Explore our special feature on health insurance in Indonesia
Given the limitations of local infrastructure, including the private sector, expatriates have every interest in having international health insurance that covers their care in the private sector and evacuation to a country with more comprehensive facilities in case of major problems.
| Healthcare expenditure par capita and per year | $ 73.9 |
| Annual indexing of health care expenses | 1.88% |
| CFE hospitalization reimbursement rate | 67% |
| Number of insurance companies available | 15 |
| Annual cost of hospitalization coverage for a 30-year-old | € 672 |
| Annual cost of hospitalization coverage for a 50-year-old | € 1,200 |
In Indonesia, the healthcare system is undergoing significant changes since the 2014 reform and the implementation of the National Social Security Law (Jaminan Kesehatan Nasional or JKN). This major reform aims to provide social coverage for the entire population (citizens and permanent residents). The primary objective of health insurance is to ensure access to basic healthcare for all residents while reducing regional inequalities in this area.
However, the Indonesian healthcare system faces several challenges: funding issues, insufficient qualified medical personnel, and a lack of medical infrastructure and equipment, making it one of the poorest healthcare systems in Southeast Asia. In 2020, the WHO reported only 0.6 physicians per 1000 inhabitants in Indonesia, with a concentration of specialists in major cities.
Due to these limitations, those who can afford it turn to the private sector or even neighboring countries. Each year, significant amounts, approximately 160 trillion rupiahs, are spent abroad by Indonesian residents in search of quality medical services. Nevertheless, the government has undertaken measures to improve the situation, including an ambitious project to renovate 100 hospitals annually by 2025, as well as the adoption of a new healthcare reform in 2023, aiming to curb the 'exodus' of patients to neighboring countries with better-equipped facilities, such as Singapore and Malaysia.
Indonesia, the fourth most populous country in the world, faces significant challenges in public health. Its numerous geographical attractions and pleasant living conditions also attract many expatriates, especially to islands such as Bali, which has become a haven for digital nomads, freelancers, and entrepreneurs of all kinds.
Without health insurance, this foreign population with relatively small budgets may find themselves in critical medical and financial situations. Road accidents, especially involving scooters, are the major health risk for expatriates in Indonesia. Without insurance and requiring evacuation to a neighboring country, it may be necessary to resort to 'DIY solutions,' such as online crowdfunding, to cover the medical expenses of a serious accident.
Regarding health risks in Indonesia, they correspond to the typical risks of tropical climates, such as consuming non-potable water, heat-related issues (dehydration), endemic diseases like malaria and dengue fever, as well as risks related to pollution in major cities like Jakarta (respiratory problems). While no vaccines are mandatory to enter Indonesia, it is advisable to ensure all vaccinations are up to date; for example, tuberculosis remains common in the country.
The quality of healthcare in Indonesia varies between the public and private sectors, but one constant remains: the quality of care generally falls below international standards in most establishments, which can have a significant impact on expatriates. Bali and Jakarta are the cities best equipped, particularly due to the importance of the tourism industry.
In the public sector, establishments are often overcrowded, leading to considerable waiting times. Additionally, the lack of medical staff and modern equipment is a recurring problem. In 2020, there were 1614 public hospitals. Additionally, the public healthcare system includes numerous primary health centers, primarily for day-to-day primary care. These are known as Pukesmas, numbering 9700 in 2020, distributed throughout the country and often as overcrowded as hospitals. In the event of a serious problem, no care will be provided at the Pukesmas, which will direct the patient to the nearest hospital.
Expatriates, if not employed residents, have access to public facilities provided they pay for care. However, the deficient facilities, lack of hygiene, and language barrier can quickly discourage them, leading expatriates to prefer private establishments. It should be noted that only local doctors have the right to practice, while foreign doctors are limited to providing their expertise as consultants in private facilities.
The private sector generally offers higher quality care, with healthcare staff more often bilingual in English, but this comes with higher healthcare costs. However, the number of available spots is quite limited, with 996 hospitals in 2020, and the facilities are not always the most modern; some equipment or technologies may be lacking, leading to the decision for medical evacuation. For this reason, it is strongly recommended for expatriates to subscribe to minimal insurance covering hospitalization and repatriation. Finally, unlike public hospitals, which lack ambulance services, private hospitals have their own ambulance services.
In Indonesia, only a few hospitals meet international standards. Among the high-quality establishments are the 2 BMIC (Bali International Medical Centre) and the Rumah Sakit and Siloam (Denpensar) hospitals in Bali, the Bintaro Premier Hospital and Jatinegara Hospital in Jakarta, as well as the Siloam Karawaci Hospital in Tanggerang, or the Eka Hospital and Santosa Hospital in Bandung.
In the public sector, you will not have the choice of your doctor, and chances are slim that they speak English. Bringing a translator with you is the best solution if you need to visit a public facility. Moreover, it is generally preferable to seek consultations in the evening to have access to the best doctors, as they often consult in public facilities during the day. The 2023 Health Reform is expected to facilitate the work of foreign practitioners to address the shortage of doctors in the country; however, this process may be lengthy and complex.
In case of hospitalization, you need to provide proof of insurance or payment before care can be initiated. In the private sector, daily hospital fees for a single room range from 45 to 80 euros (equivalent to 1,300,000 IDR), depending on the location of the facility.
A consultation with a private doctor varies between 15 and 85 euros, depending on the duration of the consultation and the specialization of the doctor. It ranges from 250,000 to 400,000 IDR for a general practitioner (450,000 IDR for a French-speaking doctor), and from 350,000 to 1,400,000 IDR for a specialist. Home consultations cost between 120 and 215 euros (2,000,000 IDR). It is common to settle the consultation fee before receiving treatment. Similarly, a physiotherapy session costs approximately 600,000 IDR, and an osteopathy consultation around 750,000 IDR.
Pharmacies are accessible in major cities and harder to find in rural areas, where health centers dispense medications. To avoid counterfeits or poorly stored medications, it is recommended to choose a large pharmacy chain such as Apotikk or Kimia Farma, and to know the names of generics. Many medications are available without a prescription; however, presenting a prescription is mandatory for reimbursement from your insurance. Expatriate health insurance contracts often include the option of teleconsultation, which is very useful for prescription requests and consultations for minor conditions.
Regarding dental care, a dentist consultation in the private sector costs between 30€ and 90€. In international facilities, it will be more in the range of 100 to 170 euros. For instance, a simple cleaning averages around 1,500,000 IDR, a scaling around 2,800,000 IDR, while a filling costs approximately 600,000 to 1,000,000 IDR. A crown averages around 350,000 IDR.
Regarding maternity care, hospitals in urban areas have a good reputation, and their staff is slightly more qualified than a few years ago. Doctors have a marked preference for cesarean sections, which allow choosing the birth date and avoiding complications of natural delivery, but most importantly, allow charging higher fees. It is necessary to specify the desired type of delivery in advance. In public hospitals, a cesarean section costs $ 500, whereas in an international hospital, it will be approximately $ 2,200. An ultrasound costs around 500,000 IDR.
The Caisse des Français de l'Étranger (CFE) is one of the healthcare insurance solutions for expatriates in Indonesia, including EU citizens. The coverage is similar to the French Social Security basis for health. The CFE reimburses many medical expenses, such as routine medical care, surgical procedures, hospitalization, dental care, optical services, laboratory tests, and others, within the limits of the rates and tariffs applied in Zone 1 of the CFE.
The CFE operates as a first level of reimbursement, meaning that it does not cover all of your medical expenses. However, this limitation is generally less restrictive in Indonesia, where the reimbursement rate for hospitalization is 67% of the expenses, and 65% for pharmacy bills (which may be capped at the rate applied in France). This implies that the out-of-pocket expenses for the insured are at least 33% for hospitalization expenses and 35% for pharmacy expenses. It's important to note that the CFE does not cover repatriation, which is essential in Indonesia.
Depending on your needs and financial resources, you have several options. You can choose to pay for all of your medical expenses on the spot, subscribe to a local insurance with its limitations, opt for CFE coverage alone with the resulting out-of-pocket expenses, subscribe to a complementary insurance to the CFE, or a first euro contract.
An expatriate insurance in addition to the CFE (or first euro) guarantees full coverage of your hospitalization expenses, regardless of the healthcare facility, and offers additional reimbursement for your routine expenses, especially if you are seeking good reimbursement in the private sector; as well as a comprehensive repatriation assistance option (or medical evacuation).
The JKN, or Jaminan Kesehatan National, is the universal health insurance established in 2014 by the Indonesian government. However, its full implementation takes time and its effectiveness is still limited. The JKN is intended for citizens and permanent residents (holders of KITAP and KITAS visas). Public healthcare facilities are accessible to all, with insured individuals receiving free care, while non-beneficiaries must pay out of pocket.
The JKN is based on a solidarity principle divided into two distinct branches:
The KIS (Kartu Indonesia Sehat): This first branch covers the most deprived (those without income).
The BPJS Kesehan (Badan Penyelenggara Jaminan Sosial Kesehatan): This second branch is intended for the active population and contributes to the financing of the first.
Employees in Indonesia are mandatory enrolled in the JKN by their employer, and it is the contributions of the employees and the state that finance the Social Security system. The employee contribution, which is directly deducted from salaries, amounts to 5%, of which 2% is specifically allocated to health insurance under BPJS. Although this public healthcare system may seem inadequate for expatriates, it has contributed to improving the living conditions of local employees. Insured individuals receive an insurance card that allows them to access healthcare facilities affiliated with BPJS for free. Before the implementation of the JKN, all healthcare expenses were entirely borne by the patients.
The JKN provides free coverage for hospitalization (up to 3 million rupiahs), emergency care, maternity expenses, and preventive dental care. However, for more comprehensive coverage and lower out-of-pocket costs, especially for care in the private sector, health insurance is necessary. Since 2015, the JKN also offers social benefits such as work accident insurance, old-age and death benefits, and family benefits. To receive public retirement benefits, the state requires mandatory savings from employees with a provident fund.
Local health insurances are available to cover certain expenses incurred in both public and private healthcare facilities. However, they only function within Indonesia and must be used within a specific network of care providers. The coverage limits are often restricted, preventive care is generally excluded, as are treatments related to pre-existing medical conditions. These insurances do not offer evacuation services.
Several international health insurance providers specializing in Southeast Asia also offer coverage in addition to local options. They provide slightly more comprehensive benefits and coverage extended to certain countries within the region. However, these contracts typically operate on a mixed local and Anglo-Saxon model, with deductibles or co-payments, networks of care providers based on the level of contribution, specific coverage limits, and systematic exclusion of pre-existing conditions. Evacuation services are usually included as part of the coverage options.
For a more flexible, easier to understand, and reassuring international health insurance, expatriates are recommended to opt for international insurance with repatriation option.
For your safety and that of your family, private insurance provides access to services and expertise that meet international standards. Unlike local private insurances, no network or location of care is imposed on you, and hospitalization expenses are covered at 100% of the costs. You can access the best diagnostic equipment and treatments, as well as essential repatriation assistance coverage in Indonesia.
Today, expatriate insurances offer efficient teleconsultation services, which represent a significant advantage in a country like Indonesia, where language barriers and access to healthcare can be challenging. You can schedule appointments with a general practitioner or a specialist who can provide a second medical opinion or guide you for treatment locally.
Additionally, your expatriate contract covers you during your occasional travels and guarantees you at least emergency coverage internationally, especially in the event of medical evacuation to a neighboring country such as Singapore.
Finally, travel insurances will not work: many expatriates think they can save on expatriate insurance for a few weeks thanks to their travel insurance. But in case of a problem, the insurer will ask you to justify your travel conditions, return ticket, type of accommodation, Social Security reimbursement. If it is found that it is a stable stay of more than 90 days, and not a short-term trip, coverage will be refused.
Choosing expatriate health insurance is a wise choice for your safety and peace of mind. Plans can be adapted to the healthcare cost level of the country (with coverage of medical expenses at 80% or 90% in particular) and can fit all budgets.
Subscribing to expatriate insurance can be done at any time for Indonesia, whether it's before departure or once you're already there. International insurance offers flexibility, allowing you to select your coverage options and reimbursement levels based on your needs and healthcare habits. The guarantees offered are similar to those you are familiar with, thus eliminating uncertainties related to local operations.
However, it is recommended to subscribe at least 30 days before your departure, as the procedures for international health insurance membership are more complex than those for a regular health insurance. When subscribing upon arrival, waiting periods may apply, whether it's for the CFE (from 3 to 6 months) or for medical or dental/optical coverage under expatriate contracts. Planning the subscription of your health insurance contract in advance, when your situation allows it, can offer certain advantages.
When subscribing to expatriate insurance, additional management delays may be generated by the study of the health questionnaire, which is customary for all expatriate insurers. Depending on your medical history, exchanges with the medical service may be necessary, and you may be asked to provide additional medical documents (always keep your medical records accessible). You may also be required to have a doctor who follows you for a particular pathology complete a questionnaire.
On our website, you can perform online simulations to obtain quotes and compare coverage options. Our advisors are available to refine your options, answer all your questions, and guide you through the world of expatriate health insurance.
Due to the weaknesses of the Indonesian healthcare system, it is recommended for expatriates to select international insurance rather than local insurance, in case evacuation is necessary. Please note that a repatriation insurance alone does not cover hospitalization expenses once abroad.
In Indonesia, it is strongly advised to sign up for expatriate health insurance that covers hospitalization and repatriation. The reasons why repatriation insurance is essential are detailed in the following point. As a reminder, the hospitalization coverage of an international insurance allows you to benefit from direct coverage of 100% of your hospitalization costs, regardless of the chosen hospital, relieving you of any advance payment constraints.
Ideally, opt for a policy that also covers routine medical expenses. To control your healthcare budget, prioritize a reimbursement rate of 80% for these expenses, which is often sufficient. Optical-dental coverage is not as important, as dental care remains accessible in Indonesia; it is often preferable to pay for this type of expense out of pocket.
Lastly, if you have plans for pregnancy in the short or medium term, it is essential to subscribe to maternity coverage from the start, as maternity waiting periods are usually 9 to 12 months. It is important to note that no insurer covers ongoing pregnancies, including the CFE. Furthermore, it is important to consider that childbirth expenses in case of complications or neonatal care can be extremely expensive, which could complicate an already difficult medical situation.
Indonesia is a destination for which repatriation assistance is essential! In case of a major health issue, transfer to a suitable medical facility will be necessary. The closest well-equipped country is Singapore. However, repatriation to Malaysia or France may also be considered depending on the situation, as Singapore has very high healthcare costs.
Repatriation represents a considerable financial risk if you have to bear it alone. The cost of a medical repatriation depends on the place of care, means of transportation, and the level of medical care required. Without insurance, medical repatriation can cost between €10,000 and €40,000, or even more. It is important to remember that the embassy or consulate is not responsible for covering repatriation costs. To avoid a financial tragedy, hospitalization with repatriation assistance is the minimum recommended for expatriation in Indonesia.
Repatriation assistance also offers 'comfort' services that can be particularly useful in difficult situations. This may include paying for a relative's travel to your bedside, organizing childcare or transferring your children, or repatriating the body in case of death.
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