Estimation of Inpatient Health Insurance Premiums using the RP-2000 Table with Medical Cost Projection Scenario

Neva Satyahadewi; Hendra Perdana; Ray Tamtama

doi:10.30598/pijmathvol4iss2pp97-104

Neva Satyahadewi Department of Mathematics, Mathematics and Natural Science Faculty, Tanjungpura, Indonesia
Hendra Perdana Department of Mathematics, Mathematics and Natural Science Faculty, Tanjungpura, Indonesia
Ray Tamtama Department of Mathematics, Mathematics and Natural Science Faculty, Tanjungpura, Indonesia

DOI: https://doi.org/10.30598/pijmathvol4iss2pp97-104

Keywords: Insurance, Medical Costs, Mortality Table

Abstract

Inpatient health insurance serves as an essential form of financial protection to mitigate the risk of loss arising from hospitalization costs. This study aims to estimate inpatient health insurance premiums by combining the Indonesian Mortality Table IV and the RP-2000 Combined Healthy Table to determine age-specific hospitalization probabilities. Methodologically, this research employs a quantitative actuarial modeling approach based on life table techniques and expected present value calculations, using secondary data from the Indonesian Mortality Table IV, the RP-2000 Combined Healthy Table, and published information on medical inflation in Indonesia. The numerical illustrations are obtained through spreadsheet-based actuarial calculations. In addition to age, the premium calculation incorporates the interest rate, the insured’s gender, and cost components such as inpatient care, surgery, and intensive care unit (ICU) treatment so that the premium structure aligns with the coverage provided. A scenario of rising hospital costs due to medical inflation, assumed at 13% per year, is also included to obtain more realistic and economically relevant premium estimates. A case study is conducted for a 30-year-old participant with a two-year coverage period, offering benefits of an inpatient daily allowance of IDR 300,000 (maximum 40 days), surgical expenses up to IDR 3,000,000, miscellaneous hospital care up to IDR 7,000,000, and an ICU allowance of IDR 600,000 per day (maximum 15 days). The analysis results show monthly premiums of IDR 113,341 for male participants and IDR 121,904 for female participants, where the difference is attributed to higher hospitalization risks among females. Age variation analysis indicates that premiums increase with age, while interest rate variation analysis shows that higher interest rates result in lower premiums due to the discounting effect. These findings support the need for a dynamic actuarial approach to setting more accurate and sustainable health insurance premiums

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