It is common practice to reimburse domestic workers’ medical expenses upon presentation of receipts and is manageable for minor medical treatments but can very quickly add up in the event of a hospitalization. This is why we would instead recommend contributing to the National Health Insurance System (BPJS). While far from being perfect, it provides wide coverage, does not exclude preexisting conditions and is very affordable (Rp25,000 – 80,000/person/month depending on the selected class).
Individual participation is actually mandatory for all Indonesian residents, including non-formal workers such as domestic workers but only a minority of them contribute regularly and rely on their savings for medical treatments.
What does it cover?
Its coverage includes: health improvement services and disease prevention (ex: health screening, immunization, family planning and chronic disease management programs), medical treatment services by general practitioners and dentists, advanced health referral services for outpatients and hospitalizations.
Unlike private insurance, there are no exclusions due to preexisting conditions or age with BPJS, nor are there coverage limits.
Some treatments are not covered by BPJS including advanced medical treatments (such as heart surgery, advanced dental procedures), infertility treatments, alternative/experimental medecine, healthcare obtained outside the BPJS procedure, healthcare obtained at facilities not participating with BPJS…
BPJS members must first seek care from an authorized primary care facility (FasKes 1 are located all over the city, a complete list can be found here) which will recommend a more specialized care facility if needed. Members shall bring BPJS/KIS card, copies KTP, KK, and referral letters from FasKes 1 if they have been referred to a specialized care facility.
To expand coverage, BPJS members may also contact private healthcare insurance companies.
How much does it cost?
One household is given one BPJS number which will cover both spouses and up to 4 dependent children. Dependent children are unmarried children up to 21 years old, or 25 years old if attending university. (Children beyond the first 4 may be added at a different cost)
The monthly premium amount for BPJS Healthcare depends on the number of members and the selected class.
In Indonesia, hospitals have different levels of room comfort. They range from wards with 10 or more beds, to private luxury rooms the size of small apartments. The medical service itself is supposed to be equal regardless of room comfort. Therefore, classes in BPJS refer to the comfort of the room only:
|Class I||The monthly premium is IDR 80,000 per person and Class 1 room typically have 2-3 beds per room.|
|Class II||The monthly premium is IDR 51,000 per person and Class 2 room typically have 3-5 beds per room.|
|Class III||The monthly premium is IDR 25,000 per person and Class 3 room typically have over 5 beds per room.|
The monthly premium for a family of 4 who chose Class 1 would therefore be 80,000*4= Rp320,000.
Class changes can be done once every 12 months.
How can I contribute for my employee?
Employers can easily pay online using the GoJek App or Tokopedia website (see tutorial for both herebelow). All that’s needed is the BPJS number.
BPJS Healthcare members must pay their premium at the latest by the 10th day of a calendar month. Any delay in payment will cause member status to be temporarily frozen until all the late payments are paid.
My employee is not registered yet, how can he/she register?
Registration may be done in person (via BPJS office branches) or online (new members will need to go to the local BPJS office to pick up the card).
The following documents will be required:
- KK (kartu keluarga)
- KTP (kartu tanda penduduk)
- Photo 3×4 cm (2)
- Phone number
- Bank account number to pay premium from.
The complete registration process may take 1-2 months.
The information contained in this article has been compiled from here and here, but, neither Kasicare, nor any of its directors, officers, or employees accepts liability for any loss arising from the use hereof or makes any representations as to its accuracy and completeness.