economy

The DPR Requests That The OJK Postpone The Implementation Of The Insurance "co-payment"

Commission XI of the Indonesian House of Representatives has requested that the Financial Services Authority (OJK) postpone the implementation of the risk-sharing scheme (co-payment) for commercial health insurance products.

The Chairman of Commission XI, Mukhamad Misbakhun, stated during a Working Meeting with OJK in Jakarta on Monday that they support OJK's efforts to strengthen the health insurance ecosystem and create a balance of benefits between policyholders and the insurance industry.

However, regarding the co-payment scheme mentioned in the Financial Services Authority Circular Letter (SEOJK) Number 7 of 2025, he expressed hope that its implementation would be delayed until further regulations under the Financial Services Authority Regulation (POJK), which have been consulted with Commission XI, are enacted.

"We still have half a year left, so by that time we believe we will have sufficient time to consolidate from the policy side and with the public," Misbakhun stated.

He assured that Commission XI will engage in meaningful participation to gather the aspirations of stakeholders regarding the regulation of Health Insurance Product Administration.

"This is aimed at strengthening what will be decided by OJK," he added.

In response, OJK Chairman Mahendra Siregar explained that the regulations prepared by OJK encompass the strengthening of the health insurance ecosystem across various sectors.

The co-payment regulation is one of the enhancements made from the policyholder's perspective, alongside the Coordination of Benefit (CoB) arrangements for policyholders who are also active participants in BPJS Health.

In addition to the policyholder perspective, OJK is also regulating enhancements from the side of healthcare facilities and insurance companies.

"In fact, the SEOJK regulates various aspects of this matter. However, if the intention of Commission XI of the DPR is to ensure that the aforementioned ecosystem operates effectively and to take steps to involve relevant parties and components of the ecosystem, we can understand and agree," Mahendra stated.

He further added that the OJK recognizes the urgency of implementing this policy promptly, considering that Indonesia is currently facing a demographic dividend that is gradually transitioning towards an aging society.

This implies that the number of users of health services and health insurance will continue to rise, while those who bear the costs will steadily decrease.

"Therefore, the longer we take to resolve this issue, the greater the time bomb becomes, until we lose control entirely. Thus, we must truly make the most of the limited time we have to strengthen the ecosystem effectively," he remarked.

As a note, the OJK indicated that the implementation of co-payment for commercial health insurance products is one of the efforts to curb medical inflation so that it does not pose a threat to the economy. This scheme is also aimed at reducing premium costs to make them more affordable.

The co-payment implementation will be at least 10 percent of the total claims submitted for outpatient or inpatient care at healthcare facilities.

However, there is a maximum limit on the claim value that can be submitted, which is Rp300,000 per submission for outpatient claims and Rp3 million per submission for inpatient claims.

The SEOJK that governs this policy is scheduled to take effect on January 1, 2026. However, for existing insurance, the OJK has provided a grace period for adjustments until December 31, 2026."

Tag: Mukhamad Misbakhun OJK POJK