Note! These 21 Diseases and Hospital Services Are Not Covered by BPJS Health
Jakarta, CNBC Indonesia - BPJS Kesehatan is a national health insurance programme designed to provide health protection for all Indonesian citizens. However, participants need to understand that not all diseases or medical services can be financed through the programme.
The provisions regarding services not covered by BPJS Kesehatan are regulated in Presidential Regulation (Perpres) Number 82 of 2018 concerning Health Insurance. The regulation specifies 21 categories of diseases and health services that are not included in the benefit coverage.
Based on these regulations, uncovered health services generally include those that are not in accordance with procedures, are aesthetic in nature, or involve diseases or injuries resulting from specific actions that are specially regulated in legislation.
In addition, a number of services such as infertility treatment, treatment for alcohol or drug dependency, and health services performed abroad are also not included in the benefits provided by BPJS Kesehatan.
Here is the list of 21 diseases and services not covered by BPJS Kesehatan according to Presidential Regulation Number 82 of 2018, as quoted on Sunday (19/6/2026):
Diseases that are outbreaks or extraordinary events
Treatments related to beauty and aesthetics, such as plastic surgery
Teeth straightening procedures like braces
Diseases resulting from criminal acts, such as abuse or sexual violence
Diseases or injuries resulting from intentional self-harm or suicide attempts
Diseases resulting from alcohol consumption or drug dependency
Infertility treatment
Diseases or injuries resulting from preventable incidents, such as brawls
Health services performed abroad
Medical treatments and procedures categorised as experimental
Complementary, alternative, and traditional medicine that has not been declared effective based on health technology assessment
Contraceptive devices
Household health supplies
Health services that do not comply with statutory provisions, including self-requested referrals and other health services not in accordance with regulations
Health services at health facilities not cooperating with BPJS Kesehatan, except in emergency situations
Health services for diseases or injuries resulting from work accidents or employment relationships that are already covered by the work accident insurance programme or are the responsibility of the employer
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
Certain health services related to the Ministry of Defence, the Indonesian National Armed Forces (TNI), and the National Police (Polri)
Health services organised for social service activities
Services already covered by other programmes
Other services that are not related to the health insurance benefits provided.