21 Diseases and Services Not Covered by BPJS Health as of March 2026
Jakarta — The Health Social Security Administrator (BPJS Kesehatan) serves as Indonesia’s national health insurance programme, helping participants gain access to treatment and care in accordance with applicable regulations. However, it is important to note that BPJS Kesehatan does not cover all types of diseases and medical services.
In accordance with applicable regulations, there are 21 categories of diseases and services that are explicitly excluded from coverage. These provisions are set out in Presidential Regulation No. 82 of 2018 on Health Insurance.
The following is a list of 21 diseases and services not covered by BPJS Kesehatan:
Diseases in the form of epidemics or extraordinary events.
Treatment related to beauty and aesthetics, such as plastic surgery.
Orthodontic treatment such as braces.
Diseases resulting from criminal acts, such as assault or sexual violence.
Diseases or injuries resulting from intentionally harming oneself or attempted suicide.
Diseases resulting from alcohol consumption or drug dependency.
Treatment for infertility or sterility.
Diseases or injuries resulting from events that cannot be prevented, such as gang violence.
Healthcare services provided outside Indonesia.
Medical treatment and procedures categorised as experimental or trial treatments.
Complementary, alternative, and traditional medical treatments that have not been deemed effective based on health technology assessment.
Contraceptive devices.
Household health supplies.
Healthcare services not in accordance with applicable regulatory provisions, consisting of self-referred services and healthcare services otherwise not in compliance with regulatory provisions.
Healthcare services at health facilities that do not have cooperation agreements with BPJS Kesehatan, except in emergency situations.
Healthcare services for diseases or injuries resulting from workplace accidents or employment relationships already covered by a workplace accident insurance programme or falling under the responsibility of employers.
Healthcare services covered by a mandatory motor vehicle accident insurance programme up to the amount covered by such programme in accordance with the insured’s class of care.
Specific healthcare services related to the Ministry of Defence, the Indonesian Armed Forces (TNI), and the National Police (Polri).
Healthcare services provided in the form of social service activities.
Services already covered under other programmes.
Other services not related to the health insurance benefits provided.