HEALTH SERVICE SYSTEM

IN INDONESIA
(BPJS)

By:
1. Annas Masykur
2. Ainun Mutmainah
3. Agustina Retno Hapsari
4. Dita Nafira Hidayat
5. Siti Rizki Amalia
HEALTH SERVICE SYSTEM

In Law Number 36/2009 concerning health, it is explained that the

definition of a health service facility is a place used to carry out
promotional, preventive, curative and rehabilitative health service
efforts carried out by the government, local government and / or the
community (Megatsari et al. , 2019)
 Hospital (RS) is a provider of comprehensive and holistic health services, namely
health services that include promotive, preventive, curative and rehabilitative. The
complexity of health services requires hospitals to always improve the quality of their
services. One of the efforts made by cooperating with government programs that
provide health insurance is the National Social Security System (SJSN), which is
mandatory under Law No.40 of 2004.

With the enactment of Law Number 40 of 2004 concerning the National Social
Security System, the Indonesian people already have a Social Security system for all
Indonesian people. To realize the objectives of the national social security system, it
is necessary to establish an administrative body in the form of a public legal entity
based on the principles of mutual cooperation, non-profit, openness, prudence,
accountability, portability, mandatory membership, trust funds, and the results of the
management of the Social Security Fund to be used entirely for program development
and for For the benefit of Participants, a Social Security Administering Body is
established through Law Number 24 of 2011 concerning the Social Security
Administering Body. With this Law 2 (two) BPJS are formed, namely BPJS Health
and BPJS Ketenagakerjaan.
What is the implementation stage of the BPJS?

The implementation is carried out in stages.

 The first phase starts on January 1, 2014 with the coverage of
Contribution Aid Recipients (PBI) and Wage Beneficiary
Workers (PPU) and family members, such as: Civil Servants
(PNS), Indonesian National Army (TNI) / Indonesian Police
(POLRI), Workers' Social Security (Jamsostek) includes
retirees, veterans, and independent participants.
 The second stage is all residents who have not entered as BPJS
participants by 2019 at the latest.
The implementation of health services in the JKN
era was carried out in stages. For people who
already have a BPJS health card, they must first
go through Advanced Level
Referral Health
Facility (FKRTL)

The First Level The hospital is a place of

Health Facilities referral, if the FKTP cannot
(FKTP) handle certain cases, except in
an emergency.
Suc as puskesmas, doctor's
practice, pratama clinic or
equivalent that have
collaborated with BPJS
 Health services due to criminal acts, maltreatment, sexual
violence, victims of terrorism, and criminal acts of trafficking in
persons in accordance with the provisions of laws and
regulations are not guaranteed by BPJS Kesehatan. Cases related
to legal action are not covered by BPJS Kesehatan.

If it is a victim, the state has established the Witness and Victim Protection
Agency (LPSK) that will guarantee it. This is reinforced by Law Number
13 of 2014 concerning Protection of Witnesses and Victims. Patients who
fall under the criteria for Article 52 Paragraph 1 letter r will be marked
when receiving services at a referral health facility, then the cost of
treatment is transferred to the relevant institution. However, technically the
implementation of Perpres 82 will be further regulated by implementing
regulations from the relevant ministers.
……. THANK YOU…….