List of 21 Services and Conditions Not Covered by BPJS Kesehatan
BPJS Kesehatan is a national health insurance program that is vital for the people of Indonesia. This program provides coverage for various types of medical treatments and care at partner health facilities.
However, it is important to note that not all types of health services and conditions are covered by BPJS Kesehatan. Based on the latest regulations in effect until August 2026, there are 21 categories of medical conditions and services that are not included in the insurance coverage.
Some of the categories not covered include services of an aesthetic or cosmetic nature, such as plastic surgery unrelated to emergency medical conditions. Furthermore, health services already covered by other insurance programs or those related to illegal acts cannot be claimed through BPJS Kesehatan.
In addition to cosmetic services, BPJS Kesehatan also does not cover costs for alternative treatments that have not been medically proven. This is done to ensure that social security funds are used effectively for medical procedures that have been clinically tested and meet national health standards.
For the public, understanding this list of exclusions is essential to avoid misunderstandings when in need of medical care. The public is advised to always check the latest information through official BPJS Kesehatan channels or consult with the relevant health facility before undergoing specific medical procedures.