BPJS is Indonesia’s national health service. It is a subscription service, i.e. you pay a monthly fee and this entitles you to free health care.
Since it is now available to ex-pat residents, I though it might be useful to post a translation of the procedures for using it, gleaned from the official sources (at https://www.indonesia.go.id/layanan/kesehatan/sosial/cara-berobat-pakai-kartu-bpjs-kesehatan)
- I cannot 100% guarantee the translation. In particular item A6 below was a bit confusing. This is my best effort.
- This article is about using the BPJS once you are registered. It does not cover the registration process.
How to Get Care using the BPJS Health Card
Published MONDAY, AUGUST 20, 2018 | 4:11 WIB
The first requirement is a Health BPJS card as proof of participation. The card does not have to be physical, but it can also be a digital version by downloading on the JKN Mobile application on mobile.
There are two circumstances where it can be used. The procedure is slightly different.
- Non-urgent treatments
- Emergency treatment
A) Non-urgent treatments
- Come to the first level health facility (puskesmas, pratama clinic, or individual practice doctor who works with BPJS Health) which corresponds to the BPJS Health card. (Note: Some clinics also provide some dental care. If you have not yet registered for BPJS, check this out as you have to select your clinic when you register.)
- Be examined there (puskesmas etc). If according to the doctor it is necessary to take the next step, you will be referred to a hospital (with a referral letter).
- At the hospital, you must re-show the Health BPJS card (and the referral letter).
- You may get outpatient and / or inpatient services at the hospital as referred by the examining doctor.
- BPJS has three different monthly subscription rates. The hospital service level will depend on the rate chosen (e.g. type of room, not level of medical care). If you cannot show your participation number, you will be treated at the general patient rate (lowest level).
- Unless the hospital doctor provides a specific referral letter, and if you need further attention, you must go back to the first level health facility
B) Emergency treatment
- You can go directly to the IGD in the hospital in an emergency. A doctor at the hospital will determine whether it actually is an emergency and may direct you back to the first level health facility.
- You ( or the person accompanying you ) must show a physical BPJS card or the digital Health BPJS card in the JKN Mobile application. If not, it will be included in the general patient rate.
- You will get outpatient and / or inpatient services according to health indications.