Household workers count as employees under Indonesian law, and that includes nannies and helpers working in a private home. The obligation to register them for BPJS falls on you as the employer, not on the worker to sort out alone. This sits alongside the other paperwork families are expected to handle when they take someone on, covered in more detail in the legal requirements for hiring a nanny or helper in Bali, including a written agreement and fair pay.
In practice, a lot of household hiring in Bali still happens informally, with pay handed over in cash and no paperwork at all. That doesn't make BPJS optional, it just means enforcement is inconsistent. If you want to do this properly, register your helper for BPJS Kesehatan and BPJS Ketenagakerjaan yourself once you've agreed on hours and pay, and build the employer contribution into your monthly budget the same way you would salary or a bonus. Putting this in writing from the start, as outlined in the Bali nanny contract legal checklist, makes it far easier to keep the arrangement fair and avoid disputes later.
BPJS Ketenagakerjaan matters because it gives your helper real protection, including cover for work injuries, something a private health plan won't touch. Some families also carry private insurance for their helper because BPJS clinics can mean long queues, but the two serve different purposes and aren't a straight swap; you can weigh the differences in public BPJS versus private international health insurance for families. Before assuming your helper has no coverage, ask directly, since some workers already hold BPJS Kesehatan through a spouse or a previous employer.
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