This is the Rule of Limitation for Using BPJS Health in a Month

This is the rule for the limitation of using BPJS Kesehatan for medical treatment in a month.

Dream - Health is the main priority for everyone. In Indonesia, BPJS Health is present as an important pillar in ensuring equal access to healthcare services for the community. BPJS Health provides quality and affordable health protection. Not only as an institution, but also as a symbol of the state's commitment to realizing social welfare.

Through a wide network and various innovative programs, BPJS Health has become a loyal partner in maintaining the health and quality of life of the Indonesian people.

This is the Rule of Limitation for Using BPJS Health in a Month

By paying regular contributions, BPJS participants obtain health facilities ranging from examination services, outpatient care, to inpatient care.

Then how many times a month can participants use the BPJS Health service? This question may arise in the minds of some people. Especially those who have health problems, so it forces them to seek treatment according to the regulations. To answer it, please read the following review!

"No Limitations"

Within one month, there are no restrictions for BPJS Kesehatan participants to use its services. Each participant can seek treatment whenever necessary using BPJS Kesehatan at a healthcare facility that is appropriate for the registered location (FKTP).

"Specific Limitations"

While seeking treatment at healthcare facilities in a different location than the registered area, there are applicable rules. As regulated in Article 55 of the Presidential Regulation of the Republic of Indonesia Number 82 of 2018 regarding Health Insurance.

Based on the presidential regulation, participants who are outside the area of the First Level Health Facility (FKTP) where the participant is registered can access first-level outpatient services at other FKTPs for a maximum of 3 visits within a maximum of 1 month at the same FKTP. It should be noted that if BPJS Health participants access FKTP services outside the registered FKTP area, participants are only allowed to seek treatment a maximum of 3 times in a month.

Procedure for seeking treatment at FKTP with BPJS Kesehatan

Visit the registered FKTP according to the BPJS Health card. Patients will be examined at the FKTP. If they require further treatment, patients will be referred to a higher-level referral facility. Patients must present their BPJS Health card when at the hospital.

If referred by the examining doctor, the patient will receive outpatient or inpatient care at the hospital. The inpatient class will be adjusted based on the class of BPJS Health participants. The doctor can provide a referral letter so that healthcare services are returned to the first-level health facility. If the hospital doctor does not provide a control letter, the next examination will return to the first-level health facility.

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