The Health Minister Letter No. 78/Minister of Health/Decision Letter/VI/2003 stated in 2003/2004 the Health Maintenance Organization for Poor Families (Jaminan Pemeliharaan Kesehatan bagi Keluarga Miskin/JPK-Gakin) pilot projects were done in 3 Provinces and 13 Regencies in Indonesia. The study aimed to determine patient expenditures and health services utilization by members of the JPK-Gakin. It was an evaluation study using a cross sectional design conducted in 3 Regencies of the JPK Gakin pilot projects: Rembang, Pati, and West Lombok. Each Regency, 1 (one) health center and 1 (one) District Hospital were selected. This was conducted June to July 2004. The total respondents were 315 patients composed of 127 patients from Pati, 99 patients from Rembang, and 89 patients from West Lombok Regency, respectively. Data were collected by indepth interview, questionaires and secondary data. Analysis were done descriptively. Results showed that expenses claimed for medical operation in District Hospitals highly varied between the 3 (three) Regencies. The expenses for medical operations were Rp446,385,- per patient at Pati District Hospital, Rp281,938,- per patient at Rembang District Hospital and Rp428,421,- per patient at West Lombok District Hospital, respectively. Meanwhile the average expenses on laboratory examinations were Rp 137,015,- at Pati District Hospital, Rp 109,500,- at Rembang District Hospital and Rp92, 730,- at West Lombok District Hospital, respectively. Roentgen examination were provided to 83.8% hospitalized patients, with average costs per patient were Rp63, 121,- at Pati District Hospital, Rp56,954,- at Rembang District Hospital and Rp98,445,- at West Lombok District Hospital, respectively. Drug expenses covered by the JPK-Gakmwere Rp897,329,- per patient at Pati District Hospital, only Rp221,562,- at Rembang District Hospital and Rp64,641,- at West Lombok District Hospital, respectively. For drugs purchasing for poor families at dispensary outside the Hospitals were Rp56,500,- at Pati District Hospital but Rp115,050,- at West Lombok District Hospital. The proportions of health care utilization of Health Services Organization (PPK) by poor families have not been achieved yet, only 2. 7% at Rembang District Hospital, 4.58% at Pati District Hospital and 7.62% at West Lombok District Hospital, respectively. While the Utilization standard is 10%-18% from total poor families per month. Therefore the valid period for the JPK-Gakin program should be considered, especifically to empower poor families.