pay or availability of insurance.

This is a short-term accident and health policy and the insurer is not required to renew this policy. The insurer may terminate this policy by giving you 30 days notice in writing.

Underwritten by: PT. Asuransi Artarindo

Arranged and administered by: APRIL Singapore Pte Ltd