Indonesian healthcare (BPJS): How does it work?

Alexis
Modified on December 28, 2023

The Indonesian healthcare system is often misunderstood by tourists and expats alike. Here is what you should know on the matter.

The different types of Medical Centers in Indonesia

In Indonesia, there are several types of medical centers where you can receive care. These places depend on your geographical location, the type of issue you are facing, or your health coverage.

Private Hospitals: Usually the Best-Equipped Medical Centers

Private hospitals are often the best places to seek medical treatment in Indonesia. 

They generally have the best equipment and also the best doctors. Private hospitals are also your best option if you don't want to wait too long and/or if you are looking for healthcare personnel who speak English (especially in Bali).

As their name suggests, these establishments are private, so by definition, they are not free.

You can find private hospitals in major Indonesian cities or on tourist islands like Bali, but much less in remote areas of the archipelago.

Among the well-known private hospitals in Bali, we can mention:

  • BIMC Hospital
  • SILOAM
  • Kasih Ibu Hospital

But there are many others.

private hospital bali siloam

Public Hospitals: Present in All Major Cities

Public hospitals are fewer in number than private hospitals but remain very good options for receiving medical care.

Equipment can vary widely from one establishment to another, as can comfort.

In many public hospitals, doctors (especially specialists) work for both public hospitals, private clinics, and/or their own practice. So, it cannot be said that doctors are better or worse in private or public since they are often the same people. However, sometimes equipment can make a difference in favour of private hospitals, but that's not always the case. 

Like private clinics and hospitals, public hospitals are not everywhere. They are generally located in major Indonesian cities.

The cost of care depends on many factors, including whether you are an Indonesian resident or not. Some Indonesian residents (foreigners with KITAS / KITAP) who have subscribed to BPJS may have part or all of their public healthcare reimbursed under certain conditions.

In Bali, the main public hospital is Sanglah Hospital, located in Denpasar.

public hospital sanglah bali

Puskesmas: Community Medical Centers

Puskesmas are somewhat unique care centers but very prevalent throughout Indonesia.

In short, they are something between public hospitals but on a very small scale, and a small practice. Puskesmas are primarily intended for people in very specific areas, often small villages. 

Some have beds and can hospitalise you, while others more closely resemble medical offices.

Puskesmas are the first-line medical centers, found in every corner of the archipelago. When you are in a remote corner of Indonesia, this may be your only option.

Of course, puskesmas are not intended to treat serious illnesses. If you have broken half your skeleton in a scooter accident or suffer from cancer, puskesmas won't be able to do much for you, except perhaps help take you to a real hospital and provide first aid. 

But for what we could call "everyday ailments": cuts requiring a few stitches, bali belly, or a nasty cold, puskesmas can be enough, and they can even be a very convenient option if you are in the middle of nowhere.

puskesmas indonesia

Doctor and Specialist practices

Like everywhere, hospitals and puskesmas are not your only options for medical care in Indonesia; you can also simply go to a doctor's practice.

There are doctors of all types operating independently: general practitioners, of course, but also specialists (ENT, dermatologist, ophthalmologist, etc.).

Some consultations with these doctors may be free if you go through BPJS; otherwise, it is still possible to consult them on your own and be reimbursed by your private insurance or pay out of pocket.

JKN and BPJS Kesehatan: The Indonesian Public Healthcare System (for residents only)

The Indonesian public healthcare system is a bit complicated to understand. If you are not a resident in Indonesia (holder of a KITAP or KITAS), this part does not concern you. You can directly move on to the next section. 

The universal nature of healthcare for Indonesians is in law, but the practice is more complex. Here's what you need to know about the subject.

What is Jaminan Kesehatan Nasional (JKN)?

Jaminan Kesehatan Nasional or JKN could be translated as the universal health insurance or "universal healthcare" in English.

In other words, it is a program launched in 2014 by the Indonesian government with the aim of making healthcare accessible to all Indonesians. Before this date, there was not really a public healthcare system available to everyone, and citizens had to regularly pay out of pocket, subscribe to private insurance, or not seek medical care at all.

JKN is actually composed of two separate subprograms:

  • Kartu Indonesia Sehat (KIS)
  • BPJS Kesehatan

KIS is intended for the poorest citizens, without income conditions. 

BPJS Kesehatan is intended for active individuals that contributes monthly through their company and serves to finance the public healthcare program.

While coverage by some form of health insurance has improved considerably in almost 10 years, it cannot be said that 100% of Indonesians are covered.

What is BPJS Kesehatan?

BPJS Kesehatan is the mandatory health insurance program for all employees in Indonesia (and recommended for freelancers).

The operation is quite simple: you pay a monthly contribution, and in return, you are entitled to public health services.

BPJS Kesehatan is open to all employees residing in Indonesia, regardless of their nationality. If you are formally employed in Indonesia by an Indonesian company (meaning you have a work KITAS), you are eligible even if you are not an Indonesian citizen.

The contribution amounts to 5% of the salary of all Indonesian employees: 4% is paid by the employer, and 1% is paid by the employee. Those who work independently or in the informal economy can also join by contributing a fixed amount each month.

bpjs kesehatan card

How does BPJS Kesehatan work?

When you enter the BPJS Kesehatan system, you will be associated with a clinic or an appointed care center.

When you have a problem, you must first go to this appointed clinic, which usually provides a free consultation. If specialists are needed, your clinic will give you documents and recommend you to a specialist or a specific treatment. Generally, most of these consultations are free or the out of pocket payment is minimal.

The system works quite well, but it has some drawbacks:

  • It is quite bureaucratic and time-consuming
  • Costs are highly optimised, including for treatments
  • The comfort of a hospital covered by BPJS is not always up to Western standards
  • You do not have the choice of your healthcare facility or your doctor
  • You do not always have a choice in treatment (you must opt for whatever is covered by the system, often the cheapest option)

If you work in Indonesia, you are automatically enrolled, so it's a good "just in case" solution, but you need to be aware of its flaws and limitations.

Does the BPJS Kesehatan cover all medical expenses?

No, BPJS Kesehatan does not always reimburse all medical expenses.

It is quite likely that you still have to pay for certain parts of the care. The system is constantly in deficit, so costs are kept to a minimum.

But it is still a preferable option to paying the entire cost, especially for long-term hospitalisations or surgeries.

To have the best chance of free treatment or reimbursement, you must follow the system to the teeth, and in case of emergency, pick a facility that collaborates with BPJS when possible.

Keep in mind that BPJS remains a backup system intended to provide access to care. Indonesians who can afford it often have additional private insurance to complement it.

Who can receive care in Indonesia?

Depending on your nationality, what you contribute to, and your health issue, you will not have the same benefits or access to the same healthcare facilities in Indonesia.

Only employees in Indonesia (including foreigners) who contribute can benefit from free care from BPJS

If you want to benefit from the Indonesian health coverage system, there is no other choice than participating in BPJS Kesehatan.

For this, you must be an Indonesian resident (so holder of a KITAS or KITAP) and pay a monthly contribution.

The facilities you can go to when you have BPJS are limited, but they have the benefit of being free or almost free.

Anyone (including tourists) can access hospitals and care centers as long as they pay

Admission to a private or public hospital in Indonesia when you do not have BPJS depends only on one thing: your payment.

Your visa, nationality, or health issue generally matters little. As long as you pay or your travel insurance or expatriate insurance takes care of the bill, you will have access to care.

What happens in case of emergency if you cannot pay your hospital fees?

When you are not on the BPJS system, care is provided AFTER receiving payment or after prior agreement with your insurance company.

This is especially true for foreigners, whether they are tourists or expatriates in Indonesia. No hospital will provide care until they are sure they can be paid. The severity of the situation does not change this.

No money = no care.

Many Western tourists (and some expatriates) learn this the hard way and realise the day they are in a serious condition that healthcare is not guaranteed in Indonesia.

Unfortunately, it is often too late, and they have to pay hefty sums to receive treatment or launch crowdfunding campaigns to fund their medical expenses.

It goes without saying that not everyone survives.

When you go to Indonesia, travel insurance or expatriate insurance is not really an option.

Your life can (really) depend on it.

emergency indonesia

What is the quality of healthcare in Indonesia?

The quality of healthcare is highly variable in Indonesia and depends on many factors:

  • Hospital equipment
  • Where you are located
  • The health issue you have

Some health issues that Indonesians are accustomed to are generally well-treated, even when they are quite serious, such as dengue.

It becomes more variable for certain traumatic accidents like scooter accidents that result in multiple fractures. In some cases, your insurance may decide to repatriate you to your home country or to a third country for specialised care.

Many wealthy Indonesians also go to Thailand or Singapore when they have health problems that require specific care.

For the majority of everyday issues, the care received in hospitals in major Indonesian cities is more than enough. But as soon as the situation becomes more complicated or once you move into rural areas, everything becomes quickly more uncertain.

Where to seek medical help if you have an issue in Indonesia?

When the situation is not too severe, it is better to opt for a private hospital that is close to Western standards, requires less paperwork and less waiting time, and is more likely to have medical teams that speak English.

If you have travel insurance or expatriate insurance, contact them first to check the hospitals they recommend. Generally, they mostly work with private hospitals. In Bali, most insurances collaborate with BIMC, SILOAM, or Kasih Ibu, and quite often with Sanglah Public Hospotal which are all of very good quality.

If the situation is serious, go to any hospital to receive initial care and contact your insurance as soon as possible to explore options for hospitalisation or even repatriation to your home country or a third country.

For minor issues, you can go to puskesmas or medical clinics. If you are a resident and enrolled in BPJS, you may even have access to some free care.

Bali: Future Destination for Medical Tourism?

2 million Indonesians seek medical treatment abroad every year, and the current government aims to change this trend! 

The International Hospital of Bali, located in Sanur, should be completed and fully operational by 2023. 

Indonesian President Joko Widodo declared: "With the completion of the international hospital, we hope that our citizens will no longer go abroad for treatment, but that foreigners will come to Indonesia for care, as it is a collaboration with the renowned Mayo Clinic (a well-known American hospital-university federation)."

We will see in the future if his prophecy comes true and what the costs of care at this state-of-the-art hospital will be.

Is it mandatory to have health insurance in Indonesia?

Health insurance in Indonesia is not mandatory but proves to be indispensable.

Public hospitals will not treat you for free even if they are public. And their costs for foreigners who are not enrolled into the BPJS program (meaning all non-residents) remain very high. 

Even if you are an Indonesian resident and have BPJS, the medical facilities of public hospitals are limited, and the staff is often overwhelmed. 

Private hospitals and clinics are almost always a better option, especially when you are a foreigner, whether you are a tourist or a resident. 

Private hospitals are not hesitant to spend more to ensure higher quality care, while public hospitals are much more limited by costs and efficiency.

Getting international health insurance, whether for passing travelers or expatriates, allows you to receive treatment in the best conditions without worrying about the cost of your health care.

The benefits of expatriate/travel insurance in Indonesia

The main advantages of expatriate insurance or travel insurance in Indonesia are as follows:

  • You can receive treatment in both a public hospital and a private Indonesian hospital
  • Insurance may prevent you from having to pay hospitalisation costs yourself
  • Most travel or expatriate insurances in Indonesia collaborate with the best private hospitals in the country
  • Medical or health repatriation is a basic offering in almost all contracts
  • You can call medical assistance 24/7
  • A multilingual service can coordinate with the hospital
  • You can be covered in Indonesia as well as in other countries. If you want to travel the world, go on vacation during your expatriation, or return to your home country, you are covered.

Conclusion

The Indonesian healthcare system is quite different from Western healthcare systems, and it's essential to know this to avoid (very) unpleasant surprises.

If you hold a work KITAS in Indonesia, you are likely (or can be) covered by BPJS Kesehatan, which can be a decent option if you have the time and are not seeking expensive care or too much comfort. Supplementing with expatriate insurance is still recommended to access private hospitals and emergency repatriation.

If you are a tourist in Indonesia, you are not entitled to ANY free care, regardless of the severity of your situation. While travel insurance is not mandatory, it is strongly advised not to play with fire if you are not wealthy!

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