Health Insurance in Indonesia For Foreigners and Expats
Indonesia’s healthcare system has a few bright spots but many challenges. Ranked 92nd by the World Health Organization, Indonesia has undertaken ambitious plans to improve universal access to care across the board. Additionally, patient facilities in Jakarta continue to improve. However, the standard of public healthcare in Indonesia is far beneath what most expats are used to. The situation is so serious that the US State Department itself declares that “Sanitation and health care conditions in Indonesia are far below U.S. standards. Routine medical care is available in all major cities, although most expatriates leave the country for all but the most basic medical procedures. Psychological and psychiatric services are limited throughout Indonesia.” With these stern words in mind, here’s what would-be expats should know about health insurance in Indonesia.
Overview of Indonesia’s National Health Insurance System
The Indonesian healthcare system is a mix of private insurance plans and basic, government-funded care. In 2014, Indonesia launched a mandatory health insurance program. Called Jaminan Kesehatan Nasional (JKN), it’s designed to bring basic medical treatment and facilities to all citizens.
The JKN program carries heavy expectations that it will evolve into a comprehensive universal healthcare program. If it succeeds, it could be the largest publicly funded healthcare system in the world. But for now, its progress is stymied. Among the most serious obstacles are hospitals and clinics themselves, many of which haven’t opted to join the program. As such, patients are left to cobble together usable solutions using a combination of facilities.
The facilities that make up Indonesia’s healthcare system, such as it is, are organized in tiers. At the top are community health centers, known as puskesmas. In the middle are health sub-centers. And at the third level are village-level integrated posts.
Benefits of a Global Medical Insurance Plan
The quality of public healthcare in Indonesia falls short of the standards that most expats are used to. For that reason, the vast majority hold an international health insurance plan.
Holding private insurance gives expats the option to receive healthcare in private hospitals and clinics. There, patients will find modern, comfortable services at an international standard. Additionally, private facilities are much more likely to have English speaking staff than their public counterparts.
An important aspect of any private insurance policy for foreigners living in Indonesia is air evacuation. Not only is such an option important for those living in rural and remote areas, but it’s also essential for emergency transportation to Singapore. Singapore’s health insurance services are outstanding and often fill the gaps where Indonesia’s system fails.
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Pros and Cons of Using the Local Health Insurance System
Indonesia has inadequate public healthcare. Wait times are long and some specialists are hard to find. As well, it is common for public healthcare facilities to be understaffed, overcrowded, and lacking patient privacy. Few facilities can be described as sparkling clean and diagnostic equipment is often out of date. As well, it’s important for expats to note that most doctors and nurses in the public healthcare system don’t speak English.
However, in rural areas, a public clinic is often your only recourse for local healthcare. It’s a smart idea to familiarize yourself with your nearest health center’s hours, services, and staff qualifications.
How Expats Can Qualify For Health Insurance
As part of the effort to expand the number of people enrolled, everyone who is formally employed in Indonesia is required to register in the JKN program, which itself is administered by the Badan Penyelenggara Jaminan Sosial or BPJS social security program. Program enrollees include expats, as long as they’re part of the formal employment sector.
The terms of BPJS don’t allow for exclusion on the basis of pre-existing conditions. However, in order to receive treatment, you must visit a participating clinic or hospital. Alas, only a small proportion of eligible facilities have signed up. As such, you’re signing on for a program that you can only use in limited circumstances.
What You Need To Know About Processes
If you’re an expat working in a professional capacity in Indonesia, your employer is obligated to register you and your family members in the JKN program. In order to claim eligibility, you must be working in the country for at least six months. Upon registration, you and your family members will receive BPJS cards. You need to bring this card with you when you visit public hospitals, clinics, or puskesmas.
Your employer will also arrange for an automatic salary deduction to pay for the program. The BPJS premium is equal to 5% of your monthly salary, 4% of which is paid by the employer and 1% is paid for by the employee.
How Routine Doctor Visits Work
Most expats, especially those in Jakarta, utilize group practice medical clinics. In many ways, these are like very small hospitals. In addition to general practitioners, they have a wide range of specialists on staff and can take care of most medical concerns. Clinic services often include laboratories, radiology centers, pharmacies, dental care, psychiatry, physiotherapy, and more. In some cases, they even offer emergency room services and ambulance care.
While group practice medical clinics offer comprehensive care, new residents might still experience culture shock. In Indonesian culture, doctors are afforded tremendous respect and are seen as figures of authority. This might be difficult for foreigners who are used to prodding their family doctors for second opinions or detailed explanations of diagnosis might experience some push back.
After all medical appointments, you’ll have to settle your bill in cash. Keep all paperwork so you can then submit your receipts for insurance reimbursement. Note that very few medical facilities in Indonesia accept credit card payments.
How To Find A Family Physician
If you’re generally a healthy person who rarely visits the doctor, you might not be too worried about finding a doctor in Indonesia. However, the country has innate conditions that may threaten your health. From air pollution to tropical diseases to traffic accidents, Indonesia isn’t exactly a healthy living destination despite its many yoga retreats and beachside wellness centers.
Expats well established in Indonesia recommend working with your insurance broker to get a list of English-speaking physicians in your area. From there, you can narrow down your choices based on hours of operation, breadth of services, and reputation. Having a clinic and practitioner you’re comfortable with before it’s absolutely needed is a tremendously practical step in a country where comprehensive care is lacking.