List of 21 Illnesses Not Covered by BPJS Kesehatan as of July 2026

The Social Security Administering Body for Health (BPJS Kesehatan) is designed as a national health insurance programme aimed at providing health protection for all Indonesian citizens. However, it should be noted that not all types of illnesses and medical services are covered by BPJS Kesehatan. Based on applicable regulations, there are 21 categories of illnesses and services that are explicitly excluded from the coverage. These provisions are stipulated in Presidential Regulation No. 82 of 2018 concerning Health Insurance. The following is the list of 21 illnesses not covered by BPJS: 1. Illnesses that constitute an outbreak or extraordinary event. 2. Treatments related to beauty and aesthetics, such as plastic surgery. 3. Teeth straightening procedures, such as braces. 4. Illnesses resulting from criminal acts, such as assault or sexual violence. 5. Illnesses or injuries resulting from intentional self-harm or attempted suicide. 6. Illnesses resulting from alcohol consumption or drug dependency. 7. Infertility treatment. 8. Illnesses or injuries resulting from preventable events, such as brawls. 9. Health services performed abroad. 10. Medical treatments and procedures categorised as experimental. 11. Complementary, alternative, and traditional medicine that has not been declared effective based on health technology assessment. 12. Contraceptive devices. 13. Household health supplies. 14. Health services that do not comply with statutory provisions, consisting of self-requested referrals and other health services not in accordance with laws and regulations. 15. Health services at healthcare facilities that do not cooperate with BPJS Kesehatan, except in emergency situations. 16. Health services for illnesses or injuries resulting from work accidents or occupational relationships that are already covered by the work accident insurance programme or are the responsibility of the employer. 17. Health services covered by mandatory traffic accident insurance, up to the value covered by the traffic accident insurance programme according to the participant’s class of care entitlement. 18. Certain health services related to the Ministry of Defence, the Indonesian National Armed Forces (TNI), and the Indonesian National Police (Polri). 19. Health services organised in the context of community service. 20. Services already covered under other programmes. 21. Other services unrelated to the health insurance benefits provided.