Tag: patients

Health insurance companies do not receive from the package of money collected on the health insurance contributions the same amount for every insured. It depends on the factors of age, gender and economic category, and if the patient has some of the serious diagnosis which requires administering of expensive pharmaceuticals. The money is reallocated among health insurance companies by means of cost risk index for health care. According to health insurance company Dôvera the preciseness of estimation of the amount of the cost according to the cost risk index differs from the real cost by about 20 %. Until the last year was this estimation according to health insurance company much less precise, it was about 4 %.

Health insurance companies will return for the fourth quarter of 2012 hundreds of thousands euros for surcharges for thousands of disabled and retired patients. Policyholders will receive the money automatically to the account, so there is no need to apply for them. General Health Insurance Company will send back surcharges for pharmaceuticals to 23.517 policyholders, in amount € 448.206. Health Insurance company Dôvera will send back surcharges for pharmaceuticals to 5.886 policyholders, in total amount of 112.213 euros. Union Health Insurance Company will return to 1.500 policyholders the payments in total amount of more than € 30.600.

According to the survey by the Institute for Public Affairs and Agency Focus, cancellation of plurality health insurance system and introduction of one insurance company considered as right 41% of Slovaks and 46% wrong. Did not kwon 13% of respondents. Approval of the introduction of a unitary system of public health insurance is supported by less educated people; workers in unskilled manual professions and people older than 65. Significantly more critical are people with higher education, performing skilled professions, such as students and businessmen, and residents of big cities. With unitary system agree mainly supporters of political party Smer-SD and disagree mainly supporters of political parties SDKÚ and SaS.

Returning of surcharges for the third quarter will affect 17.689 disabled and retired patients. Health insurance companies according to protective limit on payments for drugs should return € 311.129. Policyholders will get pay automatically, it is not necessary to apply for them. General Health Insurance Company (Všeobecná zdravotná poisťovňa) will pay to 13.432 policyholders amount of € 237.588. Health Insurance Company Dôvera sent back supplements in the amount of € 58.777 to 3.407 policyholders. Union Health Insurance Company reimbursed to 850 policyholders € 14.764. The information was provided by health insurance companies.

If patient visits private doctor, who has contract with the health insurance companies, health care should be provide for free. Fee may doctor ask for priority treatment. Doctors, however, have to ask the self-governing region for approval of the fee that will be charged to the patient. Region also decides on the maximum amount of the fee, which is different per each higher territorial unit. According to the president of the Association of Private Doctors Ladislav Pasztor, the highest fee for priority treatment is in the Žilina´s region (€ 25), while in Trenčin region is it € 3.32. The doctor may ask for direct payment also for administrative procedures.

For surgery are waiting at the end of the year more patients of General Health Insurance Company than in September. And despite of a public promise that gave the director of insurance company Marcel Forai in September that insurance company will reimburse to hospitals all costs of medical care to ensure that on waiting list will be any patient by the end of this year. In September 2012, there were 6.706 policyholders on waiting list; today it is around seven thousand.

After two years old promise of former Minister of Health Ivan Uhliarik (KDH) about better monitoring of decubitis in hospitals, only present Minister of Health Zuzana Zvolenská came with the Government ordinance these days. According to daily SME, the improvement is minimal; whereas the new government ordinance only amplifies the scale of decubitis ranking and the key parameter which accounts their occurrence did not change. On the present, there are some hospitals which do not report any decubitis during all year to the health insurances companies. The better reporting should be guaranteed by new legal standards of the Ministry, which it is allegedly already working on.

From the beginning of next year the state will stop paying contribution for some of its policyholders like working pensioners, students, and women receiving the parental allowance, whom an annual assessment base 15 times exceeds the subsistence minimum, which is for next year 2 918.7 euro. State will be no longer paying health insurance contributions for those policyholders, who are working and their monthly assessment base of their employment will be higher than € 243.2. This stems from an amendment to the Health Insurance Act, which was on November 29, 2012 approved by parliament. Currently, the state pays health insurance for its policyholders even if these people have earned some income. This leads to parallel payments of health insurance contributions by working state policyholder and also by state. 

From January the payments in pharmacies may change. Pharmacies will have to withdraw the loyalty cards and programs. Instead of this, they will be able to give a discount on its margin, which ranges from twelve to fifteen per cent according to the price of the product. Surcharge for individual drug will not be able to reduce by more than half. This is proposed by Minister of Health Zuzana Zvolenska in drug reform, which parliament should approve in the coming days. Analysts and Ministry of Finance, however, worries that the new measure will have a negative impact on public finances. Health insurance companies do not like the proposal either.

Released doctors of Faculty hospital in Žilina refuse to work the evening service during the notice period, what is around a third of all services in December. Spokeswoman of the hospital claims that the hospital is able to secure fully constitutional emergency services for all departments. Ministry of Health, however, is not satisfied with the situation. According to its spokeswoman, hospital is looking for all options to ensure evening service. On such a critical situation warned the deputy head of emergency department, Jozef Trgiňa, already at the end of last week.