BPJS change of rules re foriegn pensioners ?

@ enduring word
I must say that insurance companies dont have to be moral. They exist in having to make a profit. As much as possible and for shareholders. It is true and cannot be helped.

of course they can do what they wish ,

but in thailand and the philipines , bupa to quote 1 example , have a reasonably priced policy for local and foriegn alike without some of the onerous restrictions that apply here  , why I wonder ?,  are the agents here worried about their commissions ?   hmmm

To Ubudian:

"As for the current discussion regarding what happens at and after age 70…most all private plans will no longer renew individual medical plans after age 70 and that's even after years of previously being covered by that carrier and having little or no medical claims with them…or, if they do allow the renewal, the premiums are extremely high."

Yup that is correct.

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Hansson, I hear what you are saying (post #45), but you need to accept the fact that covering foreign retirees under the national health care system can be done as a benefit to the overall plan.

You seem to be stuck in this assumption that including them would only be a detriment to the plan.  That is simply not true.  Moreover, you keep calling this "free health care" which is entirely misleading. 

My prior posts have explained how this is done using actuarial science and sound underwriting principles.

***

tel522 wrote:

@ enduring word
I must say that insurance companies dont have to be moral. They exist in having to make a profit. As much as possible and for shareholders. It is true and cannot be helped.

of course they can do what they wish ,

but in thailand and the philipines , bupa to quote 1 example , have a reasonably priced policy for local and foriegn alike without some of the onerous restrictions that apply here  , why I wonder ?,  are the agents here worried about their commissions ?   hmmm

@Tel,
I agree that Thailand especially has great health care costs that is affordable.
The problem lies with the rort in the Indonesian health care system. Recently KPK arrested a government officer rorting the BPJS in the provinces.
We dont know how much systemic it is. However, I have been hearing hospitals class 3 beds are full and medicines are out of stock.
It is like someone is driving up prices purposefully. It is still a broken system and has not reached there.
I have private insurance and the costs they charged is really huge and could be similar to a developed country like Singapore. I am not out of pocket, but the system would be - that is why the high premium rates.

Some example stories of how BPJS system is rather broken.
http://manadoexpress.co/berita-11199-wa … -bpjs.html

Yes I agree with Hansson.
***

***
like any national health care plan, it will evolve as time goes by, and actual statistics relative to the experience of the plan (premium in, claims out, administration costs) are revealed.  This is the basis of all large group medical plans…often called renewal underwriting.

with the great intentions of bpjs to help all the people , "based on need cradle to grave " , unfortunately it has to face the vagaries of life here , so it still has a long way to go , but I wish the goverment luck with this endeavour.

"with the great intentions of bpjs to help all the people , "based on need cradle to grave " , unfortunately it has to face the vagaries of life here , so it still has a long way to go , but I wish the goverment luck with this endeavour."


Amen to that!   

I have to support the government's health care scheme because it's pretty much guaranteed to help a lot of people.
I've seen people die of an easily cured or manageable disease, and others scared for life because they couldn't afford health care after an accident. One especially sad case was a young girl with facial injuries that could have been minimised if her family could have afforded care.
That lack of cash left her badly disfigured for life, something that must be awful for a young girl to live with.

To the topic in question, pensioners, we must know it they're net contributors or not (Over their total time in Indonesia). If we know that, we can move on to consider the social aspects.

enduringword wrote:

We dont know how much systemic it is. However, I have been hearing hospitals class 3 beds are full and medicines are out of stock. ....
......Some example stories of how BPJS system is rather broken.

My son's immunisation is out of stock all over this area, and probably others. I'm unsure why such common drugs should be a problem, but they are. Of course, we pay for those.

I've every confidence BPJS is broken, but it's a lot less broken that not having it.

for sure there are issues in bpjs especially in high population areas , I hope the government can solve these problems , then maybe international  insurance companies will bring inexpensive products here  as sold in thailand and the philipines .

Fred wrote:

enduringword wrote:

We dont know how much systemic it is. However, I have been hearing hospitals class 3 beds are full and medicines are out of stock. ....
......Some example stories of how BPJS system is rather broken.

My son's immunisation is out of stock all over this area, and probably others. I'm unsure why such common drugs should be a problem, but they are. Of course, we pay for those.

I've every confidence BPJS is broken, but it's a lot less broken that not having it.

I think we all can agree that BPJS is broken. That much we all seem to agree on.
And also that in how having BPJS National Healthplan is better than nothing.

That is why Hansson and I, have expressed our views that in a broken system - we should not put in more weights into it. Or find another cheaper solution to bring down the deficit and high costs to the health care system.

And Tel the OP seems to agree on that one too.

To those who disagree with our views. And hold that likely expectation that the system of foreign retirees under Indonesian retirees progam, tapping on the broken system, can please agree to disagree. That is all.

I don't see many foreigners bothering with it, but some might well be in need, especially long term residents who stayed here after work or moved here for marriage.

Fred wrote:

I don't see many foreigners bothering with it, but some might well be in need, especially long term residents who stayed here after work or moved here for marriage.

Fred,
We can discuss that - There 3 types of foreigners coming to Indonesia. There might be more but we shall focus on 3 for now.
The ones you highlighted above are 2 types.
1) Foreigners working here, they are paying taxes and must qualify under the work program

2) Foreigners coming here and eventually married an Indonesian.
They will enjoy the benefits of being married and sponsored by rights of marriage laws.

Then there are the 3rd type, that we on this thread has focused on.
3) Foreign retirees under Indonesian retirement program. They are not working and thus not taxed under work contributions. They are allowed into the system because the government wants them to spend and bring in dollars as a contribution and are need extending their stay and meet the requirements. And by no means they are guaranteed to stay if they dont meet the requirements.

@ enduringword

“That is why Hansson and I, have expressed our views that in a broken system - we should not put in more weights into it.”

Those weren't any of the objections or views I've been reading on this thread…viz, that by mandatory inclusion of foreign retirees, it would be putting more “weight” into it.  Rather, what I've been reading as primary objections consists of social and moral objections relating directly to these retirees not being Indonesian, or setting up Indonesia as some sort of “nanny state for retirees.”  Objections on that basis have been frequent, they begin with post #5 and are consistently woven throughout this entire thread.  I've found this odd since there has been no objection voiced relating to the mandatory inclusion in the BPJS program when it comes to active foreign workers in Indonesia.

In any event, the current issues with BPJS are primarily logistical and administrative.  Whether these issues are so extensive as to call the system “broken” is debatable.  But, adding foreign retirees on a mandatory basis would not be “putting more weight” into the current plan, but it surely would be putting a lot more premium into the plan…once again calling attention to the actuarial/underwriting issues repeatedly discussed and the certainty that many retirees would not use the plan, but rather, would opt for other means of medical care.

Hello everyone,

I have moderated and removed some inappropriate and off topic messages. Could we now please calm down and stop argue / provoke each other. Again this is a mutual help forum, we are all here to share our knowledge, our opinion, please do respect each other when participating on the forum. Let me remind you these three key words about the values of Expat.com : respect, friendliness and mutual aid.

@tel522 > you are the OP of this thread, do you have any questions about your subject?

Thank you,
Christine
Expat.com

@tel522 > you are the OP of this thread, do you have any questions about your subject?

thanks no , interesting  views though

I think the bottom line is that BPJS is indeed important as I think everyone has said. It's just a matter of whether retired expats should or shouldn't be allowed access to it. In it's current state, it seems that it cannot support foreign retirees as it runs at a deficit. But, with a revamp it could become more workable.

the nhs , one of the better health services ,ya it runs in deficit  ,  but it will always be supported by the uk government , health is one of the foundations of any caring society.

tel522 wrote:

the nhs , one of the better health services ,ya it runs in deficit  ,  but it will always be supported by the uk government , health is one of the foundations of any caring society.

I think some of the other health services in the EU are very good, but I heard that the NHS is fraught with problems..

for sure nhs has problems , you will find better in scandinavia , holland and germany  , none are perfect , but the philosophy of health cradle to grave dependent on need , I believe is a good one .
Thats why I commend indonesia for bpjs , imperfect though it is .

The horror stories I heard b4 bpjs , babies being kidnapped until parents could pay for the birth , people being left in casualty after a road crash with no treatment , etc etc , terrible .

Tel522, what is your source ?
Thank you

living in indonesia forum and bali pod , if you notice the ? at the start of the thread I was looking for confirmation from our learned posters .

I am here on a retired visa, and have been spending 9 plus months per year in Indonesia on a KITAS. In order to renew my KITAS every year, I must provide "proof of health insurance coverage".  If I could just show immigration a BPJS card it would save me $1400 for the policy I buy to cover medical emergencys, medivac, repatration, lost luggage and cancled flights. Being from the US and being 65 y/o I must pay for MEDICARE ($132/mo) in order to keep my free medical provided to retired military members.  MEDICARE does not cover medical expenses  outside the US.  My military medical does cover outside the US if I file my own claim (I personally have never filed a claim due to never needing any big ticket medical treatment over here...knock wood!). The few times I have been to see a Dr here in Indonesia, it has cost me about $20 including lab and meds.  Until reading this thread, I had no idea what BPJS was, much less used it.  Current system of retired visa expats providing their own medical insurance seems fair to me.  If, on the other hand, we would be included in BPJS we should pay our fair share. I would still need to buy my current travel medical policy if for no other reason then to have medivac coverage.  Anyone who might think that it is a good idea to retire here in order to participate in BPJS might want to rethink their plan.

Given your very unique situation it obviously would make no sense for you to enroll in the BPJS plan should enrollment in the plan be voluntary for those on retirement KITAS visas.  It would be redundant.  Undoubtedly, others who are here on retirement visas will be in similar unique situations.             

This is precisely why if BPJS is to be extended to those on retirement visas, the only logical way to do that would be to require BPJS plan enrollment for all retirement visa holders in the exact same manner as BPJS enrollment is required of all active employees, be they local or Indonesian.

I agree totaly with tour opinion. When you can come to bali and have your pension you are enough riche you paye your assurance.

Kudos for the two statements Ubudian that was moderated sadly and I agree with you some time the truth should be told Ahok style .   I am a Ahok Fan.... I come from SA and unfortunately most of my savings went into medical bills. SA currency is lower than Indonesia. Have not got a pension so it is just survival. Through Gods mercy I still make it and is thankful so I cant complain.

Many thanks for your kind comments.  I agree, in certain situations, and when dealing with certain individuals there is no better alternative than the Ahok style.  It's often the most effective, less time consuming, and it leaves little opportunity for misunderstanding.

I hope God's mercy and just some plain old good luck continues to prevail for you!

Cheers!

I think the gentleman was referring to those living on a "Retirement Visa", and if you check out the steep requirements for said visa (in line with those in place in Thailand, the Phils etc) then you have to be pretty high on the hog - no average middle-class pensioner need apply. If you have that kind of money you should not be cadging on a "poor man's health safety net".

I wouldn't have described it that way, but yes that's exactly how I feel too.

I mean Indonesia is already one of the cheapest places to live in Asia, it has some of the cheapest food, cheapest labour, so already foreigners living here are having it pretty good and their money can already go a long way compared to if they lived in some of the other countries in this region.

There are locals who earn just a few hundred thousands of rupiah each month. These are the people that the local healthcare needs to be spending their money on helping. Some of these elderly local men hauling garbage to rubbish dumps all day long, it's unhygienic work and they struggle to support their families. These are the people who really need help.  Not poor foreigners who are looking for a free ride in paradise.

As in many other countries in the region, the laws should stipulate that foreigners who live here under a retirement visa should prove that they have their own medical insurance (I'm sure most of them already do have one) and not be eligible to benefit from BPJS.

**

if a country wishs to attract foreign pensioners it should make sure there are suitable insurance policies available , unfortunately here the private insurance companies kick out people over 70 or 65 , so what do they do for insurance ? if they get sick during 1 premium year , the said companies  can cancel their policy , again no solution for the unfortunates .

maybe indonesia should raise the bar like malaysia , sending all the middle income or poor pensioners home , and only allowing the more affluent to enter ?

I think there are better countries in asia than here to retire , better healthcare , cheaper insurance and  facilities , which are tailored more towards the foreign retiree.

Yup, In Malaysia if you want to retire under the MM2H program you must:

1) Place RM250k (Rp850,000,000) in a Fixed Deposit account . This money cannot be touched except to pay for medical expenses or education, and at least Rp200,000,000 of it must remain in that account at all times. You cannot uplift the Fixed Deposit without a letter from the Minister of Tourism.

2) If you are below 50 years of age that Fixed Deposit amount becomes RM500k (Rp1,700,000,000 miliar).

3) Proof that you have an overseas income of RM10k (Rp34,000,000) per month

4) Proof that you hold a personal medical insurance policy

5) A certificate of full medical checkup.

In comparison, foreigners are currently able to retire in Indonesia without having to meet most of the above requirements that countries like Malaysia impose. That is why Indonesia is a perfect place to retire if you are a poor foreigner and want to live in the tropics.

But suggesting that retired foreigners should be allowed to benefit from BPJS is just too much. Perhaps the government should start imposing stricter financial requirements for future potential retirees. Perhaps that would prevent many of the "undesirable" foreigners from coming and settling down here.

“I am actually surprised that some who profess to care about this country and it's (sic) people would still want to try to take advantage of the health system here.”

You've “said” that before, (post #18), and that comment has already been addressed in great detail. 

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Having foreign retirees required to be in the basic national health care system isn't about “taking advantage of the health system here.”  Rather, it is all about “spreading the risk” which has been previously explained on this thread, almost ad nausea.

For certain, well financed retirees will no more take “advantage” of the national health care system here than will well paid foreign expats who are required to be enrolled in the national health care program. 

If you can accept the requirement that all foreign employees are to be enrolled, then it makes no sense to me, nor does it make any actuarial sense, that foreign retirees should not be required to participate in this program with the revisions also already discussed...keeping in mind that the retirement visa here starts at the young age of 55.   
 
**

Actually my viewpoint is different to yours and it appears to me that perhaps you are looking at it from the viewpoint of a foreigner rather than as an Indonesian? But of course you are welcome to your opinions as is everyone here.

"Actually my viewpoint is different to yours and it appears to me that perhaps you are looking at it from the viewpoint of a foreigner rather than as an Indonesian? But of course you are welcome to your opinions as is everyone here."



Not at all.

Two points:

1)    I am now an Indonesian.  My heart and soul is with this country. 

2)    My expert opinion (not a viewpoint), is based on a long professional career as an actuarial underwriter for many years specializing in large group (over a million participants) medical plans.

But again, that has already been discussed.   

Ergo, there is no need to rehash what is already present on this thread.

Hey folks, get to know your poster.  Then make up your own mind.  For me, here are just a couple of links:

My Interview with Expat.com:  https://www.expat.com/en/interview/292_roy-in-bali.html

Some of my Writings on Bali:  http://members.virtualtourist.com/m/deec0/

Sorry Ubudian but it is still just your opinion whether you sold insurance or not. But we all are entitled to an opinion. Some here seem to agree with me that retired foreigners should not be entitled to benefit from BJPS.

Now should there be changes in the system whereby retired foreigners are required to make substantial contributions then that may be worth looking into but until that happens then I believe that retired foreigners should not expect to benefit from BPJS.

@Tel
There are plenty of insurance that covers medical health and hospitalisation till 80 years old or even beyond perhaps.
Do shop around and ask the big providers. The premium is big though,  howeved it could be worth it to guard against a rainy day. The only worry is about pre existing conditions though.
They have no reasons to deny you service, if the claims are valid. The reputation is greater than the cost of the individual.
I wish all retirees the best of health, and that they may find the most suitable plans that can cover their needs in the long term.
For health is correlated to happiness, and no amount of wealth in the world can make you happy if you are not well. Be sure to cover well.

“Sorry Ubudian but it is still just your opinion whether you sold insurance or not. But we all are entitled to an opinion.”

I never stated I sold insurance Hansson…rather I clearly stated that I underwrote large group medical plans.  So please, don't twist words or put them in my mouth.  Underwriting is actuarially determining the premium using a variety of data.  And stating fact is not expressing an opinion.   

@Tel
There are plenty of insurance that covers medical health and hospitalisation till 80 years old or even beyond perhaps.
Do shop around and ask the big providers. The premium is big though,  howeved it could be worth it to guard against a rainy day. The only worry is about pre existing conditions though.
They have no reasons to deny you service, if the claims are valid. The reputation is greater than the cost of the individual.
I wish all retirees the best of health, and that they may find the most suitable plans that can cover their needs in the long term.
For health is correlated to happiness, and no amount of wealth in the world can make you happy if you are not well. Be sure to cover well.

ya I know of some of the larger companies who will insure , ie bupa but the premiums omg ! scary !
and ya the pre existing conditions rule , where the monster premiums may be invalid for your treatment under the rule .

on policy cancellation , there are a number of major companies here who have written in to their policies , the right to cancel at the end of policy year with no reason which is immoral , in my view , including mine Alianz .

so unfortunately, discounting bpjs , indonesia does not have a good solution for retirees , other asian countries who are serious about attracting retirees do , a better solution than here for sure.