21 This disease will no longer be covered by BPJS Health as of August 2024

foto: bpjs-kesehatan.go.id

As time goes by and there are changes in health policies, BPJS Health continues to adjust the types of services covered.

Brilio.net - BPJS Health (Social Health Insurance Administering Agency) is a government institution formed to administer the National Health Insurance (JKN) program in Indonesia.

This institution aims to provide access to affordable and quality health services to all Indonesian people. BPJS Health plays an important role in ensuring that every citizen gets medical services without having to worry about burdensome costs, with monthly fees that vary based on service class.

Diseases that are not covered by BPJS
bpjs-kesehatan.go.id

In carrying out its duties, BPJS Health provides various types of health services ranging from routine health checks, disease treatment, to hospital care. The JKN program is governed by the principle of mutual cooperation, where participants pay contributions which are used to cover the costs of the medical services they receive. With this system, it is hoped that all levels of society, especially the less fortunate, can gain access to adequate health services.

However, as time goes by and there are changes in health policies, BPJS Health continues to adjust the types of services covered. This adjustment was made to optimize budget allocation and improve the quality of health services provided to participants. This includes revisions to the types of services covered by the JKN program.

Diseases that are not covered by BPJS
bpjs-kesehatan.go.id

Starting August 2024, BPJS Health will change the list of covered health services, removing several services from the covered list. According to the Official BPJS Health Website, this change aims to adjust to the available budget and focus on more urgent and critical services.

Reported by brilio.net on the official BPJS Health website on Thursday (1/8), it was stated that the elimination of several services was carried out after an in-depth evaluation of the effectiveness and need for existing health services. Complete information regarding these changes can be found at www.bpjs-kesehatan.go.id which outlines the reasons and details of services that are no longer covered.

The BPJS Health organizers also informed participants through BPJS Health Circular Letter No. 045/SE/2024, which explains that some health services that are deemed not urgent or ineffective will be removed from coverage. This is expected to increase focus on more essential health services and increase budget efficiency.

Participants are encouraged to periodically check for changes to this policy and prepare for possible additional charges for services that are no longer covered. BPJS Health provides the latest information through various communication channels, including their official website and customer service.

Diseases that are not covered by BPJS
bpjs-kesehatan.go.id

Based on Article 52 of Presidential Regulation Number 82 of 2018 concerning Health Insurance, the following are 21 types of health services that will not be covered by BPJS Health starting August 2024:

1. Health services that do not comply with statutory provisions;

2. Health services provided in Health Facilities that do not collaborate with BPJS Health, except in emergency situations;

3. Health services for illnesses or injuries resulting from work accidents or work relations which are guaranteed by the Work Accident insurance program or are borne by the Employer;

4. Health services for which coverage is provided by a mandatory traffic accident insurance program up to the value or conditions covered in accordance with statutory provisions and provided in accordance with the Participant's treatment class rights;

5. Health services provided abroad;

6. Health services for aesthetic purposes;

7. Services to treat infertility;

8. Teeth straightening or orthodontic services;

9. Health problems or drug and/or alcohol dependence;

10. Health problems due to intentionally hurting yourself or as a result of engaging in hobbies that endanger yourself;

11. Complementary, alternative and traditional medicine that has not been declared effective based on health technology assessment;

12. Treatment and medical procedures are categorized as experimental trials;

13. Contraceptive devices and drugs and cosmetics;

14. Household health supplies;

15. Health services resulting from disasters during emergency response, extraordinary events or epidemics;

16. Health services for preventable adverse events;

17. Health services provided within the framework of social service;

18. Health services resulting from criminal acts of abuse, sexual violence, victims of terrorism, and criminal acts of human trafficking which have been guaranteed through other funding schemes implemented by ministries/institutions or Regional Governments in accordance with the provisions of statutory regulations; Decree No. 191960A

19. Certain health services related to the Ministry of Defense, the Indonesian National Army, and the National Police of the Republic of Indonesia;

20. Other services that are not related to the Health Insurance Benefits provided; or

21. Services that are already covered under other programs.

(brl/ola)