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Coordination of BPJS benefits - insurance completed

Reporter: Christine Novita Nababan | Editor: Sanny Cicilia

JAKARTA. Finally, the Social Security Administering Bodies (BPJS) in the health sector and the private insurance industry conclude a benefit coordination cooperation agreement or coordination of benefits (COB). The contract will regulate the health care benefits of participants, payment of premiums or contributions, education, claims, including information systems.

Fachmi Idris, President Director of BPJS Kesehatan, said that the benefit coordination scheme will allow participants to get more health service benefits, especially non-medical benefits by participating in private insurance companies.

“The principle of benefit coordination applies if participants purchase additional health insurance from the Organizer of the Additional Health Insurance Program or other insurance bodies in collaboration with BPJS Kesehatan,” he said, Thursday (2/4).

Benefit coordination is a process whereby two or more insurers cover the same person for the same health insurance benefits, limiting the total benefits to a certain amount that does not exceed the number of health services guaranteed.

Through this mechanism, continued Fachmi, BPJS Kesehatan participants can upgrade to treatment classes and get other benefits that are not covered by the National Health Insurance program. Participants can also enjoy health services at private hospitals that have not collaborated with BPJS Kesehatan. “With a note, you already have additional insurance,” he concluded.

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