Note! These 21 Conditions Are Not Covered by BPJS Health

Jakarta, CNBC Indonesia - The Social Security Organising Agency (BPJS) Health is a national health insurance programme designed to provide medical protection for all Indonesian people. Through this scheme, participants can access various health services with costs covered according to the provisions. However, not all types of diseases or medical services fall within the coverage of the insurance. The government has set several limitations regarding services not covered by BPJS Health. Referring to Presidential Regulation No. 82 of 2018 on Health Insurance, there are 21 categories of diseases and services explicitly excluded from the insurance benefits. This regulation remains the main reference until March 2026. Here is the list of 21 diseases and services not covered by BPJS Health: 1. Diseases in the form of outbreaks or extraordinary events 2. Treatments related to beauty and aesthetics, such as plastic surgery 3. Teeth alignment such as braces 4. Diseases resulting from criminal acts, such as assault or sexual violence 5. Diseases or injuries due to intentionally harming oneself or suicide attempts 6. Diseases due to alcohol consumption or drug dependency 7. Infertility or sterility treatment 8. Diseases or injuries due to unavoidable events, such as brawls 9. Health services provided abroad 10. Treatments and medical procedures categorised as trials or experiments 11. Complementary, alternative, and traditional treatments that have not been declared effective based on health technology assessment 12. Contraceptive devices 13. Household health supplies 14. Health services that do not comply with legal regulations, consisting of self-referrals and other health services not in accordance with legal regulations 15. Health services at facilities not cooperating with BPJS Health, except in emergencies 16. Health services for diseases or injuries due to work accidents or work-related matters that are covered by the work accident insurance programme or borne by the employer 17. Health services covered by the mandatory traffic accident insurance programme up to the value covered by the traffic accident insurance programme according to the participant’s treatment class rights 18. Certain health services related to the Ministry of Defence, the Indonesian National Armed Forces (TNI), and the National Police (Polri) 19. Health services organised as part of social services 20. Services already covered by other programmes 21. Other services that have no relation to the health insurance benefits provided.