BPJS Kesehatan

Indonesian national health insurance program

Logo of BPJS Kesehatan

BPJS Kesehatan (Badan Penyelenggara Jaminan Sosial Kesehatan) is the national health insurance program of Indonesia. It is a government agency responsible for administering the national health insurance scheme, which aims to provide universal health coverage for all Indonesian citizens. BPJS Kesehatan was established to ensure that all Indonesians have access to necessary healthcare services without financial hardship.

History

BPJS Kesehatan was established on January 1, 2014, as part of the Indonesian government's efforts to reform the healthcare system and provide universal health coverage. The program was created under the National Social Security System (Sistem Jaminan Sosial Nasional, SJSN) Law No. 40 of 2004 and the Social Security Providers Law No. 24 of 2011. Prior to the establishment of BPJS Kesehatan, healthcare coverage in Indonesia was fragmented and limited to certain groups, such as civil servants and employees of state-owned enterprises.

Objectives

The primary objective of BPJS Kesehatan is to provide comprehensive health insurance coverage to all Indonesian citizens. The program aims to:

• Ensure equitable access to healthcare services for all citizens.
• Reduce the financial burden of healthcare costs on individuals and families.
• Improve the quality of healthcare services in Indonesia.
• Promote preventive healthcare and healthy lifestyles among the population.

Coverage

BPJS Kesehatan covers a wide range of healthcare services, including:

• Primary care services, such as consultations with general practitioners and basic medical treatments.
• Specialist care, including consultations with specialists and advanced medical procedures.
• Hospitalization services, including inpatient care and surgeries.
• Maternity care, including prenatal, delivery, and postnatal services.
• Preventive care, such as immunizations and health screenings.

Funding

The funding for BPJS Kesehatan comes from contributions made by participants, which include employees, employers, and the government. The contribution rates are determined based on the income level of the participants. The government provides subsidies for low-income individuals and those who are unable to afford the contributions.

Challenges

Despite its achievements, BPJS Kesehatan faces several challenges, including:

• Financial sustainability: Ensuring that the program remains financially viable in the long term.
• Service quality: Improving the quality of healthcare services provided under the program.
• Accessibility: Ensuring that healthcare services are accessible to all citizens, particularly those in remote and rural areas.

Related pages

• Healthcare in Indonesia
• Universal health coverage
• Social security