BPJS Kesehatan Madiun Branch emphasized the importance for National Health Insurance (JKN) participants to understand the benefit limitations provided. This aims to allow the public to utilize this health protection program optimally in accordance with applicable regulations.
Head of BPJS Kesehatan Madiun Branch, Wahyu Dyah Puspitasari, explained that although JKN covers a wide range of services from First-Level Health Facilities to complex medical procedures, there are 21 types of services that are not covered by the program. This provision refers to Article 52 of Presidential Regulation Number 82 of 2018.
Some of the uncovered services include aesthetic medical procedures, infertility treatments, teeth straightening such as braces (orthodontics), as well as complementary or alternative treatments that have not been clinically tested. In addition, healthcare services resulting from substance abuse and alcohol, experimental procedures, and services already covered by other insurance programs are also excluded from JKN coverage.
Wahyu Dyah Puspitasari added that education regarding these rules is crucial to prevent misunderstandings when participants access services at health facilities. She advised the public not to hesitate to contact BPJS Kesehatan's official channels directly if they encounter uncertainty regarding coverage for a medical procedure.
On the other hand, positive responses came from participants. Siti, a JKN participant from Madiun Regency, expressed that clear information from official sources helps the public correct perceptions regarding coverage limits. She hopes public awareness to seek information from official channels will continue to increase for mutual convenience in obtaining healthcare services.
