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BPJS Kesehatan provides surgery services eye that can be used by participants. What types of eye surgery are covered by BPJS Kesehatan?
Quoted from the page BPJS KesehatanBPJS Kesehatan regulates service guarantee procedures health for cataract surgery and medical rehabilitation.
Cataract is a degenerative disease which is the number one cause of blindness in the world. The cause of cataracts is the aging process or trauma that causes tissue changes in the eye.
The symptoms vary, ranging from blurred vision like being covered in fog, double vision, glare when looking at the light, and others.
Types of Eye Surgery Covered by BPJS
Illustration. The type of eye surgery covered by BPJS Health is cataract surgery (Safir Makki)
The type of eye surgery covered by BPJS Health is cataract surgery. BPJS Health guarantees cataract surgery services based on medical indications and in accordance with service standards.
Cataract surgery service guarantee is given to BPJS Health participants who suffer from cataracts with medical indications in the form of:
- decreased visual acuity with vision less than 6/18;
- other conditions have been found, such as phacomorphic glaucoma, phacolytic glaucoma, lens dislocation, and anisometropia;
- fundus visualization in eyes that still have visual potential is necessary, whereas cataracts make visualization difficult;
- traumatic and complicated cataracts; And
- cataracts in infants and children.
Cataract surgery services in question are carried out through the following actions:
- Small Incision Cataract Surgery (SICS)
- Extra Capsular Cataract Extraction (ECCE), or
- Intra Capsular Cataract Extraction (ICCE).
Terms and How to Manage Cataract Surgery
JKN-KIS participants can get cataract surgery services for free by following the established procedures BPJS Kesehatan the following.
1. Visit the FKTP
The first step, participants must go to the First Level Health Facility (FKTP) to have their eyes checked.
The doctor will do a thorough examination of the eye and suggest recommendations for further treatment if there are indications of a health disorder.
If you need to get treatment from an eye specialist, the doctor will provide a referral letter to the Advanced Referral Health Facility (FKRTL).
2. Check with FKRTL
After getting a referral letter, you can go to an eye specialist who is an Advanced Level Referral Health Facility (FKRTL).
At the poly or eye specialist, the doctor will decide whether an abnormality in the participant’s eye requires surgery or not.
If you need surgery, the doctor will suggest and schedule surgery, according to the terms and conditions that apply.
3. Meet the requirements of the new rules of cataract surgery
BPJS Health has issued new rules for cataract surgery coverage. Now, only a certain level of visual acuity gets service, namely visual acuity less than six eighteenths.
Cataract surgery guarantee is also carried out if there are medical indications for other conditions such as phacomorphic glaucoma, phacolytic glaucoma, lens dislocation, and anisometropia.
Other Eye Diseases
Illustration. Types of eye surgery covered by BPJS Kesehatan (Adhi Wicaksono)
In addition to cataracts, BPJS Health also covers glasses for minus and astigmatism in accordance with applicable regulations, which can be done every two years.
BPJS Kesehatan only provides financial subsidies for spherical lenses with a minimum size of 0.5 diopters and cylindrical lenses with a minimum size of 0.25 diopters.
How to claim glasses from BPJS Health
Here’s how to claim glasses at optics that work with BPJS Health:
- Visiting BPJS Kesehatan partner optics.
- Bring KTP (Identity Card).
- Bring BPJS Health Card.
- Bring a doctor’s prescription that has been legalized from the BPJS Kesehatan office.
- Purchase glasses at the optician of the BPJS Kesehatan partner and select them frames as desired.
- Waiting for the glasses to finish.
Later, the glasses you get will adjust to the ceiling of each class.
That is the type of eye surgery covered by BPJS Kesehatan. Hope it is useful!