BPJS Kesehatan: 178,000 recipients lose coverage in Semarang and Demak

Approximately 178,000 recipients of the Contribution Assistance Recipient (PBI-JK) program in Semarang and Demak have had their health insurance coverage revoked due to changes in their economic decile status. According to Debbie Nianta Musigiasari, Head of the Semarang Branch of BPJS Kesehatan, the Ministry of Social Affairs issues monthly decrees regarding these deactivations. In Semarang, 113,569 individuals were deactivated, while 62,439 were affected in Demak.

Under government policy, only those in deciles 1 through 5 qualify for PBI-JK. Affected citizens may apply for reactivation through their respective local social services within six months of the deactivation decree. BPJS Kesehatan noted that they must wait for updated data from the Ministry of Social Affairs to process such changes.

Separately, it is noted that the National Health Insurance (JKN) program does not cover all medical services. Exclusions include treatments for aesthetic or cosmetic purposes, dental alignment for aesthetics, injuries resulting from criminal acts or self-harm, illnesses caused by alcohol or drug addiction, infertility treatments, and medical services provided abroad. Additionally, experimental treatments and certain unproven traditional or complementary medicines are not covered under current regulations.