Video: OJK's Strategy to Boost Health Insurance Penetration to 20% by 2029

During the Health Insurance Ecosystem Forum 2026, Ogi Prastomiyono, the Executive Head of Insurance, Guarantee, and Pension Fund Supervision at the Financial Services Authority (OJK), outlined steps to strengthen the health insurance ecosystem via OJK Regulation (POJK) Number 36 of 2025.

Prastomiyono noted that health insurance has become a global concern due to surging medical inflation. In Indonesia, medical inflation reached 13.6% in 2025 and is projected to hit 14.4% in 2026. This rise in healthcare costs, coupled with over-utilisation of services, has burdened insurers, with claim ratios exceeding 100%.

POJK 36/202<0xA0>5 was developed to accommodate the interests of insurers, patients, hospitals, BPJS Kesehatan, and relevant stakeholders, following consultations with Commission XI of the Indonesian House of Representatives (DPR RI). A key policy within this regulation is the introduction of a health insurance re-sharing or co-payment scheme. Under this scheme, insurers can offer plans where customers bear 10% of the total claim, capped at Rp300,000 for outpatient care and Rp3 million for inpatient care.

Through this regulation, the OJK has observed an upward trend in the number of policies issued and premiums received, indicating growing public awareness regarding health risk management. However, current public expenditure on health insurance stands at only 5%, or Rp35 trillion per year, out of a total national healthcare expenditure of Rp640 trillion.

The OJK is working alongside the Ministry of Health, BPOM, and BPJS Kesehatan to foster an efficient health insurance ecosystem, with the goal of increasing the user base from 5% to 20% by 2029.