DPR Asks OJK To Postpone 'Co-Payment' Health Insurance

JAKARTA - Commission XI of the DPR RI has asked the Financial Services Authority (OJK) to postpone the implementation of a risk-sharing scheme (co-payment) for commercial health insurance products.

Chairman of Commission XI DPR RI Mukhamad Misbakhun in a Working Meeting with OJK in Jakarta, Monday, June 30, stated that his party supports OJK's steps in strengthening the health insurance ecosystem and creating a balance of benefits between policyholders and the insurance industry.

However, regarding the co-payment scheme mentioned in the Circular Letter of the Financial Services Authority (SEOJK) Number 7 of 2025, he hopes that its implementation will be postponed until the enactment of further regulations in the Financial Services Authority Regulation (POJK) which has been consulted with Commission XI of the DPR.

"We still have half a year, so at that time we thought that our time was enough for consolidation from a policy perspective and to the community," said Misbakhun, quoted by Antara.

He ensured that Commission XI of the DPR carried out meaningful participation (meaningful participation) in order to absorb the aspirations of interested parties regarding the arrangement for the Implementation of Health Insurance Products.

"This is in order to provide reinforcement to what will be decided by the OJK," he added.

In response, Chairman of the OJK Board of Commissioners Mahendra Siregar explained that the rules prepared by the OJK have included strengthening the health insurance ecosystem in various lines.

The rules regarding co-payment are one of the strengthening carried out in terms of policyholders, along with the Coordination of Benefit (CoB) arrangement for policyholders who also have active participation in BPJS Kesehatan.

Apart from the policyholder side, OJK also regulates strengthening in terms of health facilities and insurance companies.

"Actually (SEOJK) regulates these various things. However, if the DPR Commission XI means that the ecosystem can run effectively and there are steps to invite related parties and parts of the ecosystem, we can understand and agree," said Mahendra.

He added that the OJK saw that the urgency of this policy was immediately implemented considering that the current situation faced by Indonesia was dividend demographics which gradually moved towards aging of the population (aging society).

This means that users of health services and health insurance will continue to increase, while those who bear it will continue to decrease.

"So, the longer we solve this problem, the bigger the time bomb, until we don't have control anymore. So we really need to take advantage of this narrow time so that our ecosystem is really strengthened," he said.

For the record, OJK said that the implementation of co-payment for commercial health insurance products is one of the efforts to suppress medical inflation so that it does not become a threat to the economy. This scheme is also intended to reduce premium costs to make it more affordable.

The implementation of co-payment is at least 10 percent of the total application for outpatient claims or hospitalizations at health facilities.

However, there is a maximum limit on the value of claims that can be submitted, which is IDR 300 thousand per application for outpatient claims and IDR 3 million per application for inpatient claims.

The SEOJK which regulates the policy is planned to take effect on January 1, 2026. However, for existing insurance, the OJK provides adjustments no later than December 31, 2026.