Change visa / kitas after marriage

[pantaiema]

Why do you think it's not legal? Another body paying monthly fees seems like a good idea. Of course some will use more than they pay but that is the rub with insurance.

BPJS runs a significant deficit every year. In reality, the Indonesian government, meaning taxpayers are the main party subsidising the system. To some extent, high-income employees also help subsidising it, since their contributions are calculated as a percentage of their salary plus their employer’s share. However, these premiums are capped at about Rp600k per month and that include their family members who are not even working/paying insurance premium. The number of people who pay at this level is also relatively small compared with the large population that relies on this social services.

Foreign workers, especially those employed by multinational companies usually have private health insurance paid for by their employers. Since they hardly use their BPJS kesehatan they effectively become another small group that helps subsidizing the BPJS system.

But still, if the system relied solely on insurance premiums like private health insurance, without substantial subsidies from the Indonesian government, it would collapse.

 

[marcus]

I will dispute this ...There is nowhere written that foreigners, Indonesian residents who have not worked in Indonesia will not qualify to join ...

So I interpret the Article 1 , item 4 below as : participants are all Indonesians (working or not) + foreigners working for more than 6 months (no other foreigners are included) .

UU no.24 Year 2011 - About BPJS - free translation
Article 1
4. Participants are all individuals , including foreigners who have worked for at least 6 months in Indonesia ...

1. When you look at the government regulation ... Article 6 Perpres_No_59_2024 ... (1) Setiap penduduk Indonesia wajib ikut serta dalam program Jaminan Kesehatan' '(1) Every Indonesian residence is obliged to participate in the Health Insurance program'

In other words : "All Indonesians must participate ..." , similar to what the Law (UU no.24 Year 2011) stated .

2. ... If BPJS approves the application, then the matter is settled ...

The cases you mention were approved by few officials , not by BPJS (except if you show an official BPJS document showing these cases are ok) .

 

[pantaiema]

So I interpret the Article 1 , item 4 below as : participants are all Indonesians (working or not) + foreigners working for more than 6 months (no other foreigners are included) .

UU no.24 Year 2011 - About BPJS - free translation
Article 1
4. Participants are all individuals , including foreigners who have worked for at least 6 months in Indonesia ...

In other words : "All Indonesians must participate ..." , similar to what the Law (UU no.24 Year 2011) stated .

The cases you mention were approved by few officials , not by BPJS (except if you show an official BPJS document showing these cases are ok) .

I am not quite sure why you still need to show the article 1 UU no.24 Year 2011. As stated above I am familiar with the referred article. Here is the point

The term “every Indonesian resident” is not equivalent to “every Indonesian citizen.” Residents are, by definition, those who possess a residence permit..

The example I mentioned earlier isn’t very old, it was reported about a year ago and the applicants were approved by the regional BPJS office. Once officially approved, they are entitled to use BPJS Kesehatan as long as they continue paying their premiums. Based on recent discussions, some people are still being approved, while others are being rejected. This suggests that there is no clear, consistent rule. For those who are denied initially, it may be worthwhile to reapply, especially if they can submit their application at a different regional office.

 

[marcus]

I am not quite sure why you still need to show the article 1 UU no.24 Year 2011 ...

Because it is the most important fact . You said you want to "dispute" about the legality but seem to not give the due importance to the Law (UU) , which is the highest legal document .

The term “every Indonesian resident” is not equivalent to “every Indonesian citizen.” Residents are, by definition, those who possess a residence permit..

This is your opinion , which contradicts the Indonesian Law , so wrong in my view .

... Based on recent discussions, some people are still being approved, while others are being rejected. This suggests that there is no clear, consistent rule ...

In my view the Law is very clear .

 

[Hawk256]

In my view the Law is very clear .

What about the spouses who have been approved and had claims paid? That doesn't mean anything? What about for chronic illnesses that need monthly doctor visits, tests, MRI's, etc. but still paid by BPJS? Surely they wouldn't pay for illegal claims.

 

[pantaiema]

Because it is the most important fact . You said you want to "dispute" about the legality but didn't say anything about the Law , which is the higher legal document .

This is your opinion , which contradicts the Indonesian Law , so wrong in my view .

In my view the Law is very clear .

This is not opinion, but it is written in Article 6 Perpres_No_59_2024 - Perubahan Ketiga Atas Perpres_No_82_2018
'(1) Setiap penduduk Indonesia wajib ikut serta dalam program Jaminan Kesehatan' '(1) Every Indonesian resident is obliged to participate in the Health Insurance program'

In the Indonesian law & regulation if it refers to every Indonesian citizens the wording shall be 'Setiap warga negara Indonesia (wni),.

And the above example that I have provided is fact, not opinion that people with ITAS/ITAP still get accepted. I have read quite a few of cases like that. As below, I attach another example. In one regional office people are being told to wait for six months, in another office people do not need to wait that long.

My conclusion sofar is that the outcome often depends on the specific regional office and the officials handling your application.

 

[marcus]

What about the spouses who have been approved and had claims paid? That doesn't mean anything?

To me , up to now , it means that officers made mistake(s) .

What about for chronic illnesses that need monthly doctor visits, tests, MRI's, etc. but still paid by BPJS? Surely they wouldn't pay for illegal claims.

What I can say is that I was a public employee in my country , wrong things in my office were almost never detected .

 

[Hawk256]

To me , up to now , it means that officers made mistake(s) .

What I can say is that I was a public employee in my country , wrong things in my office were almost never detected .

We are not talking about one mistake, we are talking about multiple instances with multiple people. As strict as they are about procedure and paying claims, I find it hard to believe that no one has caught what you say is a mistake.