Indonesia: Health insurance co-payment rules to take effect from 1 January 2026
Source: Asia Insurance Review | Jul 2025
Insurance policyholders in Indonesia will be required to cover at least 10% of the total outpatient or inpatient claims incurred at medical facilities, according to new rules set by the Financial Services Authority (OJK) to implement risk-sharing between insurers and policyholders. The new stipulation will come into effect from 1 January 2026.
This rule only applies to commercial health insurance products and not to the National Health Insurance (JKN) scheme. These rules are detailed in OJK Circular Letter (SEOJK) Number 7 of 2025 on the Implementation of Health Insurance Products and was issued on 19 May 2025.
According to a news report published in the Jakarta Daily OJK executive head for insurance, guarantee, and pension fund supervision Ogi Prastomiyono gave this information during a press briefing on 2 June 2025.
According to the new rule health insurance products will also include a coordination of benefits feature. This will allow integration between private insurance coverage and services under the JKN programme operated by BPJS Kesehatan.
OJK Financial Inclusion and Communication department acting head of the literacy M Ismail Riyadi said this regulation is intended to promote the use of higher-quality medical services and drug services.
“It will encourage affordable or more affordable health insurance premiums because premium increases can be better mitigated,” said Mr Riyadi in an official statement released by OJK.