BPJS fraud

[sumyunggai]

So my mother-in-law got ill. In hospital. No BPJS (as she couldn't be bothered).

But not to worry, it's apparently completely standard to 'borrow' someone else's name & BPJS and pay them some nominal sum to avoid the little matter of not actually being insured.

 

[scouser59]

very sad , people abusing a good system , the managers need to fix this .

 

[Davita]

very sad , people abusing a good system , the managers need to fix this .

Here's an idea...get the White House staff to work on fixing Indonesia's BPJS system after they sort their own.
America has a population of 325M, give or take some illegals. Indonesia (relatively) only has a population of 262M, give or take a few awaiting execution.
Surely, after the Donald fixes his BIG problem, he can assist in a much smaller one.
Crowing about his negotiating skills...he might even teach corrupt Indonesians how to do things better.

 

[Puspawarna]

Here's an idea...get the White House staff to work on fixing Indonesia's BPJS system after they sort their own.
America has a population of 325M, give or take some illegals. Indonesia (relatively) only has a population of 262M, give or take a few awaiting execution.
Surely, after the Donald fixes his BIG problem, he can assist in a much smaller one.
Crowing about his negotiating skills...he might even teach corrupt Indonesians how to do things better.

To paraphrase Henny Youngman, "A good businessman has lots of skills. Take our president...please!"

 

[sumyunggai]

So apparently the BPJS hasn't been paid for a year. So the deal is to pay that off AND pay the person money.

 

[Davita]

I've been told you can register with BPJS anytime including just before going to a BPJS approved hospital...but cannot verify.
I read that one of the problems with the BPJS budget is people don't register until they need medical attention. It wouldn't be rocket science to make it mandatory.

We made our house-staff register but we pay their subscriptions...that way if they leave, or we terminate, they have the option to continue with their own subscriptions.

 

[scouser59]

I've been told you can register with BPJS anytime including just before going to a BPJS approved hospital...but cannot verify.
I read that one of the problems with the BPJS budget is people don't register until they need medical attention. It wouldn't be rocket science to make it mandatory.

We made our house-staff register but we pay their subscriptions...that way if they leave, or we terminate, they have the option to continue with their own subscriptions.

As I understand it you have to be a member for a month b4 you can get treatment , BPJS membership will be a critical factor ,in the near future , for government services ie sim etc .

 

[Davita]

As I understand it you have to be a member for a month b4 you can get treatment , BPJS membership will be a critical factor ,in the near future , for government services ie sim etc .

I cannot argue, as I don't really know, but I understood, when we registered our staff, the benefits were immediate.

Also...this is from LII....it doesn't mention about waiting a month.....

"3. The BPJS member can register him/herself and the members of his/her family: spouse and up to 3 children. On the day of the registration they should pay their first monthly contribution by choosing the level of contribution corresponding to the class they will get in case of hospitalization:

First class: Rp 80,000 / member
Second class: Rp 51,000 / member
Third Class: Rp 25,500 / member



​

 

[sumyunggai]

I've been told you can register with BPJS anytime including just before going to a BPJS approved hospital...but cannot verify.
I read that one of the problems with the BPJS budget is people don't register until they need medical attention. It wouldn't be rocket science to make it mandatory.

We made our house-staff register but we pay their subscriptions...that way if they leave, or we terminate, they have the option to continue with their own subscriptions.

It says clearly here: https://daftar.bpjs-kesehatan.go.id/bpjs-online/


" Menyetujui membayar iuran pertama paling cepat 14 (empat belas) hari kalender dan paling lambat 30 (tiga puluh) hari kalender setelah menerima virtual account untuk mendapatkan hak dan manfaat jaminan kesehatan"


In other words there is a mandatory 14 day wait, but it could take up to 30 days.

 

[macvert]

Does this mean it can take BPJS up to 30 days or it can take an Indonesian 30 days to wait 14 days.......

 

[Davita]

It says clearly here: https://daftar.bpjs-kesehatan.go.id/bpjs-online/


" Menyetujui membayar iuran pertama paling cepat 14 (empat belas) hari kalender dan paling lambat 30 (tiga puluh) hari kalender setelah menerima virtual account untuk mendapatkan hak dan manfaat jaminan kesehatan"


In other words there is a mandatory 14 day wait, but it could take up to 30 days.

Thanks for that...it does indicate it could take between 14 days to 30 days.
But I didn't read it was mandated ...seems to me it's an administrative time for approval for applicants using the internet.

I wonder if any member, physically applying, has received approval instantly or was required to wait. I imagine, those employed, would be worried if it took a month for medical benefits to be approved whilst required to work during that time.

 

[macvert]

I wonder if any member, physically applying, has received approval instantly or was required to wait. I imagine, those employed, would be worried if it took a month for medical benefits to be approved whilst required to work during that time.

My wife received our cards the same day as she registered (physically submitted the forms) & was told the cards would be active in 7 days, that was about 2 years ago.

 

[fastpitch17]

We received the SMS with our numbers last night. A little over one business day of processing. Will pay this week and take reciepts to them and supposedly get our cards. We will ask when they actually take effect.

 

[deborahk]

I've been told you can register with BPJS anytime including just before going to a BPJS approved hospital...but cannot verify.
I read that one of the problems with the BPJS budget is people don't register until they need medical attention. It wouldn't be rocket science to make it mandatory.

We made our house-staff register but we pay their subscriptions...that way if they leave, or we terminate, they have the option to continue with their own subscriptions.

I think it is mandatory if you are working. My company said we have to pay it even though they provide a private medical insurance too. It automatically gets taken from our salaries every month. This is for expats and Indonesians. The good thing is that BJPS covers our whole family as the private insurance from the company just covers the individual worker.

 

[Davita]

I think it is mandatory if you are working. My company said we have to pay it even though they provide a private medical insurance too. It automatically gets taken from our salaries every month. This is for expats and Indonesians. The good thing is that BJPS covers our whole family as the private insurance from the company just covers the individual worker.

That's correct...all WNI working in the formal sector are mandated to be members as are all WNA who have worked for more than 6 months in RI. It's planned to make it compulsory for all WNI by 2019 but ...who knows..... this is Indonesia.

 

[Felicity]

So apparently the BPJS hasn't been paid for a year. So the deal is to pay that off AND pay the person money.

From what I understand, to keep having benefit of BPJS then the arrears (tunggakan?) should be paid. In this case, 12 months x monthly payment (depends on the class).
After payment, you can use the benefit of BPJS as normal, exclude hospitalisation. If you use this service use BPJS within 45 days after payment, then you will have to pay 2,5% fine (2,5% x 12 x hospitalisation cost). => this hospitalisation fine is also applied even when arrears are below 12 months.

I don't understand to whom you pay and for what money?

It says clearly here: https://daftar.bpjs-kesehatan.go.id/bpjs-online/
" Menyetujui membayar iuran pertama paling cepat 14 (empat belas) hari kalender dan paling lambat 30 (tiga puluh) hari kalender setelah menerima virtual account untuk mendapatkan hak dan manfaat jaminan kesehatan"
In other words there is a mandatory 14 day wait, but it could take up to 30 days.

In my understanding, the mandatory is for the applicants to do the payment within 14 days and at last 30 days after they receive virtual account number. After the payment is done, and the BPJS card is issued anytime (2 days - 2 weeks), then you can use the BPJS completely.

That's correct...all WNI working in the formal sector are mandated to be members as are all WNA who have worked for more than 6 months in RI. It's planned to make it compulsory for all WNI by 2019 but ...who knows..... this is Indonesia.

I heard BPJS will become a mandatory as there will be public service sanctions (sanksi?) if they don't have BPJS such as can't process Passport, STNK, etc.

Source : https://www.panduanbpjs.com/akibat-terlambat-bayar-iuran-bpjs/


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The procedure written is that the applicant should get an SMS of virtual account number in at least 3 days after submitting the documents in person (I tried with online and it was even within hours) - then do the payment - wait for at least 2 weeks to get the card (go to the BPJS Kesehatan office) - and then use the card to do registration in Puskesmas.

In my experience, I came in person to BPJS BSD (as there is problem with online system) with all the documents, got in line for not too long, handed them, and went home. I never got any SMS, and in 2 weeks (just because I was busy) after submission I went to the office, got the virtual account, did the payment through ATM nearby (gladly), handed the receipt, a minute later I got the card.

Went to Puskesmas Bintaro on Saturday, got checked and got reffered to RSUD Tangerang Selatan or RS Hermina Ciputat (because I needed a specialist), went to RS.Hermina Ciputat. Done. All free.

I don't understand where is the "fraud" of BPJS?

 

[Jaime C]

My FIL had the mid level policy when he was hospitalized. My personal doctor said I should have upgraded him to the First Class plan as soon as he was admitted, and that it's normal and allowable to do so.

 

[fastpitch17]

We were not allowed to pay until the 31st. Did that and on Monday the third we went to the office. Shown we paid and were handed our cards so good to go now I guess.