BPJS Kesehatan Covers Costs for Glasses for Myopia, Here Are the Requirements

JAKARTA - The Head of Communications for BPJS Kesehatan, Rizzky Anugerah, explained that eye health checks at the doctor are covered by BPJS Kesehatan. However, to receive healthcare services, one must be officially registered as an active participant in the National Health Insurance (JKN) programme. Participants must also actively pay their monthly contributions and follow the established referral pathway. What is the referral pathway for accessing BPJS Kesehatan facilities? Here is the explanation. Doctors at First-Level Health Facilities (FKTP), typically at nearby clinics or community health centres (Puskesmas), diagnose eye health to determine if it can be handled at the primary level or requires referral to the next facility. If further treatment is needed, the doctor issues a referral letter to the Follow-Up Referral Health Facility (FKRTL). If the participant indeed requires glasses according to medical indications, the full cost of production is covered by BPJS. The doctor will prescribe the type of glasses for the patient, which is then taken to an optician cooperating with BPJS Kesehatan. Rizzky revealed the types of eye diseases whose medical treatment is covered by BPJS Kesehatan, namely: glaucoma, conjunctivitis, diabetic retinopathy, hypertensive retinopathy, keratitis, blepharitis, and cataracts. As many as 96.8 million people registered in the PBI BPJS Kesehatan will benefit from this. “The rupiah value deposited each month by the Ministry of Health to BPJS is more than Rp 4 trillion per month, and over Rp 48 trillion for the year. This is the allocation for PBI JKN,” he said on Wednesday (15/4/2026). Only people in deciles 1-5 qualify for the PBI BPJS Kesehatan benefits.