untuk pengisian data bisa diisikan

untuk pengisian data bisa diisikan pada table: copy of inload, dengan penjelasan sbb:
Plan no(kelas kamar peserta)-->bisa diliat pada table benefit Blue Saphire, Kelas kamar dari 100 s/d vip 1200.000-,
Sex : Jenis Kelamin-->"F": Female(wanita) -->"M": Male(Laki-laki)
Relation(Hubungan) : "E" Employee(Karyawan) ;"S" Spouse (istri/suami) ; "C "Child (Anak)

PROGRAM ASURANSI KESEHATAN KUMPULAN
SMARTHEALTH – BLUE SAPPHIRE

Manfaat Rawat Inap
Manfaat ini adalah manfaat utama dari program Allianz SMARTHEALTH – BLUE SAPPHIRE.
Tersedia berbagai manfaat yang dijamin antara lain biaya pengobatan rawat inap dan pembedahan
serta biaya Dokter, obat-obatan dan biaya perawatan lainnya selama di rawat di rumah sakit.
Kami menyediakan berbagai pilihan program yang berlaku di seluruh dunia.

Manfaat Rawat Jalan
Pertanggungan manfaat Rawat Jalan ini dirancang untuk memberikan kebebasan kepada Anda untuk
memilih Dokter Umum atau Dokter Spesialis dengan rujukan. Manfaat ini juga memberikan jaminan
obat-obatan dan pemeriksaan diagnostik serta fisioterapi. Terdapat pilihan ko-asuransi yang dapat
disesuaikan dengan kebutuhan perusahaan.

Manfaat Kehamilan, Persalinan dan Nifas
Manfaat ini memberikan penggantian biaya persalinan normal maupun persalinan dengan komplikasi
termasuk bedah Caesar, serta biaya pemeriksaan sebelum dan sesudah persalinan.

Manfaat Rawat Gigi
Untuk melengkapi berbagai pilihan manfaat diatas tersedia pula jaminan perawatan kesehatan gigi
Anda.

Manfaat Kacamata
Untuk melengkapi berbagai pilihan manfaat diatas tersedia pula jaminan pembelian kaca mata dan
lensa termasuk pemeriksaan kelainan refraksi.

KEISTIMEWAAN SMARTHEALTH – BLUE SAPPHIRE
Proteksi 24 jam di seluruh dunia.
Terdapat beberapa pilihan fasilitas penggunaan manfaat :
- Klaim “Reimbursement”
- Sistem Kartu atau Sistem “Cashless” , ekses klaim ditanggung dulu oleh Allianz, atau
- Sistem Swipe Card dimana ekses klaim ditagihkan di tempat.
Fasilitas RS jaringan untuk sistem kartu yang luas.
Bila minimum Premi Rawat Inap Rp. 15 juta, maka dapat menggunakan fasilitas “Cashless”
atau biasa disebut dengan sistem kartu. Saat ini Allianz mempunyai lebih dari 300 RS Jaringan.
Tidak ada masa tunggu.
Peserta dapat langsung merasakan manfaat produk ini, tanpa melewati batasan waktu tertentu.
Khusus penyakit yang telah ada sebelumnya (pre-existing diseases), sepanjang polis ini telah
berjalan 12 bulan maka secara otomatis penyakit-penyakit tersebut akan ditanggung.
Tidak ada batas maksimum klaim per tahun.
Untuk Rawat Jalan, Peserta dapat langsung berobat ke Dokter Spesialis Anak, Dokter Spesialis
Kandungan dan Dokter Spesialis Mata.
Tersedianya penggantian biaya pengobatan 30 hari sebelum dan 30 hari sesudah perawatan
Rumah Sakit.
Tersedianya Santunan Kematian secara cuma-cuma.
Tidak ada batasan dalam penggunaan jenis obat-obatan dan tindakan diagnosa, sepanjang
diperlukan secara medis.
Akses ke Customer Service Hotline Allianz-24 jam, 365 hari setahun untuk semua keperluan
medis Peserta.

RAWAT INAP

MANFAAT
1. Kamar Rumah Sakit
2. Kamar Unit Perawatan Intensif (Intensive Care Unit / ICU)
3. Kunjungan Dokter yang merawat
4. Konsultasi Dokter Spesialis
5. Pembedahan
6. Perawatan Lain-lain
7. Sebelum Rawat Inap
8. Sesudah Rawat Inap
9. Perawatan di Rumah
10. Ambulan Lokal
11. Rawat Jalan Darurat karena Kecelakaan
12. Rawat Gigi Darurat karena Kecelakaan
13. Santunan Kematian

PENGECUALIAN
1. Penyakit atau luka yang telah ada sebelumnya (pre-existing diseases), kecuali Polis telah berlaku
selama 12 (dua belas) bulan berturut-turut.
2. Transplantasi organ, termasuk semua perawatan dan/atau pengobatan yang berkaitan dengan
transplantasi organ.
3. Semua alat penunjang atau alat bantu buatan atau bahan sintetis baik yang di luar atau melekat
pada tubuh, termasuk namun tidak terbatas pada kursi roda, kruk, anggota tubuh palsu, alat pacu
jantung, alat bantu dengar, alat bantu penglihatan, kecuali alat penunjang atau alat bantu yang
dibutuhkan pada saat pembedahan di kamar operasi seperti stent, pen, plate, screw, K-wire,
lensa intra okular, dan sejenisnya.
4. Dialisa, termasuk semua perawatan dan/atau pengobatan yang berkaitan dengan Dialisa.
5. Perawatan dan pengobatan eksperimental, tradisional dan/atau alternatif yang di luar ilmu
kedokteran barat yang tidak terbatas pada akupuntur (kecuali dilakukan oleh Dokter), sinshe,
dukun patah tulang, paranormal, chiropractor, naturopath, holistik dan sejenisnya.
6. Gangguan kejiwaan atau syaraf termasuk psikosis, neurosis, stres, depresi, psikogeriatrik dan
manifestasi fisiologis atau psikosomatisnya, perawatan kecanduan obat dan/atau alkohol
7. Semua perawatan dan/atau pengobatan yang berhubungan dengan :
a. Infertilitas, termasuk inseminasi buatan, bayi tabung, dan pengembalian kesuburan.
b. Impotensi.
c. Semua terapi hormonal yang berkaitan dengan syndrome premenopause.
8. Perawatan dan/atau pengobatan untuk mengurangi atau menambah berat badan.
9. Perawatan dan/atau pengobatan yang berkaitan dengan kosmetik, termasuk bedah plastik
kecuali untuk bedah plastik rekonstruksi fungsional akibat kecelakaan yang dilakukan 30 (tiga
puluh) hari setelah kecelakaan.
10. Pemeriksaan fisik secara berkala, Check Up kesehatan (Medical Check Up) atau pemeriksaan
penunjang yang tidak berhubungan dengan pengobatan atau diagnosa dari Penyakit/luka yang
ditanggung.
11. Perawatan dan/atau pengobatan yang berkaitan dengan :
a. Hernia di bawah usia 10 tahun
b. Kelainan bawaan dan/atau kelainan/keterlambatan tumbuh kembang
12. Kelainan refraksi mata, termasuk perawatan dan/atau pengobatan yang berkaitan dengan
kelainan refraksi mata.
13. Sunat yang tidak berhubungan dengan suatu Penyakit atau Kecelakaan.
14. Perawatan dan/atau pengobatan yang berkaitan dengan :
a. HIV / AIDS, termasuk penyakit atau kondisi yang berkaitan HIV / AIDS.
b. Penyakit Menular Seksual
15. Biaya Non Medis, namun tidak termasuk biaya administrasi.
16. Vitamin tanpa rekomendasi dokter dan tanpa indikasi medis.
17. Zat makanan pelengkap (Food Supplement)
18. Imunisasi, termasuk perawatan dan/atau pengobatan yang berkaitan dengan komplikasinya.
19. Keluarga Berencana, termasuk perawatan dan/atau pengobatan yang berkaitan dengan
komplikasinya.
20. Perawatan dan/atau pengobatan akibat :
a. terlibat aktif dalam perang, kerusuhan, perkelahian atau perbuatan kejahatan,
b. luka yang disengaja serta percobaan bunuh diri.
21. Perawatan dan/atau pengobatan karena keikutsertaan dalam aktivitas atau olahraga berbahaya
yaitu:
a. Mendaki gunung, panjat tebing, panjat gedung, bungee jumping, arung jeram
b. Olahraga berkuda
c. Tinju, segala jenis olahraga kontak fisik
d. Segala aktivitas terbang di udara (terjun payung, terbang layang, sky diving, Ultralite, dan
lain-lain)
e. Segala aktivitas menyelam yang menggunakan alat bantu pernapasan (diving, dan lain-lain)
f. Segala aktivitas lomba kecepatan dengan kendaraan bermesin (balap motor, mobil, perahu,
dan lain-lain)
22. Perawatan dan/atau pengobatan yang diakibatkan karena Peserta melakukan penerbangan
dengan menggunakan pesawat udara carteran, militer/polisi, atau helikopter.
23. Rawat Jalan bukan akibat kecelakaan, kecuali polis dilengkapi dengan Asuransi Tambahan
Rawat Jalan yang akan diatur dalam ketentuan tersendiri.
24. Rawat Gigi bukan akibat kecelakaan dan pemasangan gigi palsu oleh sebab apapun, kecuali
polis dilengkapi dengan Asuransi Tambahan Rawat Gigi yang akan diatur dalam ketentuan
tersendiri.
25. Perawatan Kehamilan, Melahirkan, Keguguran kecuali polis dilengkapi dengan Asuransi
Tambahan Perawatan Kehamilan dan Melahirkan yang akan diatur dalam ketentuan tersendiri.
26. Perawatan dan/atau pengobatan yang telah mendapat penggantian dari Jamsostek, Asuransi
Kesehatan dan/atau pihak lain.

DEFINISI PENYAKIT/LUKA YANG TELAH ADA SEBELUMNYA
(PRE EXISTING DIESEASES)

Penyakit atau luka yang telah ada sebelumnya (pre existing diseases) adalah semua penyakit,
luka atau keadaan kesehatan seorang Peserta sebelum tanggal berlakunya Polis, yang:
a) Telah mendapatkan diagnosa; atau
b) Pada umumnya seseorang secara wajar akan berusaha untuk mendapat suatu diagnosa,
perawatan, pengobatan, atau
c) Telah dianjurkan oleh dokter untuk mendapat pengobatan medis, terlepas dari pengobatan
sebenarnya telah dilakukan ataupun tidak.

KEHAMILAN, PERSALINAN & NIFAS
MANFAAT
1. Melahirkan Normal / Abnormal
2. Tambahan untuk Melahirkan Abnormal
3. Melahirkan dengan Pembedahan
4. Keguguran
5. Sebelum & Sesudah Melahirkan
6. Komplikasi Kehamilan
Penggantian biaya perawatan melahirkan termasuk biaya kamar, Dokter Ahli Kandungan, perawat,
bidan, ruang persalinan, obat-obatan dan biaya lain yang berhubungan dengan proses melahirkan.
PENGECUALIAN
1. Peserta Wanita dengan umur dibawah 16 tahun atau lebih dari 45 tahun.
2. Perawatan yang berhubungan dengan aborsi ilegal, sterilisasi, pemeriksaan kesuburan dan
perawatan yang berkaitan dengan kemandulan.
3. Peserta dalam keadaan telah hamil sebelum tanggal efektif Peserta diikutsertakan dalam
Asuransi Tambahan Perawatan Kehamilan dan Melahirkan ini.

RAWAT JALAN

MANFAAT
1. Konsultasi Dokter Umum
2. Konsultasi Dokter Spesialis
3. Obat-obatan
4. Pemeriksaan Diagnostik
5. Fisioterapi
6. Imunisasi Dasar
Terdiri dari :
- Imunisasi Dasar : BCG 1x, DPT 3x, Polio 3x, Campak 1x bagi anak berusia dibawah 1 tahun
- Hepatitis B 3x bagi anak dibawah 5 tahun
7. Keluarga Berencana
Terdiri dari konsultasi dan pelayanan Keluarga Berencana, termasuk pemasangan IUD, suntik, pil
dan susuk.

PENGECUALIAN
Sama dengan Rawat Inap

KO ASURANSI*
Ada pilihan ko asuransi yang dapat disesuaikan dengan kebutuhan perusahaan
Pilihan ko asuransi 0%, 5%, 10%, 15% atau 20%

RAWAT JALAN

MANFAAT
1. Konsultasi Dokter Umum
2. Konsultasi Dokter Spesialis
3. Obat-obatan
4. Pemeriksaan Diagnostik
5. Fisioterapi
6. Imunisasi Dasar
Terdiri dari :
- Imunisasi Dasar : BCG 1x, DPT 3x, Polio 3x, Campak 1x bagi anak berusia dibawah 1 tahun
- Hepatitis B 3x bagi anak dibawah 5 tahun
7. Keluarga B

Hasil (Inggris) 1:

for the filling of data can be filled in on a table: copy of the sbb inload, with explanations:Plan No. (class room participants)--> can diliat in Saphire Blue benefit table, class room from 100 s/d 1200.000-vip,Sex: Sex--> "F": Female (woman)--> "M": Male (male)Relation (Relationship): "E" Employee (Employee); "S "Spouse (wife/husband); "C" Child (Children)GROUP HEALTH INSURANCE PROGRAMSMARTHEALTH-BLUE SAPPHIREInpatient BenefitThese benefits are the main benefits of the Allianz SMARTHEALTH – BLUE SAPPHIRE.There are various benefits are guaranteed, among others, the cost of inpatient treatment and surgeryas well as the costs of doctors, medications and other treatment costs for in-patient in the hospital.We provide a wide range of program options that apply throughout the world.Outpatient BenefitsOutpatient benefits coverage is designed to give you the freedom toChoose a general practitioner or a specialist with a citation. This also gives benefits guaranteedrugs and diagnostic examination and physiotherapy. There is a choice of insurance that can ko-adapted to the needs of the company.Benefits of pregnancy, delivery and ParturitionThis benefit provides reimbursement of the cost of labor and vaginal birth with complicationsincluding caesarean section, as well as the examination fee before and after childbirth.Dental Care BenefitsTo complement the extensive range of benefits is available on the dental health care assuranceYou.Benefits Of SunglassesTo complement the extensive range of benefits above there is also a glass eye and a purchase guaranteelens refraction disorder examination included.SMARTHEALTH PRIVILEGES – BLUE SAPPHIRE  Protection 24 hours a day around the world.  several facilities of use benefits:-Claims Of "Reimbursement"-Card systems or the systems of "Cashless", the excesses of the past are borne by Allianz claims, or-Swipe Card System where claims excesses charged in place.  Facilities RS networks for broad card system.When minimum Inpatient Premium Rp. 15 million, then it can use "Cashless"or referred to by card systems. Allianz currently has more than 300 RS network.  no waiting period.Participants can immediately feel the benefits of these products, without passing through a certain time limit.Specific existing diseases (pre-existing diseases), all of these policies have beenrunning 12 months then automatically the diseases will be borne.  no limit maximum claims per year.  For Outpatient treatment, participants can direct to a specialist, a specialist doctorObstetrician and a specialist eye.  the availability of reimbursement of medical expenses 30 days before and 30 days after treatmentThe Hospital.  the availability of compensation for death is free of charge.  no limitations in the use of these types of drugs and diagnostic actions, allIt is medically necessary.  access to Customer Service Hotline Allianz-24 hours, 365 days a year for all purposesmedical participants.INPATIENTBENEFITS1. Hospital Rooms2. intensive care Unit Room (the Intensive Care Unit/ICU)3. the treating physician Visits4. Consulting a specialist5. the Surgery6. other Treatments7. Before Hospitalization8. after Hospitalization9. home care10. Local Ambulance11. Outpatient Emergency accident12. Emergency Dental Care because of an accident13. compensation for DeathEXCEPTION1. illness or injury that has existed previously (pre-existing diseases), unless the policy has been appliedfor 12 (twelve) consecutive months.2. organ transplantation, including all the care and/or treatment relating toorgan transplant.3. All ancillary equipment or artificial or synthetic materials either outside or affixed toon the body, including but not limited to, wheelchairs, crutches, prosthetic limbs, pacemakerheart, hearing aids, vision AIDS, unless the supporting tool or toolsrequired at the time of surgery in the operating room such as a stent, pen, plate, screw, K-wire,intra ocular lenses, and the like.4. Dialisa, including all the care and/or treatment relating to Dialisa.5. care and experimental treatments, traditional and/or alternative outside of scienceWestern medicine is not confined to acupuncture (unless done by a doctor), sinshe,Shaman fractures, paranormal, chiropractor, naturopath, holistic and the like.6. neurological or psychiatric disorders, including psychosis, neurosis, stress, depression, psikogeriatrik andphysiological manifestations or psikosomatisnya, addiction treatment drug and/or alcohol7. all the care and/or treatment relating to:a. infertility, including artificial insemination, baby tubes, and restoration of fertility.b. Impotence.c. All hormonal therapy-related syndrome premenopausal.8. Care and/or treatment to reduce or gain weight.9. Care and/or treatment related to cosmetics, including plastic surgeryexcept for the plastic surgery of functional reconstruction of the accident conducted 30 (threetwenty) days after the accident.10. periodic physical examinations, Health Check-Up (Medical Check-Up) or the examinationsupport not related to treatment or diagnosis of Illness/injuriesborne.11. Care and/or treatment with regard to:a. Hernia under 10 years of ageb. congenital abnormalities and/or disorders/delays grow hibiscus12. eye refraction, Disorder including treatment and/or treatment relating toabnormalities of the refraction of the eye.13. the Circumcision not associated with a disease or an accident.14. Care and/or treatment with regard to:a. HIV/AIDS, including illness or condition pertaining to HIV/AIDS.b. sexually transmitted disease15. the cost of Non-medical, but not including administrative expenses.16. doctor's recommendation and without Vitamins without medical indication.17. complementary food Substances (Food Supplement)18. Immunization, including maintenance and/or treatment relating to its complications.19. family planning, including the care and/or treatment relating toits complications.20. Care and/or treatment due to:a. actively involved in war, riots, fights or deeds of evil,b. accidental injuries and attempted suicide.21. care and/or treatment because of the participation in dangerous sports or activitiesIE:a. mountain climbing, rock climbing, climbing buildings, bungee jumping, white water raftingb. Sport ridingc. boxing, any kind of physical contact sportsd. all activities of flying in the air (parachuting, gliding, sky diving, Ultralite, andothers)e. All diving activities use respiratory AIDS (diving, and others)f. all activities-engined vehicle with speed races (motorcycle racing, cars, boats,and others)22. care and/or treatment resulting because Attendee flightusing the Charter aircraft, military/police, or helicopter.23. Outpatient rather than as a result of the accident, unless the policy is equipped with Additional InsuranceOutpatient to be arranged in a separate provision.24. Dental Care is not the result of an accident and the fitting dentures by any cause, exceptpolis is equipped with an additional Dental Care Insurance to be arranged in terms ofall its own.25. Pregnancy, childbirth, Care of miscarriage unless policy comes with InsurancePregnancy and Childbirth Care Supplement will be provided for in a separate provision.26. the care and/or treatment that has gotten reimbursement from social security, insuranceHealth and/or other parties.THE DEFINITION OF DISEASES/WOUNDS THAT HAVE BEEN THERE BEFORE(PRE EXISTING DIESEASES)Illnesses or injuries who have been there before (pre existing diseases) are all diseases,cuts or State of health a participant before the date of the enactment of the policy, that:a) has received the diagnosis; orb) generally someone reasonably will attempt to obtain a diagnosis,care, treatment, orc) have been recommended by doctors to get medical treatment, regardless of the treatmenthas actually been carried out or not.PREGNANCY, CHILDBIRTH & PARTURITIONBENEFITS1. give birth to Normal/Abnormal2. in addition to the Birth of Abnormal3. Delivery with surgery4. Miscarriage5. Before & After Childbirth6. pregnancy complicationsReimbursement of expenses including the cost of delivery care room, Doctor, nurse, Content Expertmidwife, birthing room, medications and other costs related to the process of childbirth.EXCEPTION1. Participants women with age under 16 years or over 45 years.2. Treatment related to illegal abortions, sterilization, fertility and examinationtreatment-related infertility.3. participants in the State have been pregnant before the effective date of participants included in theAdditional Care Insurance pregnancy and giving birth to it.OUTPATIENTBENEFITS1. Consulting a general practitioner2. Consulting a specialist3. medical supplies4. Diagnostic Examination5. Physiotherapy6. Basic ImmunizationConsists of:-Basic Immunization: BCG, DPT 3 x 1 x, 1 x, 3 x, measles Polio for children aged under 1 year-Hepatitis B 3 x for children under 5 years old7. family planningComprises consultations and family planning services, including fitting of IUD, injection, pilland pegs.EXCEPTIONSame as InpatientKO INSURANCE *There are options that can be customized insurance ko with company needsChoice ko insurance 0%, 5%, 10%, 15% or 20%OUTPATIENTBENEFITS1. Consulting a general practitioner2. Consulting a specialist3. medical supplies4. Diagnostic Examination5. Physiotherapy6. Basic ImmunizationConsists of:-Basic Immunization: BCG, DPT 3 x 1 x, 1 x, 3 x, measles Polio for children aged under 1 year-Hepatitis B 3 x for children under 5 years old7. family B

Hasil (Inggris) 2:

to be loaded into the data entry table: copy of inload, with the following explanation:
Plan no (class room participants) -> can diliat in Table benefit Blue Saphire, Class rooms from 100 s / d vip 1200.000-,
Sex: gender- -> "F": Female (women) -> "M": Male (Male)
Relations (Relations): "E" Employee (Employee); "S" Spouse (husband / wife); "C" Child (Children) HEALTH INSURANCE PROGRAM COLLECTION SmartHealth - BLUE SAPPHIRE Inpatient Benefits Benefits are the main benefits of the program Allianz SmartHealth - BLUE SAPPHIRE. There are a variety of benefits which include medical expenses guaranteed hospitalization and surgery as well as physician costs, drug- medicines and other treatment costs for in-patient at the hospital. We provide a wide selection of programs that applies worldwide. Benefits Outpatient Ambulatory Insured benefits are designed to give you the freedom to choose a General Practitioner or Specialist Physician with referral. These benefits also provide assurance of medicines and diagnostic tests and physiotherapy. There is a choice of co-insurance that can be tailored to the needs of the company. Benefits of Pregnancy, Childbirth and Postpartum These benefits provide reimbursement for normal labor and delivery with complications including caesarean section, as well as the cost of the examination before and after childbirth. Benefits of Dental Care To complete a variety of benefit options above also available dental health care guarantee you. Benefits Glasses To complement the above benefits of various options available also guarantees the purchase of glasses and lenses, including examination of refractive disorders. SPECIALTY SmartHealth - BLUE SAPPHIRE Proteksi 24 hours worldwide. Terdapat some facilities use options benefits: - Claims "Reimbursement" - Card System or System "Cashless", excess claims are borne out by Allianz, or - Swipe Card Systems which are charged at the excess claims. Fasilitas RS for the network card system wide. If the minimum premium Rawat Confinement Rp. 15 million, then it can use the facility "Cashless" or commonly called the card system. Currently Allianz has more than 300 hospital network. Tidak no waiting period. Participants can immediately feel the benefits of this product, without passing through a certain time limit. Special pre-existing disease (pre-existing diseases), as long as this policy has run 12 months then automatically these diseases will be covered. Tidak no maximum limit claims per year. Untuk Outpatient, participants can directly go to Doctors Child Specialist, Doctors Specialist Gynecology and Ophthalmologist. Tersedianya medical reimbursements 30 days before and 30 days after treatment hospital. Tersedianya Death Benefit at no charge. Tidak no limitation in the use of medication and diagnostic actions, as long as medically necessary. Akses to Customer Service Hotline Allianz- 24 hours, 365 days a year for all purposes of the medical participants. HOSPITAL BENEFITS 1. Hospital Room 2. Room Intensive Care Unit (Intensive Care Unit / ICU) 3. The treating physician visits 4. Consultation Specialist 5. Surgery 6. Other treatments 7. Before Hospitalization 8. After Inpatient 9. Home Care 10. Local Ambulance 11. Outpatient Emergency Accident 12. Emergency Dental Care for Accident 13. Death Benefit EXCEPTION 1. Disease or injury that has been there before (pre-existing diseases), unless the policy has been in force for twelve (12) consecutive months. 2. Organ transplants, including all maintenance and / or treatment related to organ transplantation. 3. All the supporting tools or aids both artificial or synthetic ingredients or attached to the outside of the body, including but not limited to wheelchairs, crutches, artificial limb, the pacemaker of the heart, hearing aids, visual aids, unless the supporting tools or tools aids are required at the time of surgery in the operating room such as a stent, pen, plate, screw, K-wire, intra-ocular lenses, and the like. 4. Dialysis, including all the care and / or treatment related to dialysis. 5. Care and treatment of experimental, traditional and / or alternative outside science of western medicine is not limited to acupuncture (unless done by a doctor), sinshes, shaman fractures, paranormal, chiropractor, naturopath, holistic, and the like. 6. Psychiatric disorders or neurological including psychosis, neurosis, stress, depression, psikogeriatrik and physiological manifestations or psikosomatisnya, treatment of drug addiction and / or alcohol 7. All care and / or treatment related to: a. Infertility, including artificial insemination, IVF and fertility returns. b. Impotence. c. All hormonal therapy is associated with premenopausal syndrome. 8. Care and / or treatment to reduce or gain weight. 9. Care and / or treatment related to cosmetics, including plastic surgery except for plastic surgery due to an accident reconstruction performed functional 30 (three thirty) days after the accident. 10. Periodic physical examination, Check Up Health (Medical Check Up) or examination support unrelated to the treatment or diagnosis of illness / injury are covered. 11. Care and / or treatment related to: a. Hernia under the age of 10 years b. Congenital abnormalities and / or abnormal / delayed growth and development 12. Refractive eye disorders, including the treatment and / or treatment relating to eye refractive disorders. 13. Circumcision is not related to an illness or accident. 14. Care and / or treatment related to: a. HIV / AIDS, including diseases or conditions associated with HIV / AIDS. b. Sexually Transmitted Diseases 15. Non-Medical Costs, but does not include administrative costs. 16. Vitamins without a doctor's recommendation and without medical indication. 17. Substance complementary foods (Food Supplement) 18. Immunizations, including the care and / or treatment-related complications. 19. Family planning, including the care and / or treatment-related complications. 20. Care and / or treatment as a result of: a. actively involved in the war, riots, fights or acts of crime, b. unintentional injuries and suicide attempts. 21. Care and / or treatment because of participation in dangerous sports or activities , namely: a. Mountain climbing, rock climbing, climbing buildings, bungee jumping, rafting b. Equestrian sports c. Boxing, any kind of physical contact sport d. All activities fly in the air (skydiving, hang gliding, sky diving, Ultralite, and others) e. All diving is on a ventilator (diving, etc.) f. All the activities of the race with a speed of motorized vehicles (motor racing, cars, boats, etc.) 22. Care and / or treatment resulting from the participants engage in flight using a chartered aircraft, military / police, or helicopter. 23. Ambulatory not the result of an accident, except insurance policy comes with additional Outpatient be regulated in separate provisions. 24. Dental Care is not due to an accident and the installation of dentures in any way, except insurance policy comes with Extra Dental Care will be subject to the provisions of its own. 25. Care Pregnancy, Childbirth, Miscarriage except insurance policy comes with Pregnancy and Maternity Care Supplement which will be arranged in separate provisions. 26. Care and / or treatment that has received reimbursement from Social Security, Insurance Health and / or other parties. DEFINITION OF DISEASE / INJURY THAT THERE HAVE BEEN PREVIOUSLY (PRE EXISTING DIESEASES) illness or injury that has been there before (pre-existing diseases) are all illnesses, injuries or state of health of a Participant prior to the effective date of the policy, which: a) has been getting a diagnosis; or b) In general, a person will naturally seek to obtain a diagnosis, care, treatment, or c) has been recommended by a doctor for medical treatment, regardless of the treatment actually been done or not. PREGNANCY, LABOR & POSTPARTUM BENEFITS 1. Childbirth Normal / Abnormal 2. Supplement for Childbirth Abnormal 3. Surgery gave birth to 4. Miscarriage 5. Before & After Childbirth 6. Pregnancy Complications Replacement cost of care delivery including the cost of the room, Obstetricians, nurses, midwives, labor room, medicines and other costs associated with childbirth. EXCEPTION 1. Women participants under the age of 16 years or more than 45 years. 2. Care related to illegal abortions, sterilization, fertility examination and treatment relating to infertility. 3. Participants in the state have been pregnant before the effective date of Participants included in the Additional Insurance Pregnancy and Childbirth Care this. OUTPATIENT BENEFITS 1. Public Consultation 2. Consultation Specialist 3. Drugs 4. Diagnostic Examination 5. Physiotherapy 6. Primary immunization consists of: - Basic Immunization: BCG 1x, 3x DPT, Polio 3x, 1x measles for children under 1 year - Hepatitis B 3x for children under 5 years 7. Family Planning consists of consultation and family planning services, including IUD insertion, injections, pills and implants. EXCLUSION Same as Inpatient KO INSURANCE * There is a choice of insurance co that can be tailored to the needs of companies of insurance co Option 0%, 5%, 10%, 15% or 20% OUTPATIENT BENEFITS 1. Public Consultation 2. Consultation Specialist 3. Drugs 4. Diagnostic Examination 5. Physiotherapy 6. Primary immunization consists of: - Basic Immunization: BCG 1x, 3x DPT, Polio 3x, 1x measles for children under 1 year - Hepatitis B 3x for children under 5 years 7. Family B