List of 21 Diseases Not Covered by BPJS Kesehatan as of March 2026
Jakarta, CNBC Indonesia - The National Health Insurance programme run by the Social Security Administering Body (BPJS) Kesehatan aims to provide health protection for Indonesian society at large. The scheme is designed so that the public can obtain health services at more affordable costs.
However, not all types of diseases or medical services are included in the BPJS Kesehatan financing coverage. Participants need to understand that there are several medical conditions and certain services that are not included in the benefits of the health insurance program.
Provisions regarding health services that are not covered by BPJS have been officially regulated by the government. The regulation is set out in Presidential Regulation Number 82 of 2018 on Health Assurance.
In that regulation it is stated that there are 21 categories of diseases or health services that are not included in the BPJS Kesehatan guaranty. Here is the complete list.
Here is the list of 21 diseases not covered by BPJS
Diseases that are epidemics or extraordinary events.
Treatments related to beauty and aesthetics, such as cosmetic surgery.
Orthodontics such as braces.
Diseases caused by criminal acts, such as assault or sexual violence.
Diseases or injuries due to deliberately harming oneself or suicide attempts.
Diseases caused by alcohol consumption or drug dependence.
Sterilisation treatment or infertility.
Diseases or injuries due to unpreventable events, such as brawls.
Health services conducted abroad
Treatments and medical actions classified as experiments or trials.
Complementary, alternative, and traditional medicine not proven effective by health technology assessment.
Contraceptive devices.
Household health supplies.
Health services that do not comply with statutory provisions, consisting of self-request referrals and other health services that do not comply with statutory provisions.
Health services at health facilities not operating in cooperation with BPJS Kesehatan, except in emergencies.
Health services for diseases or injuries resulting from work-related accidents or employment relationships that are guaranteed by the Work Accident Insurance program or borne by the employer.
Health services guaranteed by the mandatory Traffic Accident Insurance program up to the amount covered by the traffic accident insurance program according to the participant’s care class.
Certain health services related to the Ministry of Defence, the Indonesian National Armed Forces (TNI), and the Police (Polri).
Health services run as part of social service activities.
Services already covered under another programme.
Other services not related to the health insurance benefits provided.