co-payment
Also called: biaya berbagi
The fixed portion of medical costs that the insured always pays each time they seek treatment.
What it means
Co-payment, or cost sharing, is the portion of medical costs that the insured always bears each time they use a service, while the rest is covered by the company. The amount can be a fixed nominal sum or a certain percentage of the cost, according to the policy terms. This mechanism makes premiums lighter because the insured shares part of the cost. In Indonesia, co-payment often appears in certain health insurance products and needs to be read carefully in the policy summary.
Why it matters for families
Co-payment affects how much money a family must prepare when seeking treatment, even if they already have insurance. If ignored, a family can be caught off guard when asked to pay their own share at the hospital. Understanding the size of the co-payment helps assess whether a cheaper premium truly saves money overall.
Example
For example, a policy sets a co-payment of 20 percent for inpatient care. If the inpatient cost is Rp10 million, the insured pays Rp2 million and the company covers Rp8 million, assuming all costs fall under the benefits.
Common misunderstanding
Many think co-payment is the same as an additional premium. The correction: co-payment is the portion of medical costs paid when using a service, not the monthly policy fee.