|
 |
 |
 |
 |
 сряда, 08 септември 2010 |
HEALTH INSURANCE
What is the rate of the health insurance?
The rate of the health insurance is determined every year with the law of the budget of the National Health Insurance Service. For 2007 the rate is 6 % of the insurance income. In this instance income is not only salary but all income according to the tax declaration of the insured person.
Where is the health insurance paid in?
The health insurance contributions are paid in at the relevant territorial division of the National Revenue Agency. Contributions are paid in till 10th of the next month to the period they refer to. Contributions are paid via bank transfer or via postal order. The relevant bank accounts can be found on the following Internet address:
http://www.nap.bg/ospage?id=21
How can I verify if I am health insured?
You can check your health insurance status in the internet at the following address:
http://healthinsurance.nssi.bg/report_healthhtm_1_15_out.asp, you will need to type in your personal ID number.
What is the minimum health insurance contribution?
The minimum level of the health contribution is determined every year with law of the budget of the National Health Insurance Service. For 2007 the minimum level for the self – insured is 6 % of the minimal insurance income. The minimal insurance income (MII) is determined every year with the law of the budget of the state public insurance. For 2007 the level of MII is 220 leva.
What is the maximum level of the health insurance?
The maximum level of the insurance income is determined with the budget of the state public insurance. For 2007 the maximum monthly level of the insurance income is 1 400 leva.
What proportion of the health insurance is being paid by the employer and what proportion is being paid by the employee?
For 2007 the payment of the health insurance for the employed persons is split between the employer and the employee in proportion 65:35. For 2008 it is envisioned the proportion to be 60:40.
How are the children insured?
All children till they reach the age of 18 or till they finish high school are insured at the expense of the state budget. At the expense of the state budget full-time students till the age of 26 are also insured.
How are pensioners being insured?
All pensioners regardless of the grounds for their retirement are insured at the expense of the state budget.
Should I pay health insurance if I am a working pensioner?
Yes. You have to pay 6% of the extra income that you receive in the proportion employer-employee mentioned above.
How should I insure myself if I am unemployed?
You will be insured at the expense of the ‘Unemployment’ Fund only during the time that you receive unemployment benefits. In all other instances registration at the job center does not release you form your obligation to pay health insurance.
How are agricultural producers insured?
The minimum monthly level of the insurance income for persons who are registered as agricultural producers or as tobacco producers is determined by the law of the budget of the state public insurance. For 2007 the minimum level is 110 leva. For persons who are registered as agricultural producers or as tobacco producers and that is their only occupation the minimum monthly level of the insurance income is 55 leva. The contributions due are calculated as 6 % of the relevant minimum insurance income.
How should I insure myself I receive social welfare benefits?
Persons that receive social welfare benefits are insured at the expense of the state budget.
Should I insure myself if I receive energy benefits?
No. Persons that receive targeted support for heating expenses are insured at the expense of the state budget.
Can I be insured at the expense of the state budget if I am a post-graduate student?
No. Full-time doctor's degree students by state order are being insured at the expense of the state budget but post-graduate students are not.
Can I insure myself at the National Health Insurance Service if I am temporary staying in the country?
You are not subject to obligatory insurance if you are temporary staying in the country. All persons that have received permission to stay in the country permanently are subject to obligatory health insurance.
Am I subject to obligatory health insurance if I have on income whatsoever?
The lack of income is certified by a survey by the relevant district social welfare service If the survey determines that you meet the requirements for social welfare support or for energy benefits then your health insurance is paid at the expense of the state budget.
Can I insure members of my family?
You can insure members of your family. For that purpose you have to fill in a declaration in a form approved by the NRA and NHIS. A sample declaration you can obtain at the following internet address:
http://www.nap.bg/ospage?id=21
Do I have to insure myself if I live and work abroad?
After 31.12.2005 if you are a Bulgarian citizen and you live and work abroad you are exempt from paying health insurance contributions. For that purpose every year you have to submit to NRA a declaration for the period that you shall be absent from the country (if the period is over 183 days in one calendar year). A sample of the declaration you can obtain at the Internet address: http://www.nap.bg/ospage?id=21
Do I have to insure myself if I am a student abroad?
If you are a full time student your health insurance contributions are at the expense of the state budget till you reach the age of 26. To certify that you have to submit a legalized translation of the relevant academic records for each semester in front of territorial division of NRA according to your permanent address.
What percentage of permanent inability to work should I obtain in order to be insured at the expense of the state budget?
In all instances when the expert decision gives you the right to an invalid pension due to general illness or social pension for invalidity.
How can I buy a health insurance booklet?
The health insurance booklet is given by the chosen general practitioner. If you lose you health insurance booklet you have to submit a written request to the director of the District Health Insurance Service where you shall pay to receive a new one.
Where can I receive a prescription booklet?
A prescription booklet can be bought from a bookshop for medical documentation. The prescription booklet is used only by persons ill with diseases determined in a list by the NHIS. The prescription booklet is filled in by the general practitioner and is verified by the relevant DHIS.
EMERGENCY HEALTHCARE
In what instances can I call emergency healthcare?
In all instances of ill health that does not allow you seek medical help by yourself. We recommend that you contact your GP by telephone to receive consultation because he or she knows your condition best and knows the possible risks.
Can I be refused emergency healthcare if I have no health insurance?
Emergency healthcare cannot be refused regardless of your health insurance status.
Do I have to pay to the emergency healthcare team?
Emergency healthcare is financed by the state budget and is absolutely free of charge to the persons that seek it.
Can I go to emergency service without a medical referral?
Yes. To receive emergency help it is not necessary to present a medical referral or any other document.
In what time should the emergency team arrive after being called?
It depends on your location. According to the Rules for the structure and work of emergency healthcare centers the call should be forwarded to the nearest team within one minute of your call.
If the emergency team refers me to hospital treatment can I choose which hospital to go to?
No. You will be transported to the nearest hospital where you shall receive treatment according to your illness.
Can I receive medication at a discount if prescribed by a doctor at an emergency center?
No. Medicines that are fully or partially paid by NHIS can only be prescribed by doctors that have signed contracts with NHIS for carrying out outpatient healthcare assistance.
OUTPATIENT HEALTHCARE
How can I choose a general practitioner doctor?
You can contact the district health insurance service where you can obtain a list of GPs that have signed contracts with the NHIS..
Can I change my GP?
Yes. Twice a year within the periods 01.12-31.12 and 01.06-30.06 you can change your general practitioner. For that purpose it is necessary to visit your newly - chosen doctor and you should carry your health insurance booklet. It is not necessary to have your name struck off from the current doctor’s list.
Can my GP prescribe me medicine at a discount?
Yes. Besides for certain chronic diseases you will be able to receive a prescription booklet of the chronically – ill.
How many medical referrals for specialist consultation and tests have I got the right to?
Referrals for consultation are limited by Regulative Standards determined by the NHIS. For every quarter of the year GPs receive a limit according to the number of persons on the patients’ list. There is a complicated mechanism for regulation of the issued referrals. In general if the doctor exceeds the limit he or she will be sanctioned for that. Therefore even though you have the right to referrals for consultation and tests you might not receive them when you need them because the limit of your GP has been depleted. An outpatient specialist can also issue referrals for consultation and tests but their number is limited, too.
How can I get a preventive medical examination?
The package of services provided by the GPs includes one preventive examination for every patient with health insurance per year.
Can I receive consultation from my GP by telephone?
Yes. The general practitioner is obliged to provide a telephone for contact.
Can I contact my GP outside his/her working hours?
Yes. The general practitioner is obliged to provide 24-hour emergency healthcare to his/her patients. In this case it is possible that emergency healthcare be provided by other doctors that have signed a contract with your GP for certain periods of the day and night. Information about that you can receive from your GP or from the District Health Insurance Service.
Can I be visited by a doctor at home and in what instances?
Yes. The schedule of the general practitioner includes hours for home visits. You can be visited at home if your condition does not allow you to visit the doctor yourself.
Who should vaccinate my children?
The package of services provided by the GP includes also vaccination of his/her patients.
Can I go to a specialist doctor without referral?
You can consult a specialist doctor without referral but in that case you have to pay the consultation at a price determined by the specialist doctor.
Do I have to pay a consumer fee when I visit the doctor to get a prescription?
According to the National Framework Agreement the prescription is dispensed after a check up of the patient. Therefore the visit to get a prescription is classified as an ambulatory examination and the consumer fee is due except in cases when the patient is exempt from such a fee.
Which persons are exempt from a consumer fee?
Exempt form a consumer fee are: underage persons, unemployed persons registered at a job center, military personnel, people that have suffered in defending the country, veterans from the wars, war invalids, people under arrest, people detained under article 63 of Law on Ministry of internal affairs or imprisoned; people on social welfare support who receive benefits under the Rules for application of the Law on social welfare; people without income in juvenile homes, in social homes, homes for children in pre-school age; people with chronic diseases form a list determined in Appendix 14 of NFC; medical specialists ; cancer patients; people with high level of inability to work; pregnant women and women up to 45 days after having given birth.
What is the sum of the consumer fee?
Patients pay 1 % of the minimal monthly salary for every visit to a doctor or to a dentist. For hospital treatment patients pay a consumer fee that is 2% of the minimal monthly salary for every day of the stay in hospital but for not more than 10 days in one calendar year. The minimal salary for 2007 is 180 leva.
Should I receive a document for paying the consumer fee?
You have got the right to ask that you receive a document for the payment of the consumer fee according to the relevant tax laws.
Have I got the right to more consultations if I am chronically ill?
For certain disease determined by the NHIS you can be registered with a specialist doctor. This registration gives you with right to a number of visits to the specialist doctor without a referral from your general practitioner.
Can I choose the specialist doctor who shall carry out the consultation?
Yes. The referral for consultation that you receive does not contain a name of a doctor who you should consult. It is the right of the patient to choose the specialist doctor for consultation. The referral is valid for one month.
Can I choose the laboratory where to carry out tests?
Yes. What has been said about the consultations with a specialist doctor is also valid for the laboratory tests. When the tests involve taking biological material (blood, urine and other) the patient pays for taking the material nut not more than 2 leva regardless of the number of tested parameters.
How can I choose a dentist?
You can contact every doctor of dental medicine (dentist) who has signed a contract with DHIS. In front of the office of your chosen dental doctor there must be a pricelist of the dentist’s services and the sum of the patient’s payment depending on the type of procedure. You have to carry with you your health insurance health booklet in order to use the services paid by the NHIS.
Do I have to pay extra for dental healthcare?
Yes, to the extent determined by the NHIS for every dental procedure.
Do children have the right to free dental care?
Yes. Children with mental problems and children deprived of parent care do not pay extra for dental care. All other children have got the right to one filling with amalgam or chemical composite and one extraction of milk and permanent tooth per year.
Do I have to pay a consumer fee at the dentist’s?
Yes.
Do I have the right to a discount for medicines for home treatment?
Yes. By a list of medicines determined by the NHIS. Besides the list of medicines there programs for free treatment of certain groups of diseases for which there are provisions for special method of dispensing.
Who can refer me for certification at a LEDC(TELK)?
Every doctor form hospital or outpatient healthcare as well as the doctors’ consultative committees.
How many days of sick leave can I receive from one doctor?
You can receive up to 7 days at a time and not more than 40 days per year. Doctors’ consultative committees can issue sick leave documents for up to six months. If it is necessary to receive sick leave for a longer period that can be done by certification by LEDC(TELK).
Do I have to pay extra to receive sick leave documents?
No, you do not.
HOSPITAL HEALTHCARE
How can I be admitted to a hospital?
You can be admitted to a hospital by referral for hospitalization form a GP, from a specialist doctor from outpatient care, after referral from emergency care or after being admitted to a emergency ward at the hospital.
Have I got the right to choose a hospital where I shall receive treatment?
Yes. You can exercise you right to choose and you can receive treatment at any hospital in the country.
Can I be refused hospital healthcare if I have no health insurance?
You cannot be refused hospital healthcare but if you are not insured you have to pay for your treatment.
Can I choose a doctor at the hospital?
You have the right to choose your doctor but in most cases you will have to pay extra for that.
Have I got the right to choose a room at the hospital?
You can choose a room but in most cases you will have to pay extra for that.
Do I have to pay for medicines and tests while I am staying at the hospital?
No, you do not have to pay for anything except the consumer fee.
Do I have to pay consumer fees for my hospital stay?
Yes. As described above.
Do I have the right to a second opinion?
You have got the right to a second opinion.
Do I have the right to be visited while in hospital?
Yes, under the conditions and rules determined by the Rules of Internal Order of the hospital.
Do I have to be informed about my illness and the methods of treatment.
The Law on Health gives you the right of informed consent. Your doctor is obliged to inform you of the nature of your illness and the possible methods of treatment as well as the possible risks. It is necessary that you give your consent in writing for the whole treatment.
Can I be treated without my consent?
Treatment without the patient’s consent can be carried out only cases strictly defined by the Law on Health.
Can I leave the hospital by my will?
You can leave the hospital by your free will at any time during your stay when you sign a document for that except in cases of mandatory treatment determined by law.
Do I have the right to a companion during my treatment?
Underage patients and patients that cannot take care of themselves have the right to a companion. In all other cases you can get the right to a companion after extra payment.
What documents should I receive when leaving the hospital?
Upon leaving the hospital you have to receive your medical history. You have the right to receive also all results from image tests as well as a prescription with prescribed medicines for further treatment.
Can I receive a copy of all my medical documentation for my hospital stay?
Yes, at an extra cost for making the copies.
Can I be discharged from hospital against my will?
The time of discharge from the hospital is at the doctors’ discretion or is decided by the Head of the ward (clinic).
How many times a year can I be treated in hospital?
There is no limit to the number of hospitalizations. NHIS does not pay for one and the same diagnosis within one month.
Do I have to pay extra if I stay at a private hospital?
If the hospital has got a contract with NHIS you do not have to pay nothing more than if staying at a state or local hospital.
Can I be operated abroad at the NHIS’s expense?
Yes you can, after a permission from the NHIS for diseases or methods of treatment that are not practiced in our country.
MISCELLANEOUS
To whom can I complain if I am not satisfied with a medical service?
You can file a complaint to the Local Center of Healthcare, to the Local Health Insurance Service or to the Regional Ethics Committee of the Bulgarian Doctors’ Union.
In what cases should the company have a contract with labour medical service?
In all case when the number of employees is more than 5.
What medicines can I buy from the pharmacies without prescription?
When receiving its permission for use every medication is determined to be dispensed only by doctor’s prescription or without prescription. The Ministry of Health issues a bulletin with the marginal prices of all medicines dispensed without prescription.
|
|
|
 |
 |
 |
 |
|
| |
Patients rights 
Home | News | Lawsuits | Patients rights | Services | Contacts | 
