BPJS Health is the mainstay of the Indonesian people to obtain adequate health services and of course at affordable prices. Not only that, there are various facts about BPJS Health that you also need to know.
The current social security system in Indonesia is administered by the Social Security Administering Body or BPJS Health through the National Health Insurance Program - Healthy Indonesia Card (JKN-KIS).
Through this program, the government wants to ensure that all Indonesian people are protected by comprehensive, fair and equitable health insurance. BPJS Health also provides a special contribution assistance program for the poor so they are not burdened with the cost of contributions.
The BPJS Health program must be followed by all Indonesian citizens and foreign nationals who have been in Indonesia for a minimum of 6 months. Contributions are paid according to the level of benefits obtained.
Facts about BPJS Health
To get maximum BPJS services, here are some facts about BPJS Health that you need to know:
1. Bear various types of diseases
Unlike private insurance which generally has limitations and conditions for several types of disease, BPJS Kesehatan is designed to cover all types of diseases. This program covers all BPJS members from all age levels and all levels of disease severity.
The amount of premium paid every month is not based on age, medical history, or level of illness, but based on the health facilities enjoyed. These facilities are divided into class I, class II, and class III.
2. Implement tiered procedures
BPJS Kesehatan applies a tiered referral pattern, so that participants cannot freely check themselves to the hospital or health facility. Participants are required to go through predetermined stages.
First, participants must seek treatment at a first-level health facility, namely a puskesmas, clinic, or individual practicing doctor who has collaborated with BPJS.
If the health facility does not have adequate facilities to carry out treatment, participants will be referred to a higher health facility, such as a hospital.
3. Cover the cost of medical treatment and laboratory examination
Medical expenses and laboratory examinations for laboratory examinations are also included in BPJS Health services. Participants do not need to pay for the service again, as long as it is in accordance with the applicable BPJS Health procedures or provisions.
BPJS will not bear the cost of supporting examinations at the request of the participants themselves without indications or not in accordance with the diagnosis of the disease given by the doctor.
4. Allows participants to change classes for an additional fee
BPJS Kesehatan participants can request a treatment class that is higher than their entitlement, as long as the requested class is available at the designated health facility. However, additional fees will be charged to participants who decide to upgrade to a treatment class.
In addition, please note that upgrading the maintenance class cannot be carried out two levels higher. For example, BPJS class III participants can only go up to class II and not to class I.
5. Requires a high level of patience
The limitations of hospitals or health facilities that work with BPJS, make BPJS Health participants often have to queue to get services. However, now there are more doctors and hospitals serving BPJS Health participants.
It is important to learn the procedures for obtaining optimal services from BPJS Kesehatan. In addition, do not forget to fulfill the obligation to pay premiums every month so that there are no obstacles during treatment.
If you experience various health complaints, do not hesitate to consult a doctor at the nearest health facility. You no longer need to spend a lot of money because almost all of it is covered by BPJS Kesehatan.
