Jakarta – Recently, information has circulated suggesting that BPJS Kesehatan has limitations in covering all diseases, claiming it can only cover part of the costs.
In response, the Head of Public Relations for BPJS Kesehatan, Rizzky Anugerah, explained that the government has introduced the National Health Insurance (JKN) program to provide comprehensive health protection for Indonesians.
The scope of JKN benefits managed by BPJS Kesehatan is vast because the healthcare services covered are provided based on participants’ medical indications. Rizzky stated that thousands of disease diagnoses are covered under JKN, as stipulated in the Ministry of Health Regulation No. 3 of 2023.
“Additionally, not only are costly diseases covered, but BPJS Kesehatan also guarantees the cost of long-term or even lifetime medical treatments, such as dialysis for kidney failure patients, thalassemia and hemophilia sufferers, cancer treatments, insulin for diabetes patients, and more,” said Rizzky in a written statement received by detikcom on Saturday (January 18, 2025).
Rizzky explained that as the sole provider of social health insurance in Indonesia, JKN participants include all Indonesian residents, from newborns to the elderly. There are no age restrictions for becoming a JKN participant.
Moreover, no medical check-up is required for individuals to register as JKN participants.
“Since contributions are collected from all Indonesian residents, the JKN premium rates are relatively affordable and consider the economic capabilities of the public. People should also know that BPJS Kesehatan adheres to the principle of mutual cooperation. This means that JKN premiums from healthy participants are used to cover healthcare costs for those who are ill,” Rizzky explained.
Regarding accessibility, BPJS Kesehatan currently collaborates with 23,467 Primary Healthcare Facilities (FKTP) and 3,150 Advanced Referral Healthcare Facilities (FKRTL) spread across the country to serve JKN participants. Because the JKN program adheres to the principle of portability, participants can access healthcare services anywhere in Indonesia, regardless of their ID card domicile.
Rizzky also clarified that BPJS Kesehatan is not a competitor to private insurance providers. According to Presidential Regulation No. 59 of 2024, BPJS Kesehatan can coordinate with other insurers offering complementary health benefits.
“Becoming a JKN participant is mandatory for all Indonesian residents, but for those who can afford it and want additional non-medical benefits, they can complement their coverage with private insurance,” Rizzky said.
“Private insurance providers can develop their products to cover healthcare services beyond those guaranteed by BPJS Kesehatan. Collaboration opportunities with private insurers can be carried out by BPJS Kesehatan as long as they do not conflict with existing regulations,” he added.