The Indonesian government has introduced significant changes to the healthcare service guarantee mechanism in response to the evolving situation surrounding Covid-19. These alterations will have a considerable impact on how healthcare services related to Covid-19 are guaranteed for participants in the National Health Insurance (JKN) program once the pandemic phase has concluded.
This pivotal development stems from the official declaration made through Presidential Decree Number 17 of 2023, signifying the conclusion of the Covid-19 pandemic status in Indonesia. It is also grounded in the guidelines set forth in Minister of Health Regulation Number 23 of 2023, which outlines the framework for managing Coronavirus Disease 2019 (Covid-19).
The momentous declaration of the end of the Covid-19 pandemic in Indonesia was made on June 21, 2023, marking a transition from a pandemic to an endemic phase for the disease within the nation’s borders.
In alignment with this profound shift in status, the government has embarked on a path of substantive change, introducing clear-cut measures to recalibrate the healthcare service guarantee mechanism for Covid-19.
Agustian Fardianto, serving as the Assistant Deputy for Public Communication and Public Relations at BPJS Kesehatan, has articulated the phased approach implemented in response to these changes.
Since the conclusion of the pandemic on June 21, 2023, until August 31, 2023, Covid-19 patients necessitating healthcare services have had their financial burdens shouldered by the government. In this phase, the Ministry of Health of the Republic of Indonesia has taken on the pivotal role of being the primary provider of these crucial services.
Notably, the intricacies of administering and verifying claims tied to these healthcare services have been entrusted to the capable hands of BPJS Kesehatan. They have meticulously followed the technical guidelines that have been meticulously crafted and laid down.
However, the most noteworthy and impactful change is set to come into effect on September 1, 2023. From this date onward, the provision of Covid-19 treatment services will shift gears, transitioning to the ambit of the National Health Insurance mechanism.
This will entail a shift in the financial responsibility for these services, with the onus falling on the shoulders of the general public who will need to self-finance their Covid-19 treatments, or alternatively, these expenses may be shouldered by other guarantors, all in strict accordance with the prevailing legislative provisions.
Agustian elucidated this transformative transition in a statement made on Monday, September 11, 2023, emphasizing that, “For JKN participants in need of Covid-19-related healthcare service, including patients requiring hospitalization, starting from September 1, 2023, BPJS Kesehatan will act as the guarantor at healthcare facilities in cooperation with BPJS Kesehatan.”
It’s important to underscore that, in cases of medical emergencies, individuals will retain the liberty to seek immediate medical attention at the nearest healthcare facility, irrespective of its affiliation with BPJS Kesehatan.
The gamut of healthcare services included in this transition encompasses a comprehensive spectrum, ranging from individual promotive-preventive services to curative and rehabilitative interventions, all guided by rigorous adherence to medical indications. Crucially, participants enrolled in the JKN program will not encounter supplementary charges for these essential services.
Agustian also pointed out another noteworthy facet of this transformation – individuals who are self-isolating will have the option to avail teleconsultations. Through the Mobile JKN Application, they can connect with healthcare professionals stationed at first-level healthcare facilities (FKTP) where they hold registration. This teleconsultation option not only streamlines access to healthcare advice but also facilitates referrals as warranted by medical assessments.
Further emphasizing the intricate web of changes, Ardi highlighted that the provisioning of medicines, vaccines, and the orchestration of Covid-19 vaccination campaigns will continue to be the prerogative of the central government. This includes oversight of distribution logistics, a task that will be coordinated in collaboration with regional governments. The submission and validation of claims pertaining to Covid-19-related expenses will adhere to established protocols already in place within the framework of the JKN Program.