• published on 2/2/2023
  • 5min

Indonesia Healthcare and Insurance System

When they move to Indonesia, expatriates may not be aware of how the local healthcare system works or what kind of insurance plan they should look into.

Indonesia Healthcare and Insurance System

Knowing the ins and outs of Indonesia's healthcare system could prove vital to your expat experience. Expats living in this Southeast Asian country should understand the quality of care available, coverage options, and the process for accessing care in this country.

Indonesia’s healthcare is improving

Reforms are being implemented by several low- and middle-income nations to support Universal Health Coverage (UHC). The JKN, Indonesia's national health program, is perhaps one of the most comprehensive examples of this. Its goal is to provide access to healthcare to the country's 279 million citizens. Even while Indonesia has made significant progress, a third of the population is still uninsured, and out-of-pocket medical expenses are common, even among JKN members.

The government also believes that by enhancing the nation's healthcare system, Indonesians who travel for medical care would be persuaded to spend money locally. Over 1.2 million Indonesians yearly spend over US$2 billion on healthcare abroad, primarily in the neighbouring countries of Singapore and Malaysia.

Public vs private healthcare in Indonesia

Indonesia's central and regional governments continue to create and improve healthcare facilities since it is a national priority. Currently, there are 1,071 state and 1,854 private hospitals in Indonesia, totalling 2,925. Additionally, there are about 10,134 public health community centres (PUSKESMAS), which provide all-inclusive primary healthcare as well as immunisations.

Outside of Jakarta, Indonesia doesn't have many adequate public healthcare facilities. Patients must wait weeks before receiving the desired therapy due to the long waiting period. Although you may receive medical care in community hospitals as an expat, you wouldn’t be able to communicate with most physicians without speaking Bahasa, as they usually don't speak English. Because foreigners are not qualified for the national health insurance program, the physicians at these public hospitals would likewise demand you to pay upfront.

Only five hospitals have acquired international accreditation, and only roughly 50% of private hospitals are recognised by the Ministry of Health. Three of the five hospitals—Siloam, Gleneagles, and Mount Elizabeth's—are connected to well-known international organisations.

Due to the country's expanding middle class and the implementation of universal healthcare, demand has increased significantly across practically all segments of the healthcare sector in Indonesia, including hospitals, medicines, and medical equipment.

The quality of healthcare between cities vs rural locations

The disparity between urban and rural areas is a significant factor in Indonesia's healthcare system. The country has more than 17,000 islands spread across three time zones, so travelling between locations can be challenging. But it's not just geography that makes things difficult for patients; there are also vast differences in the quality of medical care available in different parts of Indonesia.

In rural areas, there is a lack of doctors and nurses who can provide basic care. In remote areas, there are often no healthcare facilities at all. Specialist doctors are scarce because they tend to stay in cities where salaries are higher and research opportunities are plentiful.

  • Over 60% of the population lacks access to hospitals

  • Over 60% of the population lacks access to primary healthcare facilities (Puskesmas, Pustu, Midwife)

The quality of medical education in Indonesia's universities is also considered to be lower in ranking than the ones offered by the top universities in Asia. The lack of good health facilities and services for their needs is a major obstacle for Indonesians to living healthy life. This can be seen from the fact that the majority of people in rural areas do not go to the hospital when they are sick, but rather rely on traditional medicine or self-medication.

In some areas, there is also a shortage of equipment and supplies needed for diagnostic tests or surgeries and often these must be imported from other countries at high prices. This has resulted in a large number of people travelling to big cities like Jakarta or Surabaya for healthcare services. This makes them vulnerable to the risk of picking up communicable diseases when they travel back home after treatment.

Comparing local vs international health insurance plans in Indonesia

If you are an expatriate living in Indonesia, you will want to look into private medical insurance plans to help cover the costs of treatment at private hospitals and clinics. There are two options for these insurance plans; local or international health insurance plans. These plans have quite a few differences, so it is important to have all of the details before you choose one.

Benefit levels

Understanding the differences between local and international medical insurance plans is important before you buy your own. Generally, local Indonesian insurance plans will come with lower total benefit levels and often have other limitations on the benefits, such as a limit on the amount covered per day or visit. International medical plans on the other hand usually offer higher benefit levels with fewer limitations.

When you're choosing a plan, you want to be sure that it includes the benefits that are important to you and your family. But if you have a lower annual limit or more specific limits on your plan’s benefits, you may find yourself facing additional out-of-pocket expenses which could influence where you seek treatment if you’re trying to avoid those extra costs.

Ability to offer direct billing

One area where local insurance providers excel is that they usually have extensive direct billing networks for inpatient and outpatient healthcare providers.

Depending on the company you choose, the scope of direct billing networks for outpatient treatments in Indonesia for international medical insurance plans may differ.

Coverage outside of Indonesia

Depending on the area of cover you choose, international health plans will cover you the same way whether you are in Indonesia or abroad. In case of hospitalisation outside Indonesia, APRIL will issue a Letter of Guarantee (LOG) to your hospital and settle the cost of treatment directly. Today, APRIL can place LOGs in most hospitals around the world.

However, local health insurance plans typically do not cover treatment outside of Indonesia. The providers cannot issue a Letter of Guarantee to hospitals outside the country, meaning you would have to pay for your treatment out of your pocket and your insurance will not reimburse expenses in these cases.

Most international health insurance plans also offer global portability, which means that you can take your health plan outside of Indonesia if you decide to move out of the country. This eliminates the need to go through the underwriting process again, which may exclude pre-existing conditions from coverage.

Calculating renewal premiums

Insurance companies can use two methods when setting premiums: experience rating and community rating.

As with most other international insurance providers, APRIL International uses community rating. We do not look at individual cases, but instead, we examine the performance of everyone insured under a product and then apply a fixed premium increase to everyone based on the portfolio's performance.  In other words, your annual increase will be the same regardless of your health and your consumption.

Another way insurers calculate renewal premiums is through experience rating, where they review a person’s claim history at the time of renewal. If you have a low claims year, your premium will not go up much; however, if you have a high claims year, expect your premium to rise dramatically.

Under a local health plan, if you have multiple years with high claims or develop a chronic condition that requires recurring treatment, your insurer may add limits, co-insurance, or deductibles on some benefits or simply decline to renew your policy.

Insurance for Expatriates in Indonesia

In Indonesia, MyHEALTH offers you the best of both worlds: a local insurance company's direct billing network and easy access to the excellent advantages of an international medical insurance plan.

You may create your own plan that works for your specific needs, whether you only need coverage for yourself or for your family as well. You may add outpatient, maternity, dental, and optical benefits modules to our inpatient plan, which covers critical treatments like kidney dialysis, cancer treatments, and even organ transplants. You may select one of three levels of coverage for each module.

You have a customisable coverage choice with MyHEALTH that covers you not just in Indonesian hospitals but also in hospitals all around the world. Additionally, your MyHEALTH plan is worldwide transferable, so if you ever leave Indonesia, you may take it with you to your new country with no coverage gaps at all.