Indonesia's national health insurance program, BPJS Kesehatan, is committed to providing comprehensive healthcare services to its participants. Beyond medical consultations and treatments, BPJS Kesehatan also covers several essential medical devices at no additional cost, ensuring participants have access to necessary aids for improved quality of life. Outlined in the Ministry of Health Regulation (Permenkes) No. 3 of 2023, here are seven medical devices covered under the program:

1. Eyeglasses

Participants diagnosed with vision impairments are eligible for eyeglasses coverage. Coverage is provided based on a prescription from an ophthalmologist, with the following specifications:

• Lens Requirements: Minimum of 0.5 diopters for spherical lenses and 0.25 diopters for cylindrical lenses.
• Frequency: Eligible for new eyeglasses once every two years.
• Coverage Amounts:
• Class 3: Up to IDR 165,000
• Class 2: Up to IDR 220,000
• Class 1: Up to IDR 330,000

This tiered system ensures that all participants receive support tailored to their healthcare class.

2. Hearing Aids

For participants experiencing hearing loss, BPJS Kesehatan covers the cost of hearing aids under these conditions:

• Coverage Amount: Maximum of IDR 1,000,000.
• Frequency: Once every five years.
• Requirements: Prescription from an ENT specialist.

This benefit applies regardless of whether one or both ears require assistance.

3. Dental Prosthetics (Dentures)

Participants needing dentures due to tooth loss can avail themselves of this benefit:

• Coverage Amount:
• Full Denture: Up to IDR 1,000,000.
• Per Jaw: Up to IDR 500,000.
• Frequency: Once every two years.
• Requirements: Based on medical indications.

This ensures participants can maintain oral functionality and aesthetics.

4. Limb Prosthetics

For those requiring artificial limbs:

• Coverage Amount: Up to IDR 2,500,000.
• Frequency: Once every five years.
• Requirements: Prescription from a specialist in physical medicine and rehabilitation.

This support aids participants in regaining mobility and independence.

5. Spinal Braces

Participants with spinal issues can receive coverage for spinal braces:

• Coverage Amount: Up to IDR 350,000.
• Frequency: Once every two years.
• Requirements: Based on medical indications.

Spinal braces help in supporting the spine and alleviating discomfort.

6. Neck Collars

For neck support needs:

• Coverage Amount: Up to IDR 150,000.
• Frequency: Once every two years.
• Requirements: Based on medical indications.

Neck collars assist in stabilizing the cervical spine during recovery.

7. Crutches

Participants requiring mobility support can obtain crutches:

• Coverage Amount: Up to IDR 350,000.
• Frequency: Once every five years.
• Requirements: Based on medical indications.

Crutches provide essential support for those with mobility challenges.

How to Avail These Benefits

To access these medical devices, participants should:

1. Consult a Specialist: Visit the relevant medical specialist to obtain a diagnosis and prescription.
2. Verification: Ensure your BPJS Kesehatan membership is active and up-to-date.
3. Submission: Present the prescription and necessary documents to the designated BPJS Kesehatan-affiliated provider.

By following these steps, participants can effectively utilize their BPJS Kesehatan benefits to obtain essential medical devices, enhancing their overall well-being and quality of life.