Healthcare

Translated information from the web site of national health insurance institute

I am health-insured. I have the right to:

  • accesible and quality health care;
  • information about my heath status and the methods of my medical treatment;
  • first outhospital aid;
  • special outhospital medical aid;
  • medical diagnosis tests;
  • highly specialized medical treatments;
  • hospital treatments;
  • medication for home treatments;
  • opinion from more than one doctor, about the diagnosis and the treatment of my disease;
  • denial of treatment (at my own wish).

Everything that I’ve said to the doctor is confidential.

If I’m not satisfied by the quality of the medical and dental care, provided to me by a contracted partner of NZOK/RZOK, I can send letter to the director of the Regional Health Insurance Institute (depending of the region) or directly to the director of the National Health Insurance Institute ( NZOK ). In case of illegal taking of amount of money, then a copy of the financial document made by the hospital is needed. The controlling institutions will make the necessary checks to establish the facts and I will receive a written response.

As a patient I have the right of informed consent:

At the time of receiving treatment the doctor (or dentist) will give me suitable information about treatment options. In the case of children the parent has the right of informed consent. In cases where the treatment is refused by the parent and the life of the patient is in danger, the director of the hospital can make decisions about life saving treatment on his own.

Every medical or dental activity, connected with my treatment is done only after receiving my informed consent.

The doctor or dentist responsible for my treatment has to inform me of:

  • the diagnosis and the character of my illness;
  • the purposes, methods and efficacy of the treatment ,the expected results and the prognosis;
  • the risks, connected to any treatment offered, including side effects and possible unwanted medicine reactions, pain and other discomforts;
  • the possibility of good effect or risks to health when other methods of treatment are used;
  • the increased risk for to life and health in the case of surgical operations, anesthesia and in other cases of complicated medical operations. (In these cases, the informed consent has to be given in written form).

I choose my GP on my own.

From him (her), I take my personal health insurance document.

When I have a health problem and need consultation, medical tests, home or hospital treatment and for the prescription of medicines I will first visit my GP.

If I’m away from my home area for a period of less than one month and I need medical care, I can visit any GP in the area. I will need only to give to him my personal health insurance document.

If I’m away from my home area for a period of one to five months, I have to make a temporary choice of GP. For that purpose I have to buy from the regional health insurance institute or from a specialised bookstore for medical documentation a registration form for temporary choice. The form has to be filled by the doctor that will take care of my health for the period of my living away from home. When the period expires, my constant choice of GP is automatically restored.

If I’m not satisfied by my GP or I’m going to live somewhere else I have the right to choose a new GP. This happens twice per year – from 1 to 30 June and from 1 to 31 December. For the change I need a special form which I have to buy from the regional health insurance institution or from a specialised bookstore for medical documentation. With that form I have to go to the new GP and to fill my and his personal information. I have to give him a personal health insurance document or the third copy of the registration form, if I don’t have one. It is not needed to inform the old GP of the change.

I have a health problem.

I visit my GP. He makes an examination and decides what treatment is necessary. In the GP’s room is exhibited information about which groups of people receive free medical or dental care. If I am not from one of these groups I pay a charge which is 1 per cent of the minimal salary for the country = 1.60 lv. at the moment.

If medical tests or research are needed.

My GP gives me order for medical-diagnosis tests in a laboratory. This order can be used in 30 day period after it’s issued. In the laboratory I pay a charge of 2 leva for taking a biological material procedure, no matter how many tests are needed.

I need a consultation with a doctor-specialist.

My GP gives me an order with direction to a doctor specialist with needed qualification. That order can be used in 30 day period after it’s issued. The doctor-specialist makes a medical inspection and if I need more medical tests, gives me order for them. He decides what treatment is needed. In period of 30 days, he can give an order for additional medical inspections in dependence of my health status. For every visit to the doctor, I pay 1.50 lv charge.

I need to care of my health at home.

The responsible for the treatment doctor, decides the treatment type and gives me hospital list, which allows me to stay at home (and frees me from work), but for not more than 7 days and all 40 days in the year.

For my home treatment are needed medicines.

The doctor informs me which medicines are paid partially or fully from the National Health Insurance Institute. He decides which medicines can be used for the treatment and writes them on a blank sheet of NZOK and I can obtain them from a pharmacy which have contract with NZOK. If the NZOK does not cover the full price of the medicines I pay the needed additional sum. If the medicines for my treatment are not covered at all from NZOK, the doctor just writes them on normal prescription sheet and I can by them from every normal pharmacy. For treatment of sharp diseases, the doctor prescript medicines for not more than 10 days and compulsory write the period of validation of the prescription.

I have a chronic disease.

My GP informs me, if It’s needed to be hospitalised under his care, or it is needed to be included for hospital observation to a doctor – specialist. Anyway the doctor who cares for me informs me what and how many medical examinations and consultations have to be made. He follows the history of the chronic disease.

For the treatment of my chronic disease are needed medicines. It is needed to buy from bookstore for medical documentation, a prescription book of the chronic diseased, in which the GP write his and my personal data and my chronic diseases. I have to certify the prescription book in the regional health care institution or in the RHCI office for the region. In the prescription book, my GP or the doctor – specialist writes the medicines and the medical resources needed for my treatment. Every month, the doctor that observing my chronic disease, write out the needed medicines on prescription-blank of National Health Care Institute and fill it in the prescription book. With the prescription book and the prescription blank I can take my medicines from a chemistry which has a contract with National Health Care Institute. If it’s paid only partly from the NHCI, I pay the additional sum. The prescription for the medicines for my chronic disease has a period of validation 30 days. The exception of this are only the medicines that content addicts – the period of validation is no more than 7 days from the date of writing of the prescription. It is needed on time to present my prescription book for certification in the Regional Health Care Institute. I have additionally to fill a declaration that I am health insured.

For my treatment are needed expensive medicines, prescribed by protocols IA or IB.

The Doctor–specialist who observes my medical condition inform me what documents I have to present to the Regional Health Care Institute, to have the right to expensive medicine treatment. The doctor makes and fills the needed blank protocol from the National Health Care institute. I present the documents with an ?application for the needed medicines to the director of the Regional Health Care Institute. I have to present the declaration that I’m health insured.

With the prescription book, the prescription-blank and the copy of the protocol I can take the medicine from a chemist which has a contract with National Health Care Institute. If it is paid only partly from NHCI, I pay the additional sum.

I’m taking expensive medicines from protocol IA for some disease, it’s not allowed to be prescribed other medicine for the same disease from the medical list of NHCI.

I need a dentist treatment.

I can visit any dentist, who has a contract with NHCI. In a clearly visible place in his treatment room I can see a list of medical services that are fully or partly covered from NHCI. I have to present to the dentist my personal health insurance document in which he fills what treatments covered by NHCI, he’s provided. If they are not fully covered by the NHCI I pay the additional sum. For every visit to a dentist I pay a tax of 1.50 lv.

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