Tag: health insurance companies

Union Health Insurance Company started on Wednesday according to the amendment to the act on health insurance companies to pay the overpayments for pharmaceuticals. The claim for overpayments for pharmaceuticals for first quarter of this year accrued for 2 848 policyholders in total amount of € 62 866. This is money that pensioners and disabled people paid in first quarter of this year for pharmaceuticals over the limit. The limit includes all pharmaceuticals, which are partially covered by health insurance company.

Health insurance companies have to submit by June 30th to Ministry of Health the annual data on consumption of categorized pharmaceuticals for each policyholder for previous 3 years. Health insurance companies will submit to Ministry of Health by the end of June in electronic form also the data on annual costs of health insurance company on the health care for each policyholder for previous 2 years. This results from the announcement of the Ministry of Health, which provides the data interfaces for transmission of information.

Private health insurance company Dôvera considers as unrealistic to introduce new way of reallocation of premium, so called PCG, into the practise as fast, as is proposed in the amendment to the act on health insurance. Money from new reallocation should according to Dôvera come to insurance companies in October. Dôvera pointed out, that given by the experiences from abroad it is unrealistic to handle correct and in time introduction of PCG into practise in Slovakia in one month. Efforts to immediate obtaining of resources in health care department should according to Dôvera not go at the expense of quality of forthcoming legislation.

Health insurance companies will pay hospitals according to the new payment mechanism, DRG system, not sooner than in 2014. From January next year only the reporting and collection of data in hospital will be launched. Currently many of this data are still not available. For this reason the DRG system will be launched from January 1st, 2013 on the level of consistent data collection, which are necessary for the DRG system and which are today not recognized by the system. Payments according to new system may start at the earliest in 2014. 

Health insurance companies last year paid the part or most of the costs related to the spa treatment to about 60 000 patients. Private insurance companies Dôvera and Union say that number of their policyholders treated in spa is increasing. General Health Insurance Company (Všeobecná zdravotná poisťovňa) last year recorded a little less such policyholders than it was in 2010, increased was only the number of children. In 2011 the policyholders of General Health Insurance Company was treated in 27 nature spa and 2 sanatoriums. Union has concluded the contracts with 26 spa institutions, Dôvera with all spa facilities operating in Slovakia. 

Representatives of the Association of Hospitals in Slovakia solved with private health insurance companies the conditions of their contracts from June. Dôvera allegedly expressed the willingness to meet halfway all the contract partners of the association with the aim to ensure the health care for its policyholders. Spokeswoman of Union Health Insurance Company, Judita Smatanová, promised that if € 50 million reserve from state budget will be used for increasing of the payments for state policyholders, Union is ready to transform this money into the contracts with health care providers. 

Checks in hospitals and outpatient clinics are bringing their results. State General Health Insurance Company (VšZP) thanks to them last year saved more than € 203 million. This amount represents 6.5% from total amount, which this insurance company paid to health care providers in 2011. Compared to previous year the controlling activities brought the largest insurance company 20% greater savings. The assessment is based on the control of fulfilling of applicable laws and standards, contract conditions and correct diagnosis and treatment.

According to Healthcare Surveillance Authority for now nearly 87.000 people expressed their interest to change the health insurance company from next year. Last year 162.399 applications for the change of heatlh insurance company were submitted, while Authority did not accept 5.068 of them due to varrious mistakes. From January 1st, 2012 thus 157.331 policyholders changed the health insurance company. Most applications last year were submitted to health insurance company Dôvera, followed by health insurance company Union and the least it was in Všeobecná zdravotná poisťovňa (General Health Insurance Company).

Insurance premium will be probably redistributed among health insurance companies according to the new rules, including PCG predictor. The measure, which should bring more money for state General Health Insurance Company (Všeobecná zdravotná poisťovňa, VšZP), was approved for the second reading by 98 votes of members of Parliament. The change of redistribution could bring as much as € 30 million annualy for the state owned health insurance company VšZP. Private insurance company Dôvera would, however, lose almost € 22 million and private Union Health Insurance Company will lose almost € 9 million. If approved, legal standard should enter into force in July this year.

Health insurance companies gave last year for their operation less money than in 2010. Všeobecná zdravotná poisťovňa (General Health Insurance Company) spent on its operation almost € 66 million by the number of policyholders about 3.4 million, what is a € 11 million less than year before. Dôvera had 1.4 milion of clients and for its operation needed € 31 million. Costs increased in Union Health Insurance Company, which spent more than € 10 million. With the number of 400 000 policyholders this insurance company is the smallest one.