Requirements and Procedure for Dental Scaling Using BPJS Kesehatan
Jakarta, CNBC Indonesia - There is good news for BPJS Kesehatan participants. Dental and oral care services, including dental scaling or tartar cleaning, are included in the benefits covered by the National Health Insurance (JKN) programme.
Dental scaling is a non-surgical procedure performed using an ultrasonic scaler to remove plaque and tartar adhering to the tooth surface and gum line. This action aims to maintain oral cavity health while reducing the risk of dental and gum disease.
BPJS Kesehatan explained that scaling services can be covered provided there is a medical indication.
“Dental scaling for acute gingivitis (gum inflammation) can be covered by BPJS Kesehatan with a coverage period of once every two years,” BPJS Kesehatan stated via its official social media account.
BPJS Kesehatan also emphasised that the examination and scaling procedure must be carried out based on a doctor’s examination at a registered First-Level Health Facility (FKTP).
“The examination can be conducted at a registered FKTP based on medical indication and cannot be done on one’s own request,” BPJS Kesehatan continued.
This means participants cannot apply for free dental scaling solely for aesthetic purposes or to clean tartar without a medical complaint. This provision is also stated in the JKN-KIS service guide, which specifies that health services for aesthetic purposes are not included in the covered benefits.
Requirements for Dental Scaling with BPJS Kesehatan
For the cost of dental scaling to be covered by BPJS Kesehatan, participants must meet several conditions, namely:
Be registered as an active BPJS Kesehatan participant.
Obtain an examination at a registered FKTP.
Have a medical indication, such as gingivitis or gum inflammation.
The scaling procedure must be recommended by a dentist following the examination.
The service can be covered a maximum of once every two years in accordance with applicable regulations.
Procedure for Dental Scaling Using BPJS Kesehatan
For participants wishing to utilise this service, the procedure is as follows:
Visit a registered first-level health facility (FKTP), such as a community health centre, clinic, or dentist that collaborates with BPJS Kesehatan.
Complete the administrative process by presenting the BPJS Kesehatan card or proof of active membership.
The dentist will examine the condition of the teeth and gums. If a qualifying medical indication is found, the scaling procedure can be performed at no additional cost.
If the doctor finds a condition requiring further treatment by a specialist dentist, the patient will be given a referral letter to an advanced health facility according to BPJS Kesehatan procedures.
Thus, BPJS Kesehatan participants can still obtain free dental scaling services as long as the procedure is performed based on medical necessity, not purely for aesthetic purposes.