Indonesia's Health Insurance Sector Shows Strong Growth

Significant Premium Increase

Indonesia's health insurance premiums have shown remarkable growth, rising 17.23% year-on-year to Rp30.84 trillion by November 2025. This growth represents a significant contribution of 18.82% to the total life insurance premiums in the country. The Financial Services Authority (OJK) has expressed optimism about the continued growth of health insurance products in 2026, driven by increasing public awareness of health risk protection.

Regulatory Enhancements

To support the sustainable growth of the health insurance sector, OJK has introduced new regulations through POJK Nomor 36/2025. This regulation, effective three months after its promulgation on December 22, 2025, aims to strengthen the health insurance ecosystem. Key features of the new regulation include:

1. Mandatory basic health insurance products without risk-sharing features
2. Optional products with risk-sharing features like co-payment and deductible
3. Enhanced risk management and governance practices
4. Strengthened consumer protection measures

Key Provisions and Implications

The new regulation emphasizes three main pillars:

1. Strengthening roles and responsibilities across the health insurance ecosystem
2. Prudent risk management practices including utilization reviews
3. Enhanced consumer protection through clearer product structures and claim management

These measures are designed to ensure the sustainability and health of the insurance market while protecting policyholders' interests. The regulation sets specific guidelines for risk-sharing mechanisms, including co-payment limits of 5% with maximum caps (Rp300,000 for outpatient and Rp3,000,000 for inpatient care).