General
Provision of health care for EU policyholders is completely regulated by Law No 220/2013 Z. z. amending Act No 580/2004 Coll. on Health Insurance and the Amendment amending Act No 95/2002 Coll. on Insurance and Amendment certain laws as amended and amending certain laws in force since 1.10.2013. This law has, inter alia, been transposed Directive 2011/24/EU of the European Parliament and of the Council of 9 March 2011 on the application patients' rights in cross-border healthcare (OJ L 88, 22.3.2004, p. 4.4.2011).
The law amended the following laws:
- Law 576/2004 Z. z. o. health care, health services care and amendments to certain laws, as amended Regulations (hereinafter referred to as "Law No 576/2004') OJ L 347, 20.12.2013, p. 671.
- Law No 577/2004 Z. z .o scope of health care paid to on the basis of public health insurance and payments for services related to providing healthcare and amending certain laws in as amended (hereinafter referred to as "Law No 577/2004') OJ L 347, 20.12.2013, p. 671.
- Act No. 578/2004 Coll. on Health Care Providers, Health workers, health professionals and change and the addition of certain laws as amended (hereinafter referred to as "Law No ...') 578/2004 OJ L 347, 20.12.2013, p. 671.
- Law 581/2004 Z. z. o. o. health insurance, health surveillance by caring for and amending certain laws, as amended Regulation (EC) No 581/2004 OJ L 347, 20.12.2013, p. 671.
- Act No 362/2011 Coll. on medicinal products and medical devices and on change; and supplementing certain laws, as amended (hereinafter referred to as "Law No ...') 362/2011 OJ L 347, 20.12.2013, p. 671.
In relation to implementation Regulation No 341/2013 Coll. - Ministry Decree Health of the Slovak Republic of 23 October 2013 cross-border healthcare subject to prior authorisation the health insurance undertaking concerned for the purposes of its reimbursement, which we attach to Annex. It contains a list of performances subject to prior approval the health insurance undertaking concerned.
On reimbursement for medical supplies We direct care Your attention in particular to § 9c, 9e of Law No 580/2004 Z. the text of Law No 220/2013 Coll. and § 79 §. 1 letter (o), points (zl) to (zp) and § 79b of Law No 578/2004 From 1 January to 31 December Z. z. z.
A distinction should be made between: on an EU policyholder to submit before healthcare is provided the European Health Insurance Card (EHIC), a replacement certificate; or claim document (certificate of the public health insurance policy holder with an indication EU, form E112, E123, portable document S2, S3, DA1).
These policyholders are covered by
the following European Union regulations which take precedence over our legislation:
Regulation (EC) No 883/2004 of the European Parliament and of the Council of 29 April 2004
the coordination of social security systems (External edition of EU law, Cap.
5/V5; OJ L 200, 7.6.2004) as amended.
Regulation (EC) No 987/2009 of the European Parliament and of the Council of 16 September 2009
laying down the procedure for implementing Regulation (EC) No 883/2004 on coordination
social security schemes (OJ L 284, 30.10.2009), as amended.
Such insured persons must be
the healthcare provider must not treat our policyholders from
require payment of healthcare in cash or other payment;
which does not comply with existing legislation. Such an insured person chooses
Slovak health insurance company as an institution in the place of stay or place
residence for which the healthcare provider invoices the costs for
such insured person under agreed contractual conditions.
Such an insured person may only go to healthcare providers who:
are connected to the public system, i.e. have a contract with the health insurance company.
As far as the EU policyholder is concerned, wishes to use the directive, such an insured person is shown by no evidence and may use the services of all healthcare providers regardless of whether or not they have a contract with a health insurance undertaking. Other insured person Member State of the European Union is entitled to receive cross-border healthcare care in the Slovak Republic with the healthcare provider, to which the price of such healthcare is paid directly. Provider health care in determining the price for cross-border healthcare provided care in the Slovak Republic for the insured person of another Member State of the European Union the union is governed by Law No 18/1996 of the National Council of the Slovak Republic Coll. on prices as amended. Prices to the healthcare provider care must be the same for the insured person of another Member State of the European Union; Unions as prizes to the policyholder.
Health Provider care shall be placed on an accessible basis in this regard; and visible place price list of all health performances provided Provider; the display of the price list in the Entrances, waiting rooms or other publicly accessible areas Health facilities premises and publication on the website the provider, if established.
Health Provider the care is issued to the insured person of another Member State of the European Union; the healthcare provided, which contains the date and time of the registration, method instruction, content of instruction, refusal of instruction, informed consent, refusal informed consent and withdrawal of informed consent, date and time of submission health care, if different from registration date and time, scope provided health care and services related to the provision of health care, results of other examinations, if included health care for which an alert is made, identification treating health care professional, identification of the person to whom the health care care provided, the determination of the disease, including its code, invoice with breakdown provided health services and their price and prescription the medical certificate for prescribing the medical device, if necessary.
It's for the reason you the insured person of another Member State could apply to his institution for reimbursement costs.
Against this background, National Contact Point at the Health Care Supervisory Authority which is obliged to provide information to insured persons of other Member States; and to our insured persons as well as health care providers (§ 20d Act No 581/2004 From 1 January to 31 December Z. z.). Website www.nkm.sk. Details are also provided by Decree No 232/2014 of the Ministry of Health of the Slovak Republic Z. z. governing the procedure of the healthcare provider, the health insurance undertaking and the Health Care Supervisory Authority, the provision of cross-border healthcare.
To further clarify:
Procedure under EU Regulations 883/2004 and 987/2009 on coordination social security schemes:
1. If the EU insured person is established healthcare provider in Slovakia, which is connected to the public the system, the European Health Insurance Card, the so-called EHIC, the CPC provider in Slovakia connected to the public system bills healthcare costs Slovak health insurance company, which as an institution in the place of stay the EU insured person has chosen. Slovak health insurance company will then refund the amount via the Health Care Supervisory Authority, which is the liaison in Slovakia an EU health insurance authority where the person is insured. EU policyholder draws so-called necessary health care or urgent health care; and pay only the fees paid by the insured person in Slovakia. Under EU regulations, the insured person is cured to the extent that he can go to his own country. Health care needed in relation to the insured person is a health care care required by the insured person's state of health and must be provided with Given the nature of the healthcare and the expected duration of the insured person's stay EU in Slovakia so that it does not have to return to its country due to the necessary treatment The EU was earlier than it originally intended. The extent of health care needed determines treating physician. The insured person deals with the transport himself.
2. If the EU insured person is established in Slovakia Form E106 or portable document S1 issued to him by his health EU insurance company for the purposes of residence in Slovakia with a provider of CPC which is connected to public system, Slovak health insurance company will issue a card to the insured person health insurance with an EU designation and such insured person on grounds of residence in Slovakia is entitled to full health care as insured persons of the Slovak Republic and pays only such fees paid by the insured person in Slovakia. Invoicing is the same as in the first case. The insured person deals with the transport himself.
3. If the insured person of the EU is established in Slovakia SR form E112 or portable document S2 issued to him by his health EU insurance company for planned healthcare purposes in Slovakia (may also be palliative care) with the CPC provider, which is connected to the public the scheme, such an insured person is entitled to the precisely specified CPC in the forms; and pay only the fees paid by the insured person in Slovakia. Invoicing takes place equally as in the first case. The insured person deals with the transport himself, but he can provide it The health insurance company in the EU, too, depends on the legislation of the EU country.
4. If the EU insured person fails to prove no proof referred to in the first to third points and it is the necessary CPC or an urgent CPC or a constitutional CPC which is urgent, may under regulations EU to request a CPC provider connected to a public system, relative Embassy, Health Care Supervisory Authority an EU insurance undertaking for the issue of a replacement certificate to the European ZP card; and the procedure is the same as at the first point.
In these first four points it is always important that it is about the CPC provider which is connected to the public system, i.e. has a contract with Slovak health insurance company.
Directive 24/2011 procedure
5. There may be other situations, the Directive on patients' rights in cross-border health care according to which insured persons can travel for the provision of health care anywhere in other Member States and depending on the specific country how the Directive approximated, i.e. whether it established any performances subject to prior approval or not (SR provided for performance in Decree No 341/2013 Z. z.) and can be treated with any CPC provider regardless of whether is connected to a public system or not. In such a case, the insured persons themselves have to pay the doctor for health care, together with documentation; and precisely specified documents request reimbursement of their costs the health insurance company. Transport is handled by the insured person himself. The insured person of another Member State State of the European Union is entitled to cross-border healthcare care in the Slovak Republic with the healthcare provider, to which the price of such healthcare is paid directly. Provider health care in determining the price for cross-border healthcare provided care in the Slovak Republic for the insured person of another Member State of the European Union the union is governed by Law No 18/1996 of the National Council of the Slovak Republic Coll. on prices as amended. Prices to the healthcare provider care must be the same for the insured person of another Member State of the European Union; Unions as prizes to the policyholder. The healthcare provider shall issue to the insured person of another Member State of the European Union a report on the health care containing the date and time of the registration, the method of instruction, the content Information, refusal of information, informed consent, refusal of information consent and withdrawal of informed consent, date and time of medical provision care, if different from the date and time of the registration, the extent granted health care and health services care, results of other examinations if they are part of the healthcare provided care for which registration is being carried out, identification of the caregiver health care professional, identification of the person to whom the health care provided, the determination of the disease, including its code, invoice with breakdown provided health services and their price and prescription the medical certificate for prescribing the medical device, if necessary. If the insured person of another Member State of the European Union is established with the provider medical treatment by medical prescription or by a medical voucher has been issued in another Member State of the European Union and has not been proved a licence or a replacement certificate, a person authorised to issue medicinal products, medical devices or dietetic foods give him a medicine, a medical aid or dietetic food for full payment.
6. Details of the Order Ministry of Health No 232/2014 Regulation (EU) No 182/2011 of the European Parliament and of the Council of 16 February 2011 laying down the rules and general principles concerning mechanisms for control by Member States of the Commission's exercise of implementing powers (OJ L 55, 28.2.2011, p. 13). health care provider, health insurance undertaking and supervisory authority over healthcare in the provision of cross-border healthcare care.