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Reforming Healthcare: OJK Mandates Health Insurance Co-Payments

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Algo Research Team


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Key Summary:


  • OJK mandates co-payment for all health insurance
  • Policyholders must cover minimum 10% claim costs
  • Regulation aims to control rising healthcare expenses

The Financial Services Authority (OJK - Otoritas Jasa Keuangan) issued Surat Edaran (SEOJK) No. 7/2025 on May 19, 2025, concerning the administration of health insurance products. Under this regulation, individuals are required to pay out-of-pocket when using their private health insurance.


Context: The regulation mandates that all private health insurance products must implement a risk-sharing mechanism, where policyholders are responsible for at least 10% of the total claim amount. 


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