Choice of Red Eye Pain Medication

The current national social security system in Indonesia is run by the Social Security Administrative Body (BPJS). Through the National Health Insurance Program-Healthy Indonesia Card (JKN-KIS) organized by BPJS Kesehatan, the state wants to ensure that all Indonesians are protected by comprehensive, fair and equitable health insurance.

BPJS Kesehatan is a system that must be followed by all Indonesian citizens and foreign nationals who have been in Indonesia for a minimum of 6 months. The government has set an achievement target so that all Indonesian citizens have BPJS health in 2019. This is in accordance with article 14 of Law Number 24 of 2011. Contributions are paid according to the level of benefits obtained. A special Contribution Assistance program is also provided for the poor. However, there are still many complaints from BPJS Health users.

Complaints that were received by the Indonesian Consumers Foundation (YLKI) regarding BPJS Health included hospital rejection of BPJS patients, procedural difficulties, incomplete treatment, inadequate doctor services, long queues at health facilities receiving BPJS such as emergency department at the hospital, and not paid

Choice of Red Eye Pain Medication

Facts about BPJS Kesehatan

To get maximum BPJS service, here are some facts about BPJS Health that you need to know:

  • Unlike private insurance which generally has limitations and conditions for several types of diseases, BPJS Kesehatan is designed to cover all types of diseases. BPJS Health will cover BPJS members from all age levels and all levels of disease severity.
    The amount of premium paid is not based on age, medical history, or level of illness, but is based on the health facilities enjoyed. This facility is divided into class I to class III.
  • BPJS Kesehatan adheres to a tiered referral pattern, so that patients cannot freely check themselves to the desired hospital or health facility. First, patients must seek treatment at first-level health facilities, namely puskesmas, clinics, or individual practicing doctors who work together with BPJS. Then, if the health facility is unable to treat it, it will be referred to a higher health facility or hospital class.
  • The limitations of hospitals or health facilities that work with BPJS, make BPJS Health patients often have to queue to get services. However, now there are more doctors and hospitals serving BPJS Health participants.
  • The cost of medical treatment and laboratory examination is also included in BPJS Health services. Patients do not need to pay again for these services, as long as they are in accordance with the applicable BPJS health procedures or provisions. BPJS will not bear the cost of supporting examinations at the request of the patient himself without any indication or not according to the diagnosis of the disease given by the doctor.
  • Withdrawal of fees for BPJS patients applies if the participant asks for higher facilities than the rights that should be obtained. For example, when a patient asks for a class of treatment higher than his entitlement. For this reason, patients need to inform BPJS Health and hospital staff if they want to use a higher class than the premium paid to BPJS during treatment.

It is important to learn the procedures for obtaining optimal services from BPJS Kesehatan. In addition, don't forget to fulfill the obligation to pay premiums every month so that there are no obstacles during treatment.

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