Center for Health Market Innovations (CHMI)

Programs

Dengue Fever Insurance

last updated May 10, 2012

Overview

Implementing organization: 
ACA Insurance
Implementation Partner(s): 
Hypermart, Post Office, Indomaret, Bidan Delima
Legal Status: 
Year Launched: 
2010
Stage: 
Existing/expansion stage
Income Level of Target Population: 
All income levels

Funding

Primary Source of Funding: 
Out-of-pocket payments

Technology

Technology Used: 
Phones › SMS/MMS (Text Message)
Technology Purpose: 
Streamlining Financial Transactions

Scale

Personnel Employed: 
<10
Number of Clients Served: 
270,000 (catchment area)
Summary: 

The Dengue Fever Insurance Card is a low-cost, easy-to-use health insurance card that people can buy in convenient stores to cover dengue fever, a very common illness in Indonesia.

Program goals/rationale: 

Selling health insurance can be difficult in Indonesia. The general public is mostly reluctant to pay a monthly insurance fee for a benefit they would claim only in the case of illness or accident. Even when the need arises, many individuals find it difficult to proceed with a claim, especially in the case of preexisting illness.

Average hospitalization for dengue fever lasts for 5 days and costs up to 3.5 million rupiah. This results in significant costs for the patient, both in hospital fees and in time missed from work.

Key program components: 

To address the lack of insurance coverage for basic illnesses and to reduce the amount of money one has to pay for coverage, ACA insurance has introduced an insurance plan with one specific focus: dengue fever. This illness has been chosen due to its extremely high prevalence, affecting populations from all socio-economic groups.

Designing an insurance plan that covers just one type of illness has reduced the cost of treatment. Further, since dengue fever is such a common disease, ACA views dengue fever insurance as a good entry point for talking about insurance among populations that aren't used to the idea.

ACA dengue insurance offers two different products: (1) an insurance voucher valued at 10,000 (1 USD) rupiahs (the same price as a packet of cigarettes) over three months that covers costs up to 1,000,000 rupiahs (100 USD)
(2) a 50,000 rupiah voucher (5 USD) per year that covers claims up to 2,000,000 rupiahs (200 USD). Insurance coverage begins 15 days after enrollment. A patient can enroll with multiple cards at once for coverage of up to 10,000,000 rupiah (1000 USD).

Adopting a cell phone-based marketing system, ACA insurance has designed the product to function like a pre-paid phone or a state lottery voucher. This was done to ease the marketing and enrollment process. In order to register insurance membership, all a client needs to do is scratch the voucher to uncover a unique PIN and use their cellphone to enter several pieces of information. A server at the main office will store their data in a central database.

ACA has also attempted to create an efficient system for claiming the insurance. An individual simply texts their registration number to an SMS center. It takes ten to fifteen minutes for the call center to then contact the client and conduct verification. Following verification, which includes the provision of a copy of the medical clearance and laboratory result stating that the client suffers from dengue fever, the call center makes a reference to the nearest ACA branch to proceed with claim. Note that a client will receive money regardless of whether they actually seek care at a clinic or hospital.

Downsizing the number of staff needed to manage the insurance has reduced operational costs and made the product more affordable. Currently, ACA insurance is managed by four individuals who market the plan and process the claims.

POLICY CHANGE: The last innovative component of the product is the regulatory changes it has helped influence. In Indonesia, health insurance can only be sold by the insurance company, insurance agent, or a broker. To make their product more accessible to the poor, ACA insurance appealed to the Indonesian Insurance Bureau with regard to the sales of micro-insurance product. With the permission from the regulator, ACA is now selling its product through supermarket chains, post offices, and convenience store franchises all over Indonesia. This strategy has significantly expanded their reach and product visibility.

ACA has also recently made an agreement with Bidan Delima, a midwives program in Jakarta, to have their midwives sell the insurance card. Through this agreement, the midwives receive 20,000 rupiah profit for every 12 cards sold.

ACA insurance hopes to expand the program in term of marketing and replicating similar products in future.

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