Scope of Services
The provider will be required to provide the following services, at the minimum:
- Minimum geographical coverage: Asia
- Hospitalization (In-patient services):
- Hospitalization (In-patient services): a. In-patient room and board at the level of a standard private room;
- Costs of care and treatment in Intensive Care Unit (ICU), High Care Unit (HCU) or Intensive Coronary Care Unit (ICCU);
- In-patient care, reconstructive surgery and rehabilitation, including physician and specialists fee, prescribed medications, drugs and dressings, theater use, surgeons, and anesthetists;
- Use of an ambulance, cost of other transport or airfares in case of an emergency;
- Dental and out-patient treatment due to accident;
- Pre- and post- hospitalization care for at least 30-days;
- Medical Expenses (Out-patient services)
- Medical Expenses (Out-patient services) a. Primary consultations and treatment including medical practitioner’s fees prescribed medication, drugs and dressing;
- Surgeons, Physicians and Anesthetists fees and the charge for using an operating theatre;
- Diagnostic consultations fees for specialists, pathologist and physiotherapists;
- Registered private doctor’s fees and the cost of prescribed drugs and dressings;
- X-rays, CT scans, Magnetic Resonance Imaging (MRIs), electrocardiograms, encephalograms, audiograms, radiotherapy or chemotherapy;
- Surgical appliances prescribed by a Registered Medical Practitioner;
- Dental Expenses (at least at 80% of actual expenses, within a prescribed annual limit per family);
- Optical Expenses (at least at 80% of actual expenses, within a prescribed annual limit per family).
- Emergency Treatment/Medical Evacuation
- Expenses incurred in respect of emergency treatment immediately necessary to stabilize a medical condition without which a major deterioration would develop in the member’s state of health and result in a significant reduction in life expectancy. This includes emergency transportation, evacuation and non-hospital accommodation related to evacuations.
- Maternity (at least after 6-months of membership)
- Premature and Neonatal care;
- Pre-natal and post-natal care;
- Care for complications to pregnancy.
- Preventive treatment:
- Annual Medical Checks for all Members;
Other benefits that will be considered include maximum aggregate limit, coverage of pre-existing conditions and chronic conditions.
- This tender is open for both health insurance companies and health insurance brokers. Health insurance brokers must provide a letter of attorney from the relevant insurance company.
- Proposals, along with any other supporting documents, should be sent to firstname.lastname@example.org email with “AADCP II Health Insurance Provider” as the subject of the email.
- Due date of submission: Thursday, March 7, 2019 at 17.00 WIB (Jakarta time). Proposals coming after this time will not be accepted.
- Only proposals that fully address the minimum level of services listed in the Scope of Services will be evaluated.