BPJS Indonesia is a crucial social security system that offers healthcare and financial protection to Indonesian citizens and expatriates living in the country. For anyone residing or working in Indonesia, understanding BPJS is essential, as it includes important benefits and responsibilities.

What is BPJS?

BPJS, or Badan Penyelenggara Jaminan Sosial, is Indonesia's social security agency designed to serve various population segments, including public and private sector employees and the general public.

Established under Law Number 24 of 2011, BPJS was created to implement a comprehensive social security framework known as Jaminan Kesehatan Nasional (JKN). This legislation guarantees that all Indonesian citizens have access to vital healthcare services.

BPJS Policies

All residents of Indonesia, including expatriates living in Jakarta or elsewhere for six months or more, are required to obtain BPJS Kesehatan (Healthcare BPJS). This applies to foreigners seeking BPJS in Indonesia, which can be processed independently at the local level.

Employees in Indonesia—regardless of whether they work for local or foreign companies—receive BPJS Ketenagakerjaan (Social Security Card) from their employers, ensuring they receive entitled benefits. Individuals can also opt for supplementary insurance plans based on their employer’s policies.

Healthcare Coverage

BPJS Kesehatan offers comprehensive healthcare coverage that includes essential services such as:

1. Access to primary healthcare providers, allowing residents to consult with doctors or clinics as needed.

2. Referrals to specialists or larger hospitals for more complex medical needs.

3. Coverage for hospitalization expenses.

Coverage Tiers

BPJS Kesehatan has three tiers of coverage:

– Class I: Requires a monthly premium of 150,000 IDR, providing access to hospital wards with 2-4 patients. Patients can request VIP lounge access, but additional fees may apply.

– Class II: Monthly payment of 100,000 IDR, which includes treatment in wards with 3-5 patients. Patients can transfer to higher classes for extra costs.

– Class III: Monthly fee of 35,000 IDR, covering wards with 4-6 patients. Transfers to higher-class wards are available based on capacity.

In 2023, the government plans to introduce a uniform inpatient care tier (KRIS), expected to be fully implemented by 2025. Note that some advanced medical treatments may not be covered, and individuals may need to seek independent healthcare insurance for broader coverage.

Contribution Rates

The maximum wage used for calculating healthcare contributions is set at 12 million IDR. For employees earning above this amount, contributions are capped at 480,000 IDR for employers and 120,000 IDR for employees.

– Employer Contribution: 4% (max 480,000 IDR)

– Employee Contribution: 1% (max 120,000 IDR)

Social Security

BPJS Ketenagakerjaan is mandatory for all companies in Jakarta and across Indonesia. Foreign investors must ensure their employees are registered with this type of BPJS. Employers are responsible for providing the Social Security Card, while freelancers can register independently.

Membership Benefits

Members of BPJS Ketenagakerjaan receive several protections, including:

– Old Age Protection: Offers benefits upon leaving a job, with maximum benefits for employees who have worked for ten years or more.

– Work Accident Protection: Provides compensation for injuries sustained during work hours or related activities.

– Death Benefits: Offers financial support in the event of a member's death while employed.

– cPension Protetion: Ensures compensation for individuals reaching retirement age.

Both employers and employees contribute to the monthly payments based on protection types and salaries. Independent members are responsible for their own monthly fees.

As of March 2023, the maximum wage for contributions is 9,077,600 IDR. Contributions for salaries above this amount will be at the maximum rate.

Additional Insurance

For those seeking extra protection beyond BPJS, various independent insurance options are available:

– Life Insurance: Provides benefits to beneficiaries upon the policyholder's death, with some policies allowing for early claims.

– Health Insurance: Offers additional coverage for those enrolled in BPJS Kesehatan, covering specific medical needs and procedures.

– Vehicle Insurance: Protects vehicles from accidents, theft, and other incidents. It's essential to understand the specifics of what is covered before choosing a policy.

– Property Insurance: Covers both personal and business properties against potential damages, ensuring a clear understanding of policy terms.

– Educational Insurance: Recommended for families with school-age children to safeguard their educational expenses.

– Travel Insurance: Short-term coverage that protects travelers from departure until their return.

By understanding BPJS and its related benefits, residents and expatriates in Indonesia can ensure they are well-prepared for their healthcare and social security needs.