{
    "success": true,
    "data": {
        "id": 1827174,
        "msgid": "list-of-21-illnesses-not-covered-by-bpjs-kesehatan-1782546631",
        "date": "2026-06-27 14:15:00",
        "title": "List of 21 Illnesses Not Covered by BPJS Kesehatan",
        "author": "indrastuti",
        "source": "MEDIA_INDONESIA",
        "tags": "",
        "topic": "Social Policy",
        "summary": "The Indonesian public is urged to understand the limitations of the national health insurance programme, BPJS Kesehatan, as not all medical conditions are covered. A list of 21 specific illnesses and non-essential services, such as aesthetic treatments, are excluded from coverage under Presidential Regulation No. 82 of 2018. Participants are advised to verify their benefits through official channels to avoid confusion and ensure they follow the correct administrative procedures when seeking treatment.",
        "content": "<p>The public is requested to understand the scope of healthcare\nservices that are guaranteed or not guaranteed under the BPJS Kesehatan\nprogramme. BPJS Kesehatan is a government programme that must be\nfollowed by all Indonesian citizens. Through BPJS Kesehatan, the\ncommunity can receive medical treatment free of charge. Similar to\ngeneral insurance, there are monthly BPJS Kesehatan premiums that must\nbe paid by the public according to their chosen membership class.<\/p>\n<p>Despite being a health insurance programme, not all diseases are\ncovered by BPJS Kesehatan. This is stipulated in Presidential Regulation\nNumber 82 of 2018 concerning Health Assurance. For instance, BPJS\nKesehatan does not cover services that are not considered basic\nhealthcare or are not part of medical treatment, such as aesthetic\nservices.<\/p>\n<p>Understanding the benefits of healthcare services is vital for\nparticipants to avoid errors when accessing services at health\nfacilities. By knowing the coverage provisions, the public can prepare\nnecessary documents, follow service procedures, and ensure that the type\nof service required complies with applicable regulations.<\/p>\n<p>Information regarding healthcare services is also related to the need\nfor public education. BPJS Kesehatan participants are advised to\nre-verify service provisions through official channels or by directly\nasking healthcare facility officers before undergoing certain medical\nprocedures. In healthcare services, not all actions or conditions are\nautomatically covered. Therefore, the public needs to understand the\nlimits of benefits, referral procedures, and applicable administrative\nrequirements.<\/p>\n<p>Ignorance regarding coverage provisions can lead to confusion when\npatients require services. Clear education is expected to help\nparticipants make more accurate decisions when seeking medical\ntreatment. Those requiring further information regarding BPJS Kesehatan\nservices should confirm directly with the relevant healthcare\nfacilities. Confirmation is particularly necessary if the required\nservice involves special procedures, referrals, or follow-up\nexaminations.<\/p>\n<p>By taking these steps, participants can obtain explanations regarding\nservice flows, administrative completeness, and potential costs that may\nneed to be prepared. Complete information regarding the list of diseases\nor services not covered must refer to the latest applicable regulations\nand official explanations from the relevant parties.<\/p>\n<p>Other services that have no connection to the provided health\ninsurance benefits are also excluded. Indonesian citizens need to be\naware that certain conditions fall outside the scope of coverage.\nFurthermore, the Minister of Health, Budi Gunadi Sadikin, has emphasised\nthat there are no plans to increase BPJS Kesehatan premium rates,\ndespite a potential deficit of up to Rp2 trillion per month.<\/p>",
        "url": "https:\/\/jawawa.id\/newsitem\/list-of-21-illnesses-not-covered-by-bpjs-kesehatan-1782546631",
        "image": ""
    },
    "sponsor": "Okusi Associates",
    "sponsor_url": "https:\/\/okusiassociates.com"
}