MEMANGGIL.CO - BPJS Kesehatan has become the primary choice for the community in accessing medical and health services. However, this program only covers certain types of diseases and services, so not all health conditions can be covered by BPJS Kesehatan.
Based on the Minister of Health Regulation (Permenkes) No. 28 of 2014 and Presidential Regulation (Perpres) No. 82 of 2018, there are several diseases and health services that are not included in the BPJS Kesehatan guarantee.
Here is a list of diseases and services not covered by BPJS Kesehatan:
1. Diseases related to epidemics or extraordinary events.2. Treatments related to beauty and aesthetics, such as plastic surgery.3. Orthodontic treatments, such as installing braces.4. Diseases resulting from criminal acts, such as assault or sexual violence.5. Diseases or injuries caused by intentional self-harm or attempted suicide.6. Diseases resulting from alcohol consumption or drug addiction.7. Treatments for infertility or impotence.8. Diseases or injuries caused by unavoidable events, such as brawls.9. Health services performed abroad.10. Experimental or experimental medical treatments.11. Complementary, alternative, and traditional treatments that have not been proven effective through health technology assessments.12. Contraceptives.13. Household health supplies.14. Health services that do not comply with regulatory provisions, such as self-requested referrals.15. Health services provided at facilities that do not collaborate with BPJS Kesehatan, except in emergency situations.16. Health services for diseases or injuries covered by work accident insurance programs or that are the responsibility of the employer.17. Health services already covered by mandatory traffic accident insurance programs.18. Certain health services related to the Ministry of Defense, TNI, and Polri.19. Health services provided in the context of social services.20. Services already covered by other programs.21. Services not directly related to the health insurance benefits provided.
Therefore, it is essential for BPJS Kesehatan participants to ensure that the type of disease or service they wish to use is not included in this list of exclusions.
