09/06/25

BPJS is a state health insurance program in Indonesia

In other words, social health insurance. Initially, the BPJS insurance program was designed to ensure access to quality medical services, as well as essential medicines and vaccines for everyone. Currently, being insured under the BPJS program is mandatory for all residents of Indonesia living in the country for more than six months. If you are in Indonesia on a work visa, having BPJS (specifically BPJS Ketenagakerjaan) will be a compulsory requirement. You can get BPJS Kesehatan health insurance if you have a KITAS. More about the types of BPJS below.

There are two types of BPJS: BPJS Kesehatan (health insurance) and BPJS Ketenagakerjaan (employment insurance). BPJS Kesehatan is opened by individuals and provides health protection for the insured. BPJS Ketenagakerjaan is necessary if you work for a company, whether local or foreign, or if you own a company. In that case, you must register your employees (both foreign and local) under the BPJS insurance program. To arrange both types of insurance, you must be in Indonesia for at least six months. This is a mandatory requirement to open BPJS.

BPJS Ketengakerjaan (BPJS Employment)

Provided by the employer to protect its employees. The social security package aims to maintain a decent basic standard of living when participants face loss or reduction of income due to workplace accidents, old age, retirement or death.

If you live in Indonesia and work as a freelancer, you can also register as an independent member of the BPJS insurance. In this case, you will pay the monthly contribution yourself.

If you officially get a job in Indonesia, your employer is obliged to obtain BPJS Ketengakerjaan insurance for you upon employment. The company will register you and issue you a social security card. This is a mandatory requirement under Indonesian law!

Coverage

BPJS Ketengakerjaan includes protection against workplace accidents, providing compensation for injuries and treatment, retirement protection when reaching the respective age, protection upon leaving a company (especially if you have worked at the same company for 10 years or more) and compensation in case of death. If an employee dies while working at a company, payments will be made to their family.

Payment

The monthly payments under the social insurance program must be made by both the employer and employee, i.e., the cardholder. The payment amount depends on the type of coverage you prefer and the size of the employee's salary. Deductions are automatically made from your card each month.

It's important to note that BPJS Ketengakerjaan is not a comprehensive insurance product, particularly regarding health insurance. Therefore, you can always get additional health insurance from an independent company. This is not prohibited by Indonesian law.

BPJS Kesehatan (BPJS Health)

This type of insurance can be obtained independently if you have a KITAS. If you have an investor KITAS, you can also include up to five close relatives in your insurance. They must also have long-term visas to Indonesia.

BPJS Kesehatan is a highly commendable type of insurance and, today, offers the best value for money. The monthly payments are minimal (ranging from 42,000 to 150,000 IDR per month, depending on the class) compared to any other Russian or international insurance. At the same time, this policy covers all main health protection needs.

Insurance Classes

There are three classes of BPJS Kesehatan insurance. They differ slightly in price and the quality of services provided. Mainly, the difference lies in the conditions during hospitalization. You choose which class suits you best. Be careful when selecting a category during the insurance application process. Once you receive a BPJS insurance card, changing it later will be very difficult and time-consuming. Re-issuing can take several months. Once activated, the contribution amount will be automatically deducted from your card each month.

As we've already understood, there aren't significant differences in medical services for participants in BPJS classes 1, 2, and 3. All participants will receive the same treatment following the applicable procedures. However, differences arise during inpatient treatment. The facilities in the wards vary depending on the insurance class.

Class 1: The monthly contribution is 150,000 IDR. If hospitalized, you are entitled to a ward for 2-4 patients. You can also apply to move to a VIP room if it is still available. However, be prepared to pay additional costs beyond BPJS's responsibility.

Class 2: The contribution is 100,000 IDR per month. Inpatient treatment in a ward for 3-5 patients. Like class 1 patients, class 2 BPJS patients can apply for a transfer to a VIP or class 1 ward if they are willing to pay costs exceeding BPJS coverage.

Class 3: You only need to pay 35,000 IDR per month. Your treatment will take place in a ward for 4-6 patients. But you can apply to move to class 2 and 3 wards if they are available.

What's Not Covered by BPJS Kesehatan

Indeed, BPJS is a pretty good insurance that covers an extensive list of medical services for minimal financial investment. However, no insurance covers everything.

List of diseases not covered by BPJS Health:

Diseases in the form of epidemics or emergency events.
Procedures related to beauty and aesthetics, such as plastic surgery.
Orthodontist services.
Diseases resulting from criminal actions, such as abuse or sexual violence.
Diseases or injuries resulting from self-harm or attempted suicide.
Diseases resulting from alcohol or drug addiction.
Fertility treatment.
Diseases or injuries resulting from events that cannot be prevented, such as fights.
Medical services provided abroad.
Diagnosis and medical procedures that fall into the category of trials or experiments.
Supplementary, alternative, and traditional medicine whose effectiveness has not been recognized based on health technology assessments.
Contraception.
Household health goods.
Medical services that do not meet legal provisions, consist of referrals at your own request, and other medical services that do not conform to legal standards.
Medical services in clinics that do not collaborate with BPJS Health, except for emergencies.
Medical services in the case of diseases or injuries resulting from workplace accidents or employment relationships, which are guaranteed by workplace accident insurance or covered by the employer. In this case, you are required to be insured under the BPJS Ketengakerjan program.
Medical services exceeding the amount covered by accident insurance according to participant's treatment class rights.
Services already covered by other programs.
Other services not related to the provided medical insurance benefits.

Keep in mind that when enrolling in BPJS, you will be attached to a specific local polyclinic (puskesmas kesehatan). After that, you won't be able to change it, except in the case of accidents. Subsequently, you will be treated there. If the treatment provided at this hospital does not help or if the clinic is not technically equipped to treat your condition, the doctor will refer you to another higher-level hospital.

BPJS does not only cover the treatment of actual illnesses and accidents but also screens potential diseases. This is a series of tests to identify the presence or possibility of a certain disease or condition in a person, even if they have no symptoms. Screening is important as it can help detect diseases at an early stage before they become more severe and harder to treat. BPJS Kesehatan covers several types of disease screenings, including cancer, cardiovascular diseases, and infectious diseases, and they are usually free for insurance program participants.

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