The Covid-19 Vaccine Will Be Paid in the Endemic Era, Will BPJS Cover It in the Future?

Kartu Indonesia Sehat from BPJS Kesehatan (net)

In a significant development, the government has officially announced the withdrawal of the status of the Covid-19 pandemic. As a result, the responsibility for financing Covid-19-related expenses, including both treatment and vaccination costs, will no longer rest with the government. To address this change, the Ministry of Health (Kemenkes) has devised plans to implement a system of paid Covid-19 vaccine during the endemic phase.

In response to this development, Ali Ghufron Mukti, the Director of BPJS Kesehatan, shed light on the matter of whether the cost of Covid-19 vaccinations will be covered by the Health Insurance Administration Organization (BPJS Kesehatan). Mukti emphasized that vaccinations fall outside the purview of treatments covered by BPJS Kesehatan, as they are primarily categorized as a public health measure and, thus, the responsibility of the Ministry of Health.

He elucidated, “If BPJS Kesehatan’s role is to provide coverage for non-communicable diseases, then public health matters come under the jurisdiction of the Ministry of Health. Therefore, BPJS hopes that the responsibility for covering the costs does not lie with BPJS.”

Nevertheless, Mukti affirmed that BPJS Kesehatan remains prepared to shoulder the expenses associated with the treatment of all participants infected with the Coronavirus during the endemic period. Importantly, he underscored that the financing of Covid-19 treatment would not be limited solely to specific groups, such as the Beneficiaries of Premium Assistance (PBI), but would extend to encompass all citizens enrolled in BPJS Kesehatan.

Prior to this announcement, the Ministry of Health had disclosed its intentions to introduce a paid Covid-19 vaccination system in 2024. This novel approach would primarily target individuals in Indonesia who do not belong to high-risk groups. Notably, high-risk groups encompassing the elderly, healthcare and medical professionals, and immunocompromised children aged 12 and below would continue to receive free vaccinations, even after the official removal of the pandemic status.

Maxi Rein Rondonuwu, the Director General of Disease Prevention and Control (Dirjen P2P) at the Ministry of Health, emphasized that the provision of free vaccinations for these high-risk groups was crucial, despite the absence of a pandemic declaration. Rondonuwu explained that the Covid-19 vaccine would be integrated into routine vaccination programs, mirroring the administration of vaccines like HPV and Polio for children.

This latest policy, endorsed by the World Health Organization (WHO), is expected to be implemented promptly once the Ministry of Health finalizes the drafting of the Minister of Health Regulation outlining the mechanisms for administering the Covid-19 vaccine.

“It has been determined that the Covid-19 vaccine will be seamlessly integrated into routine vaccination efforts, prioritizing specific groups such as the elderly, individuals with comorbidities, frontline healthcare workers, and young individuals with immunocompromised conditions,” Rondonuwu stated.