Universal Health Scheme Indonesia

We may have heard about BPJS Kesehatan, Indonesia’s national health insurance scheme, but do we really know what it really is? Questions surrounding the eligibility, requirement and coverage related to this government program are often raised.

BPJS, which stands for ‘Badan Penyelenggara Jaminan Sosial’ of Social Insurance Administration Body, is an authorized body that was established to provide medical coverage program for the Indonesian people. BPJS Kesehatan, which focuses on health insurance, started its operation in 2014.

Every Indonesian citizen is required to have BPJS Kesehatan. There is no exception, despite the fact that one may already have another medical insurance of his/her own. In addition to every Indonesian, foreigners who have been working in the country for at least six months are also eligible to join the program.

With regards to participants of BPJS Kesehatan, they can be classified into two categories, namely PBI Jaminan Kesehatan and Non-PBI Jaminan Kesehatan. The first category is entitled for those who are less fortunate (from low social class) and those with total disabilities. Indonesians who belong to the latter category include employees, employers, retirees, investors, and among others.

Every employee who has been registered is covered by the progam, including their family members, namely wife/husband and children (but no more than five persons in total). Furthermore, every participant of BPJS Kesehatan program should know that not every medical service is covered by the scheme. The sceme covers two kinds of medical services, the basic (non-specialist) and the advanced (specialist).

Basic medical services include promotive and preventive services, medical treatment and consultation, medicines reimbursement, blood transfusion, first-degree hospitalization based on medical indications, and first-degree laboratorium check-up. On the other hand, advanced medical services cover medical consultation and treatment by a sub-specialist and specialist, medicines reimbursement, advanced diagnostic treatment, medical rehabilitation, blood transfusion, services from forensic doctors and corpse service, non-intensive as well as intensive hospitalization.

Other countries, such as the United Kingdom (UK), Singapore and Malaysia have their own medical reimbursement systems provided by their government.

The UK government has been providing its medical reimbursemet program for quite a long time since 1948. The progam, which is called the National Health Service (NHS), provides a wide range of health care services. The services include appointments with doctors or general practitioners, hospital treatment and dental care. All British citizens are eligible to the provided medical services. Funding for the NHS comes from taxes. The NHS is free for British citizens, but not free for everyone. You may be required to pay for your healthcare if you receive medical or hospital treatment while in the UK or if you do not reside in the country on a lawful basis.

Somewhat similar to UK’s NHS program, Singapore has the Medisave scheme. It is a national savings scheme that requires every Singapore citizen and permanent resident to spare some amount of their monthly salary into their their Medisave account. The account can be used in case of future medical expenses, such as surgery, hospitalization and certain outpatient expenses at all public healthcare institutions as well as approved private institutions. Allocation rates for Medisave Account may vary depending on age. Besides the Medisave account holder, the scheme covers immediate family members.

Meanwhile, Malaysia adopts a universal healthcare system for all its legal residents. The public healthcare is funded by the government, of which the funding comes directly from taxation. The Malaysian government attempts to provide low-cost and comprehensive medical services in public hospitals to the people through the universal healthcare. Unfortunately for expatriates, they are not entitled to join such program. Expatriates who reside in Malaysia are required to purchase their own medical insurance.