No Need to Pay Expensively, Dental Scaling Can Be Covered by BPJS Kesehatan
Taking care of dental and oral health, including cleaning dental calculus, is something that everyone should routinely do. However, this is often neglected due to perceived high costs. In fact, dental and oral care, including scaling, is a medical service covered by the government. So, how can one claim this coverage?
Scaling is a non-surgical dental treatment using an ultrasonic scaler to remove plaque and tartar. This treatment aims to reduce the risk of toothache, bad breath, and prevent oral and gum diseases. Concerning the cost, scaling treatment can indeed be expensive. However, the public can receive scaling treatment for free through BPJS Kesehatan (the Indonesian Health Insurance Program).
Key Point
- BPJS Kesehatan provides coverage for scaling treatments strictly based on medical necessity, excluding aesthetic purposes. This policy is also detailed in the National Health Insurance-Healthy Indonesia Card (JKN-KIS) service guidelines established by BPJS Kesehatan
- Regarding expenses, scaling treatments can be costly. Nevertheless, individuals can obtain scaling treatment at no charge through BPJS Kesehatan
Courtesy Source: www.cnbcindonesia.com/lifestyle/20240718085237-33-555595/tak-perlu-bayar-mahal-scaling-gigi-bisa-pakai-bpjs-kesehatan
Requirements for scaling with BPJS Kesehatan:
It's important to note that scaling is only free under BPJS Kesehatan if there is a medical indication, not for aesthetic reasons.
"Scaling for acute gingivitis (gum inflammation) can be covered by BPJS Kesehatan with coverage every two years," BPJS Kesehatan stated through its official Twitter account (@BPJSKesehatanRI), as quoted on Thursday (July 18, 2024).
"Examinations can be conducted at registered Primary Health Facilities (FKTP) based on medical indications and not at the patient's request," BPJS Kesehatan continued.
According to this statement, BPJS Kesehatan only covers scaling treatment based on medical indications, not for aesthetic reasons. This is also outlined in the National Health Insurance-Kartu Indonesia Sehat (JKN-KIS) service guidelines by BPJS Kesehatan.
"Health services for aesthetic purposes are not covered by JKN-KIS," BPJS Kesehatan wrote.
Procedure for scaling with BPJS Kesehatan:
- BPJS Kesehatan participants visit the first-level health facility (Puskesmas or clinic). At the first-level facility, participants or patients with BPJS Kesehatan need to complete administrative procedures by presenting their active BPJS Kesehatan card.
- A dentist will conduct an examination. If there is a medical indication that requires the patient to receive dental calculus cleaning services, scaling can be performed free of charge at the first-level health facility.
- If there are more serious medical indications that require referral to an advanced health facility, BPJS Kesehatan participants must obtain a doctor's referral from the first-level health facility first. The referral letter will be used for treatment at the referral hospital, particularly with a specialist or sub-specialist dentist.
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