Jakarta, CNBC Indonesia – If you are a BPJS Health participant, you will definitely immediately use the card every time you need health services at the hospital. However, please note, not all services can be covered by BPJS Health.
In fact, there are a number of operations whose costs cannot be paid by BPJS Health, even though the member's membership status is still active.
One operation that is not covered by BPJS is surgery resulting from a work accident. According to the BPJS Health guidebook, the reason the operation is not covered is because health services for illnesses or injuries resulting from work accidents or employment relations are already guaranteed by the work accident insurance program or are the responsibility of the employer.
The list of operations is not covered by BPJS Health
- Operations resulting from the impact of a work accident (covered by the employer or work accident insurance program)
- Cosmetic or aesthetic surgery (surgery that is not harmful to health)
- Surgery due to self-injury (operation resulting from inaccuracy or carelessness that results in injury)
- Operations in overseas hospitals (surgeries performed outside the reach of BPJS Health)
- Operations that do not comply with BPJS Health procedures (operations that do not complete the appropriate application procedures)
Based on the guidelines for implementing National Health Insurance (JKN), namely Minister of Health Regulation (Permenkes) Number 28 of 2014, there are 19 types of operations covered by BPJS Health, namely.
1. Heart Surgery
2. Caesarean section
3. Cyst surgery
4. Myoma surgery
5. Tumor surgery
6. Odontectomy surgery
7. Oral Surgery
8. Appendectomy
9. Gallstone Surgery
10. Eye Surgery
11. Vascular Surgery Operations
12. Tonsillectomy
13. Cataract Surgery
14. Hernia surgery
15. Cancer Surgery
16. Lymph Node Surgery
17. Pen Removal Operation
18. Knee Joint Replacement Surgery
19. Thymectomy operation
[Gambas:Video CNBC]
Next Article
List of Operations Not Covered by BPJS Health, Check Out!
(hsy/hsy)