The National Health Insurance (JKN) program organized by BPJS Kesehatan indeed provides broad coverage for the public, especially for high-cost chronic diseases such as cancer, kidney failure, and diabetes. However, it must be understood that not all medical procedures or health conditions receive full coverage from the government.
Based on the regulations set out in Presidential Regulation (Perpres) Number 82 of 2018 concerning Health Insurance, there are 21 categories of diseases and health services included in the exclusion list. The provision in Article 52 aims to provide clarity for participants regarding the limits of benefits that can be claimed during their membership period.
To facilitate service access, BPJS Kesehatan now provides a digital platform through the Mobile JKN application, which can be downloaded on mobile devices. The public is urged not to wait until they are sick to register, considering the waiting period or membership verification process required before the card can be actively used.
In addition to understanding the service coverage, participants are advised to choose the primary healthcare facility (Fasilitas Kesehatan Tingkat Pertama - FKTP) closest to their domicile to facilitate the tiered referral process. A deep understanding of this service system is crucial so that each participant can optimize their health rights in accordance with applicable regulations.
