Coverage at Heartology
What to Confirm
before Your Visit.
Check the terms that apply to your membership and services. The information on this page helps you prepare the paperwork.
A partnership is not claim approval. Coverage, benefit limits, and the costs you pay follow your policy and the insurer's decision.
Benefits and Limits
Service coverage and benefit limits in your policy.
Service Network
Whether the hospital network matches your membership.
Prior Approval
Whether a referral or authorization is needed before services.
Out-of-Pocket Costs
Costs that are not covered or that exceed your benefits.
Administrative process
Understand Your Claim Process.
Members can use the AdMedika digital membership card and view their plan, benefits and claim history in the MyAdMedika app.
The claim method is not listed yet. Before you come, ask our team whether your visit with AdMedika uses cashless or reimbursement.
Visit preparation
Documents to Prepare.
Use this list as a reminder. The administration team or your insurer may ask for additional documents.
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This list is your own preparation note, not a verification. You do not need to send photos of documents for an initial question.
About and contacting the insurer
Contact AdMedika.
PT Administrasi Medika (AdMedika) is a third party administrator (TPA) that manages health claims administration and healthcare provider networks for insurance members and company employees. AdMedika is now part of the Fullerton Health group. If you hold a card bearing the AdMedika logo, your policy and the party covering your medical costs remain your insurer or employer, not AdMedika.
For claim administration, contact PT Administrasi Medika. Your policy benefits still follow the insurer or employer that covers you.
Gedung Telkom Gambir (Gedung C) - Jl. Medan Merdeka Selatan No. 12, Gambir, Jakarta Pusat, DKI Jakarta 10110, Indonesia
The insurer's contacts are separate from the Heartology help team. Links to the insurer's site open in a new tab.
Frequently asked
Questions before Your Visit.
Does cashless mean all costs are covered?
Not always. Covered services, benefit limits, and the costs you pay follow your policy and the insurer's approval.
Is a health checkup package part of my insurance benefits?
Checkup coverage differs between policies. Confirm the package and tests with your insurer before you schedule.
I use a company or TPA card. Who should I contact?
Start with the instructions on your member card or your company's HR department. The Heartology team can help explain the administrative process for your visit.