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BPJS use

steveandpenny

Active Member
Cager
Joined
Oct 30, 2016
Messages
814
I don' know if this helps but here' our crazy plan.
I' in my 60s and my wife is catching up. We have no insurance in Indonesia at this point. Oh and we live in a village in north sulawesi. We do have Medicare in the states that partial covers hospital and surgeries just in case. We use the local clinics here for normal stuff ( cuts, bites , rashsand minor illiness) which can turn ugly here in the jungle (jungle is a few hunded meters away lol) . This costs about 150,000 which includes medicine. If they can' handle it or it' more serious we go to the hospital which runs more like 300,000 not including meds. We have a cirlcle of doctors we have found that we trust (somewhat). We are alwas on the look out for recommendations.
Both me and my wife have had a couple of serious things since we got here. Me a detached retina and she had to have stomach surgery , both done in jakarta with amazing doctors and care. We paid cash for both (well credit cards).
We figured out what medical insurance would be for us (way too much) and we put half of that in a bank account each month. When it reachs a certain amount we either stop putting into that account or spend some of it.
Now understand though I'm only in my 60s it was a rough 60 years which included bike wreak, car wreaks, drug abuse, shot once, stuck with knife twice, hep c, multply broken bones, 4 back surgeries , diabetes so on and so forth. I'm kind of stuck togethe with metal , stiches ,glue and tape. So though I feel great I'm not running a malathion. I've stopped most of the drugs that western doctors said I'd need the rest of my life including pain meds. My diabetes is controlled now with just metiform which costs next to nothing here. My blood pressure is fine , my blood sugars are great and I try getting into the ocean 5 times a week.

I would rather spend my money on adventures then insurance. Our life style here is much more healthy (except for the roast pig mmm).

So far it' worked for us. Next year we will be on BPJS though to save 150,000 to 300,000 I'm not sure it will be of large value. When you are paying cash you go to the front of the line.

Most important though is reseaching the doctors and hospitals before you need them. We have had great help here with reccomendations. And when we needed it got world class care (better and faster then in the states not to mention cheaper)
Hope this helps
 

Davita

RIP
Charter Member
Joined
Aug 7, 2016
Messages
3,059
Both me and my wife have had a couple of serious things since we got here. Me a detached retina and she had to have stomach surgery , both done in jakarta with amazing doctors and care. We paid cash for both (well credit cards).
We figured out what medical insurance would be for us (way too much) and we put half of that in a bank account each month. When it reachs a certain amount we either stop putting into that account or spend some of it.


Most important though is reseaching the doctors and hospitals before you need them. We have had great help here with reccomendations. And when we needed it got world class care (better and faster then in the states not to mention cheaper)
Hope this helps
I've edited S&P's post to agree with his relevant observations of getting surgery, and medical care in Indonesia, that we might not get elsewhere, as I've written in my blogs.
Indonesians, especially wealthy ones, appear to denigrate their own medical care and fly to Singapore, KL, Penang or Bangkok for medical care. My opinion is this is just an extension of their 'show-off my wealth' mentality.
My wife's wealthy galpal had breast cancer about the same time as my colon cancer was detected. I went to Prima Medika in Bali and had the surgery in a week while she went to Singapore, took an accompanying friend who stayed in a hotel, and had her surgery there. I was given a VIP room and my wife stayed in the room with me even we only live a half-hour drive from the hospital. I cannot comment on the costs but clearly hers was many times more than mine. We both paid from our own accounts.
She has had to frequently go back to Singapore and stay in a hotel, usually accompanied by a friend or husband, while undergoing her chemo-therapy whereas I went to my oncologists clinic...a few kms from our villa.
Both of us survived the surgery but both of us have a return, or metastasis, of the cancer cell.

S&P makes a very good point if medical Insurance isn't available, or too expensive for the elderly, and is exactly what I did. That policy however may not be viable if planning to go to other Asian cities for treatment.
 
Last edited:

Fred

Member
Joined
Mar 14, 2018
Messages
296
Hospitals can be cheap and still get the job done.
Bintaro

20180416_103350.jpg
 

fastpitch17

Well-Known Member
Charter Member
Cager
Joined
Jul 19, 2016
Messages
2,683
Gonna kick this up since BPJS always seems to have a lot of questions.
I and my wife applied. Had it in a week when the new month came around. We got the 1st class which is at this time Rp 80,000 each per month. We had to choose a hospital but unless there was an emergency, we would first need to go to their approved BPJS clinic and then get a letter allowing us to go to the clinic at the hospital.

Going to a BPJS clinic first seems a waste of what could be valuable time. Others have informed us they are full of people that probably should not be but since they have the program, they go for everything and anything. Stubbed my toe, go to clinic types.

When we signed up our plan was to use BPJS only for emergencies. Doctor visits cost very little on their own and if you have the capability of looking up medications yourself as I do, you can make sure the doctor isn't prescribing you something that is high price when a cheaper one is available. Chances are they are getting a kickback. Paying cash will also move you ahead of all the BPJS patients and I have seen people that had waited to see a doctor from morning into evening hours. I'm not one of those people.

After a year, I did have an emergency. I was basically bleeding to death from the inside. Went to our hospital ER. Wife did the paperwork. Needed my BPJS Card, KK, and KTP. I get checked out. Poked and prodded. Gonna need a room. Was told that BPJS bases if it's an emergency based on the results of the blood test if it wasn't an injury. They took some from my arm and I loaded a specimen cup with it from another area. I wasn't too worried about that.

I have the VIP eligible BPJS but all those rooms were full and they said I really shouldn't wait. I really didn't plan on waiting any way. We upgraded my room to a VVIP room which would incur fees that I would be responsible for. An additional Rp 200,000 per night and the differences in doctors fees based on the rooms. That a strange on to me since I would think you would be getting the same care no matter what room you had. Oh well.

Well, fixed me up. No more bleeding. Meals were crap and were told they used to be much better but since BPJS allows so little for meals, there isn't a lot of quality left. Certainly proof the hospital has no clue as to what a dietician is. Holland bakery right next to hospital so being in the hospital completely blew the diet I had been on for 3 months and doing so well.

The hospital bill was presented upon leaving after a 4 day stay. Just under 9 juta of which I was responsible for just over 2 juta. That sounded pretty good to me. If there would have been a VIP room available, my cost would have been 0. Did have a follow up after a week with my specialist. Yeah, BPJS suck. Didn't get out until after 8 in the evening. Got a free BPJS prescription though saving me Rp 200,000. Was informed that that was the only med approved by BPJS for my condition but there was a much better one available through other Apoteks. He gave me a prescription for what I was getting free from BPJS since I said I wouldn't be coming back and going through the zoo and would pay for it. He gave me one for the better medication too in case I wanted to go that route. I went the better route and didn't even need the prescription. RP 600,000 for 30 days but I have also found it in another city for 100,000 less and they send it to me every few months along with some other meds we take.

I do highly recommend BPJS for emergency use. Otherwise, just pay cash. Hospital told me that if we are paying cash and then need the hospital, they have ways of having BPJS covering it.

I would pay even more per month for this. I hope that Indonesia can better manage it somehow to where all the non issues stop being seen and using up revenues. Even a co-pay added to it would be good. Rp 20,000 per disorder. Still a good deal
 

Jaime C

Well-Known Member
Charter Member
Cager
Joined
Jul 16, 2016
Messages
715
Gonna kick this up since BPJS always seems to have a lot of questions.
I and my wife applied. Had it in a week when the new month came around. We got the 1st class which is at this time Rp 80,000 each per month. We had to choose a hospital but unless there was an emergency, we would first need to go to their approved BPJS clinic and then get a letter allowing us to go to the clinic at the hospital.

Going to a BPJS clinic first seems a waste of what could be valuable time. Others have informed us they are full of people that probably should not be but since they have the program, they go for everything and anything. Stubbed my toe, go to clinic types.

When we signed up our plan was to use BPJS only for emergencies. Doctor visits cost very little on their own and if you have the capability of looking up medications yourself as I do, you can make sure the doctor isn't prescribing you something that is high price when a cheaper one is available. Chances are they are getting a kickback. Paying cash will also move you ahead of all the BPJS patients and I have seen people that had waited to see a doctor from morning into evening hours. I'm not one of those people.

After a year, I did have an emergency. I was basically bleeding to death from the inside. Went to our hospital ER. Wife did the paperwork. Needed my BPJS Card, KK, and KTP. I get checked out. Poked and prodded. Gonna need a room. Was told that BPJS bases if it's an emergency based on the results of the blood test if it wasn't an injury. They took some from my arm and I loaded a specimen cup with it from another area. I wasn't too worried about that.

I have the VIP eligible BPJS but all those rooms were full and they said I really shouldn't wait. I really didn't plan on waiting any way. We upgraded my room to a VVIP room which would incur fees that I would be responsible for. An additional Rp 200,000 per night and the differences in doctors fees based on the rooms. That a strange on to me since I would think you would be getting the same care no matter what room you had. Oh well.

Well, fixed me up. No more bleeding. Meals were crap and were told they used to be much better but since BPJS allows so little for meals, there isn't a lot of quality left. Certainly proof the hospital has no clue as to what a dietician is. Holland bakery right next to hospital so being in the hospital completely blew the diet I had been on for 3 months and doing so well.

The hospital bill was presented upon leaving after a 4 day stay. Just under 9 juta of which I was responsible for just over 2 juta. That sounded pretty good to me. If there would have been a VIP room available, my cost would have been 0. Did have a follow up after a week with my specialist. Yeah, BPJS suck. Didn't get out until after 8 in the evening. Got a free BPJS prescription though saving me Rp 200,000. Was informed that that was the only med approved by BPJS for my condition but there was a much better one available through other Apoteks. He gave me a prescription for what I was getting free from BPJS since I said I wouldn't be coming back and going through the zoo and would pay for it. He gave me one for the better medication too in case I wanted to go that route. I went the better route and didn't even need the prescription. RP 600,000 for 30 days but I have also found it in another city for 100,000 less and they send it to me every few months along with some other meds we take.

I do highly recommend BPJS for emergency use. Otherwise, just pay cash. Hospital told me that if we are paying cash and then need the hospital, they have ways of having BPJS covering it.

I would pay even more per month for this. I hope that Indonesia can better manage it somehow to where all the non issues stop being seen and using up revenues. Even a co-pay added to it would be good. Rp 20,000 per disorder. Still a good deal
I have the same type of insurance for similar circumstances. Glad it worked out fairly well for you.
 

scouser59

Well-Known Member
Charter Member
Cager
Joined
Jul 17, 2016
Messages
426
Unfortunately bpjs doesn't work well, queuing wise, in high population areas such as Jakarta , more work has to be done on this .

The same is not true in south bali ,we make an appointment at our initial service provider, ie clinic, which we have always used pre bpjs ,for doctor or dentist where waiting time is still less than 10 minutes ,so on that point no issues , better than uk .

Emergency wise we have 6 hospitals within a 40 minute drive , we have noticed the skill and equipment level is "patchy" ,but of course this would apply if you paid .

I have noticed if you use private insurance, a desire by some "professionals" to do unnecessary procedures , hardly following the "Hippocratic Oath" , second opinions are valued imho.

We live in a developing country ,of course including health care we depend on for any trauma.

The system here has some way to go to reach developed country standards of care . But even though there are obvious issues ,
bpjs is one of the few positive policies that are a major benefit for the population .
 
Last edited:

Dave70

Member
Joined
Dec 4, 2018
Messages
53
Emergencies or injuries due to crime, terrorism, rape, assault, vehicular accidents, etc. are not covered by BPJS anymore as per presidential degree no. 82/2018 signed by the president some weeks ago.
 

Edward

Member
Joined
Aug 3, 2018
Messages
28
Injuries due to natural disasters, I would hope, remain on the payable list?
 

Jaime C

Well-Known Member
Charter Member
Cager
Joined
Jul 16, 2016
Messages
715
Emergencies or injuries due to crime, terrorism, rape, assault, vehicular accidents, etc. are not covered by BPJS anymore as per presidential degree no. 82/2018 signed by the president some weeks ago.
So you get robbed/assaulted, and the insurance won’t pay? Seems a bit shocking.
 

colroe

Member
Charter Member
Joined
Jul 22, 2016
Messages
36
Emergencies or injuries due to crime, terrorism, rape, assault, vehicular accidents, etc. are not covered by BPJS anymore as per presidential degree no. 82/2018 signed by the president some weeks ago.
Not much point in having this if the most serious emergencies are excluded.
 

colroe

Member
Charter Member
Joined
Jul 22, 2016
Messages
36
Emergencies or injuries due to crime, terrorism, rape, assault, vehicular accidents, etc. are not covered by BPJS anymore as per presidential degree no. 82/2018 signed by the president some weeks ago.
Hi Dave, just checked at our local Puskesmas, they said accidents are covered. I particularly asked about motorbike accidents as my wife takes our daughter back and forth to school on a bike. The woman I spoke to said if you have accident must go direct to emergency. Must provide KK, KTP and BJPS card. I must provide KITAP card and BPJS card if I have an accident. Relatives of person in accident must get a letter from the hospital and take it tonPuskemad, who will in turn give an approval letterbackleto take to the hospital. I know that sometimes Presidential decrees sometimes take a while to filter down, but that is what I was told. I live in Medan
 

Dave70

Member
Joined
Dec 4, 2018
Messages
53
Hi Dave, just checked at our local Puskesmas, they said accidents are covered. I particularly asked about motorbike accidents as my wife takes our daughter back and forth to school on a bike. The woman I spoke to said if you have accident must go direct to emergency. Must provide KK, KTP and BJPS card. I must provide KITAP card and BPJS card if I have an accident. Relatives of person in accident must get a letter from the hospital and take it tonPuskemad, who will in turn give an approval letterbackleto take to the hospital. I know that sometimes Presidential decrees sometimes take a while to filter down, but that is what I was told. I live in Medan
That's good, thanks for sharing.
 

Indonesia Jones

New Member
Joined
Apr 10, 2019
Messages
3
HI,

Can anyone tell me what medical services and conditions are NOT covered by the insurance scheme with BPJS? I don't want to take the time and money to apply only to find out that the problems i want help with are not covered.
Thanks.
 

Indonesia Jones

New Member
Joined
Apr 10, 2019
Messages
3
Hi again,

Another question. Can an Indonesian citizen register for the health care insurance (BPJS) without the NPWP? Therefore not employed?
Thanks.
 

dafluff

Moderator
Moderator
Cager
Joined
Jul 13, 2016
Messages
2,842
HI,

Can anyone tell me what medical services and conditions are NOT covered by the insurance scheme with BPJS? I don't want to take the time and money to apply only to find out that the problems i want help with are not covered.
Thanks.
Here is a list of things not covered by BPJS:

https://www.expatindo.org/summary-jkn-and-bpjs/#coverage

Everything else is technically covered. However, some internal guidelines may limit what "coverage" means. This could mean less advanced procedure (eg. traditional surgery vs Laparoscopy, cheaper generic drugs, etc). Probably best to check with your local BPJS clinic to see if what you want covered will be covered.

Hi again,

Another question. Can an Indonesian citizen register for the health care insurance (BPJS) without the NPWP? Therefore not employed?
Thanks.
Yes. BPJS is technically mandatory for every citizen and resident, although as of right now there are no enforcing mechanism.
 

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