144 Diseases Covered by BPJS Kesehatan
BPJS Kesehatan provides health service guarantees for participants of the National Health Insurance (JKN) for various medical conditions. There are 144 types of diseases included in the service coverage, ranging from infectious and chronic diseases, metabolic disorders, to conditions requiring emergency treatment.
BPJS Kesehatan membership has been mandatory for all Indonesian citizens since 2014 in accordance with statutory provisions. Under this scheme, participants are required to pay monthly contributions, similar to the mechanism in health insurance programmes.
As long as membership status is active, participants can obtain free health services at clinics, community health centres (puskesmas), and hospitals that cooperate with BPJS Kesehatan.
Referring to Health Ministry Regulation (Permenkes) Number 28 of 2014 concerning Guidelines for the Implementation of the National Health Insurance Programme, there are 144 diseases covered by BPJS.
The following are the 144 diseases guaranteed by BPJS Kesehatan:
Febrile seizures
Tetanus
HIV AIDS without complications
Tension headache
Migraine
Bell’s Palsy
Vertigo (Benign paroxysmal positional vertigo)
Somatoform disorders
Insomnia
Foreign body in the conjunctiva
Conjunctivitis
Subconjunctival haemorrhage
Dry eye
Blepharitis
Hordeolum
Trichiasis
Episcleritis
Mild hypermetropia
Mild myopia
Mild astigmatism
Presbyopia
Night blindness
Otitis externa
Acute otitis media
Cerumen impaction
Motion sickness
Furuncle on the nose
Acute rhinitis
Vasomotor rhinitis
Vasomotor rhinitis
Foreign body
Epistaxis
Influenza
Pertussis
Pharyngitis
Tonsillitis
Laryngitis
Bronchial asthma
Acute bronchitis
Pneumonia, bronchopneumonia
Pulmonary tuberculosis without complications
Essential hypertension
Oral candidiasis
Mouth ulcers (aphthous, herpes)
Parotitis
Umbilical infection
Gastritis
Gastroenteritis (including cholera, giardiasis)
Gastroesophageal reflux
Typhoid fever
Food intolerance
Food allergy
Food poisoning
Hookworm disease
Strongyloidiasis
Ascariasis
Schistosomiasis
Taeniasis
Hepatitis A
Bacillary dysentery, amoebic dysentery
Haemorrhoids grade 1/2
Urinary tract infection
Gonorrhoea
Pyelonephritis without complications
Phimosis
Paraphimosis
Genital discharge syndrome (gonococcal and non-gonococcal)
Lower urinary tract infection
Vulvitis
Vaginitis
Bacterial vaginosis
Salpingitis
Normal pregnancy
Complete spontaneous abortion
Iron deficiency anaemia in pregnancy
Perineal rupture grade 1/2
Hair follicle/sebaceous gland abscess
Mastitis
Cracked nipple
Inverted nipple
Type 1 diabetes mellitus
Type 2 diabetes mellitus
Mild hypoglycaemia
Protein-energy malnutrition
Vitamin deficiency
Mineral deficiency
Dyslipidaemia
Hyperuricaemia
Obesity
Iron deficiency anaemia
Lymphadenitis
Dengue fever, DHF
Malaria
Leptospirosis (without complications)
Anaphylactic reaction
Leg ulcers
Lipoma
Verruca vulgaris
Molluscum contagiosum
Herpes zoster without complications
Measles without complications
Varicella without complications
Herpes simplex without complications
Impetigo
Ulcerative impetigo (ecthyma)
Superficial folliculitis
Furuncle, carbuncle
Erythrasma
Erysipelas
Scrofuloderma
Leprosy
Syphilis stage 1 and 2
Tinea capitis
Tinea barbae
Tinea facialis
Tinea corporis
Tinea manus
Tinea unguium
Tinea cruris
Tinea pedis
Pityriasis versicolor
Mild mucocutaneous candidiasis
Cutaneous larva migrans
Filariasis
Pediculosis capitis
Pediculosis pubis
Scabies
Insect bite reactions
Irritant contact dermatitis
Atopic dermatitis (except recalcitrant)
Nummular dermatitis
Nappy eczema
Seborrhoeic dermatitis
Pityriasis rosea
Mild acne vulgaris
Hidradenitis suppurativa
Perioral dermatitis
Miliaria
Acute urticaria
Exanthematous drug eruption, fixed drug eruption
Lacerations, puncture wounds
First and second degree burns
Blunt trauma
Sharp trauma