The Health Insurance or BPJS Kesehatan
According to article 86 Indonesian Law Number 13 the Year 2003 concerning Manpower, each labor has a right to get the protection of safety and healthy during their work. The right to get the protection is applied in giving insurance through The Social Insurance Administration Organization. The Social Insurance Administration in Indonesia is Badan Penyelenggara Jaminan Sosial or BPJS. There are two types of BPJS such as BPJS Kesehatan and BPJS Ketenagakerjaan. Herewith the explanation about The Health Insurance or BPJS Kesehatan.
The Health Insurance or BPJS Kesehatan
The insurance for health (BPJS Kesehatan) is a government program issued in December 2013. In Presidential Regulation No. 111 of 2013 concerning Amendments to Presidential Regulation No. 12 of 2013 concerning Health Insurance, there are provisions regarding BPJS Kesehatan for employees, including the following:
- Participation in compulsory and complementary Health Insurance for all Indonesian residents.
- Article 6 paragraph 3 requires the employees to accept themselves and their workers as Health Insurance participants for BPJS Kesehatan by paying contributions.
Hence, there is no exception, despite the fact that one may already have another medical insurance of his/her own. Besides Indonesian, foreigners who have been working in the country for at least six months are also eligible to be a participant.
Sanctions if The Company Does Not Follow BPJS Kesehatan
According to the BPJS Regulation, companies that fail to register their employees as BPJS participants will be subject to sanctions. The sanction can be in the form of written warnings, fines and/or not receiving certain public services, for example in the matter of licensing. Whereas, if a company violates the provisions regarding payment and deposit of social security contributions, according to Article 55, it may be subject to a maximum imprisonment of eight years or a maximum fine of Rp1.000.000.000,00.
BPJS Kesehatan Rates
For Wage Recipient Workers (PPU), company employees are subject to a BPJS Healthcare rate of 5% of wages. As a rule, 4% is borne by the employer, which is usually given in the form of BPJS Kesehatan benefits, while 1% is paid by the employee from salary deductions. With a maximum salary limit of Rp12.000.000,00.
Benefit as a Member of BPJS Kesehatan
Every employee who has been registered is covered by the program, including their family members, namely wife/husband and children (but no more than five persons in total). Furthermore, every participant of the BPJS Kesehatan program should know that not every medical service is covered by the scheme. The scheme covers two kinds of medical services, the basic (non-specialist) and the advanced (specialist).
Basic medical services include promotive and preventive services, medical treatment and consultation, medicines reimbursement, blood transfusion, first-degree hospitalization based on medical indications, and first-degree laboratorium check-up. On the other hand, advanced medical services cover medical consultation and treatment by a sub-specialist and specialist, medicines reimbursement, advanced diagnostic treatment, medical rehabilitation, blood transfusion, services from forensic doctors and corpse service, non-intensive as well as intensive hospitalization. find more, click here.
The information provided here is based on our long experience. The process or requirement may vary depending on the specific facts and conditions. Besides, the law and regulations in Indonesia subject to frequent changes. Please contact us as your consultant to get an up to date information and accurate advice. More Information click here and You can also follow our social media accounts to see the latest information posts. please click on the following links: Facebook, Instagram, Linkedin, and Twitter.