Country of Operation
- National Social Security Council (DJSN)Government
Target income level
- Bottom 20%
SummaryIn 2004, Indonesia introduced the first phase of its plan to achieve universal health coverage through a mandatory public health insurance scheme, Askeskin, which in 2008 evolved into Jamkesmas, an MoH-run "insurance" program which covers over 76.4 million poor Indonesians.
Key program components
Though the scheme has never been formally marketed, Jamkesmas has enrolled more beneficiaries than any other Indonesian health insurance plan. Its target population is defined using an annually administered national survey known as the SUSENAS according to daily household consumption estimates. P.T. Askes is the administrator of membership in the Jamkesmas program and has operated the program since 2005. P.T. Askes obtains a list of the number of persons eligible each year from the Central Bureau of Statistics which is a part of Bappenas (the national planning agency). It then distributes the cards and registers enrollees into the program.
Jamkesmas offers a comprehensive benefits package, including both inpatient and outpatient care, as well as maternal and preventive care. In terms of medication, enrollees are only entitled to coverage for drugs from specific formularies and must opt for generic drugs when filling prescriptions.
Overall, free access to many providers—both private and public—and a comprehensive benefits package make Jamkesmas more attractive to the majority of the population—even those covered under Askes and Jamsostek, two of Indonesia's other public insurance programs. Jamkesmas beneficiaries are able to seek care at both public and private outlets, though covered ambulatory services are solely public. The scheme contracts with 926 hospitals for service provision, including 220 private hospitals for certain procedures.
The Jamkesmas scheme is funded by the central government from general tax revenue. Beneficiaries are not responsible for premium payments nor are they charged a copayment at the time of visit.
While there are no formal evaluations of the Jamkesmas scheme, the Indonesian government and many international organizations, including the World Bank and GTZ, are collaborating to improve the program to address both policy and implementation challenges. Data from the government suggest that Jamkesmas has made a significant impact. A high level of coverage has been achieved within less than 2 years, reaching 76 million poor and near poor enrollees. Total utilization of services has also increased by 50% for ambulatory care and about 106% for inpatient care and the rates of service use between the most affluent and the poorest have nearly equalized.
76.4 million people covered in scheme. Public providers in network: 926 Private providers in network: 220