Начало » Актуално » Съобщения

INFORMATION ABOUT THE RULES GOVERNING BULGARIAN CITIZENS' ACCESS TO MEDICAL ASSISTANCE

INFORMATION ABOUT THE RULES GOVERNING BULGARIAN CITIZENS' ACCESS TO MEDICAL ASSISTANCE

 

IN A MEDICAL EMERGENCY

 

If you find yourself in a situation where you need emergency medical assistance, please dial the toll-free number 150 or the single EU emergency line 112. You can call 112 for all sorts of accidents and emergencies. You can reach this number even if you have no credit on your phone or you are outside the coverage of your mobile network.

The Republic of Bulgaria provides emergency care to everyone on the country's territory regardless of their nationality, location or health insurance status.

You should know that emergency medical care is provided in case of conditions creating a risk of:

1. death;

2. grave or irreversible morphological and functional impairment of vital organs and systems;

3. complications with pregnant women endangering the life of the mother or fetus.

If you find yourself in such a situation, in addition to dialing 150 or 112, you can also seek assistance in the nearest Emergency Healthcare Services Centre or another healthcare establishment. There, you will be given emergency assistance and if your condition so requires, you will be transported in a specialized medical vehicle to a properly equipped hospital.

 

WHERE MEDICAL ASSISTANCE IS NEEDED FOR DISEASES AND CONDITIONS WHICH ARE NOT A MEDICAL EMERGENCY:

If you are a Bulgarian citizen holding valid health insurance, you should know that:

Any health-insured Bulgarian citizen is entitled to:

• accessible and high-quality health care;

• information about his/her health condition and methods of treatment;
• primary outpatient healthcare;

• specialised outpatient healthcare;

• medical diagnostic tests;

• highly specialized medical activities;

• dental healthcare;

• hospital healthcare;

• medicines for treatment at home;

As a patient, you are entitled to provide informed consent:

Every medical and dental activity related to your treatment may only be performed in case you have provided your informed consent. Informed consent implies that you have been provided with medical information in an appropriate form and volume to give you options for choice of treatment. To receive informed consent, the attending physician (dentist) informs the patient or, where necessary, his/her parent, guardian or custodian, about:

the diagnosis and the nature of the illness

       the purpose, method and different options of treatment, expected outcomes and prognosis;

       risks related to the proposed treatment, including side effects, pain and other discomfort;

       the likelihood of favourable outcomes or the health risks if other methods of treatment are preferred, as well as if treatment is refused.

       the increased risk for your life and health in case of surgery, anesthesia or other complex medical manipulations (in these cases the informed consent is in writing.)
In cases where the parent, guardian or custodian refuses treatment and the patient's life is in danger, the head of the healthcare facility may independently decide on undertaking life-saving treatment.

Access to medical assistance is provided through your General Practitioner.

Your GP is the person to turn to for any sort of health problem and also when you are in need of a consultation, tests, home or hospital treatment, as well as for the prescription of any medicines. It is from your GP that you receive your health insurance card - a document you are expected to carry on your person at all times.

If you are staying in another town/village away from home for a period of up to 1 month (for example when on vacation, pleasure or business-related trip etc.) and you find yourself in need of medical assistance, you may turn for help to any General Practitioner. In such cases you should show him/her with your health insurance card.

Information about registered General practitioners in Region Dobrich, working on contract with NHIF you will be able to find at the reception desk of the hotel you are staying at, or at www.rzi-dobrich.org (The Regional Health Inspectorate maintains up-to-date information on its webpage!!!)

If you are planning to reside in another town/village for a period between one and five months, you are advised to temporarily select a local General Practitioner. This requires buying from a stationery/bookshop the necessary forms to select a temporary GP. The form will be filled by the doctor who will serve as your General Practitioner during your stay in the location. When the period of the temporary choice runs out, the default choice of General Practitioner is automatically restored.

If you have a health problem or concern

Please visit your General Practitioner. He or she will examine you and decide on a course of treatment.
Information is displayed in the doctor's office about which categories of citizens are exempt from paying a user fee when receiving medical and dental services. If you do not fall within these categories, you will be required to pay a user fee in the amount of 1% of the national minimum wage.

If you need medical tests

Your GP will refer you for medical diagnostic tests in a laboratory. The referral form can be used within 30 calendar days of the date of issue.

At the laboratory, you will be required to pay a fee for the sample-taking procedure.

If you need to consult a specialist The General Practitioner will refer you, using the required form, to the appropriate Specialist. The referral form can be used within 30 calendar days of the date of issue.

The Specialist will examine you, and if you are in need of additional tests, he/she will refer you to have such tests performed. The Specialist will decide on what treatment should be prescribed. Using one referral form, the same Specialist may perform a second examination within 30 calendar days of the first consultation.

For each visit with the doctor you will be required to pay a user fee in the amount of 1% of the national minimum wage.

If you need home treatment

The attending physician/dentist will prescribe your treatment. The doctor or dentist will issue a sick leave note for you - up to 14 days without interruption and no more than 40 days (with interruption) within one calendar year - for one or more diseases or conditions.

Where your condition so requires, after the above period elapses, you can be referred to a Doctors' Consulting Commission. 

If you are referred to treatment at home, you will need medicines

Your doctor will inform you which medicines can be fully or partially covered by NHIF. The physician will prescribe them using a NHIF form, and you can then purchase them from a pharmacy working on contract with the National Health Fund. If the National Health Fund does not provide full coverage for the medicines prescribed, you will pay the necessary amount.

If the medicines needed for your treatment are not covered by NHIF, the doctor will provide you with a regular prescription and you can then purchase them from any pharmacy.

If you need dental treatment

You may choose the services of any dentist who has signed a contract with the National Health Fund. Visibly displayed in the dentist's office should be a list of procedures which are fully or partially covered by the National Health Fund.

You will be required to provide the dentist with your personal health card, in which he/she will record the treatment provided which belongs to the NHIF-contracted activities. If the treatment you received is not fully covered by NHIF, you will be required to pay the difference.

For each visit with the dentist you will be required to pay a user fee in the amount of 1% of the national minimum wage.

If you need consultation or treatment from a dental specialist

Your dentist will refer you to a specialist using the required referral form. The dental specialist will provide consultation and treatment, for which you will either pay the difference or cover the entire amount. If you are in need of hospital treatment or surgery,  the specialist (or dentist) will issue a referral card for hospital-based treatment.

If you need hospital treatment

The General Practitioner or Specialist will refer you to a hospital of your choice, provided such hospital has signed a contract with RHIF for treatment of the respective disease under a clinical pathway. The referral is valid for 30 days, so you should present for examination at the Diagnostic & Consultation Bloc of the hospital before this period expires.

At the hospital, your attending physician will examine you, explain the diagnosis and discuss with you the method of treatment, ass well as any related risks.
NHIF will cover the full price of your treatment included in the clinical pathway, along with the medicines and consumables, with the exception of expensive consumables which are expressly listed in the algorithm for the appropriate clinical pathway.

For each day of hospital treatment will be required to pay only a user fee in the amount of 2% of the national minimum wage. If your condition requires you to stay in hospital for more than 10 days within the same year, you will not be required to pay the user fee for your stay after the tenth day.
Treatment under any clinical pathway also includes two follow-up visits with the attending physician after you have been discharged from hospital.

If your health-insurance rights have been violated

In case rights of health-insured individuals have been violated in connection with the medical and dental healthcare provided by doctors, dentists or in-patient medical treatment facilities working on contract with the National Health Insurance Fund, such individuals are entitled to lodge written complaints to the Director of the relevant Regional Health Insurance Fund (RHIF) or  the National Health Insurance Fund (NHIF) – Sofia 1407,  1, Krichim St.

For information and consultations health-insured individuals may:

- visit the RHIF office in person – Dobrich 9300, 5, Nezavisimost St. at (address)   or telephone the relevant department  058/654-500;

- call the NHIF Health Information Centre  at 0800 14 800.

 

Outside this procedure, or in case you have no health insurance with NHIF you can turn for medical assistance to all healthcare establishments registered under Bulgarian law, and pay the cost of the medical services received as per the price list of the relevant treatment facility. Information about registered healthcare establishments within the region Dobrich you will find at the reception desk of your hotel or the website www.rzi-dobrich.org(RHI)

 

Complaints related to healthcare service and patient's rights can be lodged at:

The Regional Health Inspectorate – Dobrich 9300, 57 Kiril and Methodius, St.  address, e-mail rzi-dobrich@linkbg.com

The Executive Agency «Medical Audit» at:

Address: 3, Georgi Sofiyski Blvd, Sofia 1606

Telephone:  (02) 8050433, 8050435, 8050465

е-mail: delovodstvo@eama.bg

 

 

INFORMATION ABOUT RULES GOVERNING THE ACCESS TO MEDICAL ASSISTANCE FOR CITIZENS OF EUROPEAN UNION MEMBER STATES, THE EUROPEAN ECONOMIC AREA AND SWITZERLAND

 

IN A MEDICAL EMERGENCY

 

If you find yourself in a situation where you need emergency medical assistance, please dial the toll-free number 150 or the single EU emergency line 112. You can call 112 in all sorts of accidents and emergencies. You can reach this number even if you have no credit on your phone credit or you are outside the coverage of your mobile network. 112 operators speak foreign languages.

The Republic of Bulgaria provides emergency care to everyone on the country's territory regardless of their nationality, address or health insurance status.

You should know that emergency medical care is provided in case of conditions creating a risk of:

1. death;

2. grave or irreversible morphological and functional impairment of vital organs and systems;

3. complications with pregnant women endangering the life of the mother or fetus.

If you find yourself in such a situation, in addition to dialing 150 or 112, you can also seek assistance in the nearest Emergency Healthcare Services Centre or another healthcare establishment. There, you will be given emergency healthcare and if your condition so requires, you will be transported in a specialised medical vehicle to the properly equipped hospital.

 

WHERE MEDICAL ASSISTANCE IS NEEDED FOR DISEASES AND CONDITIONS WHICH ARE NOT A MEDICAL EMERGENCY:

 

If you are health-insured in a European Union Member State, the European Economic Area and Switzerland

From the day of Bulgaria's full membership in the European Union (1 January 2007), under the directly applicable EU legislation valid for all Member States in the field of social security (including  health insurance),  the citizens of European Union Member States are guaranteed equal treatment to that provided for national citizens.

Be advised that:

·       For any citizen of an EU Member State/EEA/Switzerland in need of emergency and immediate medical services (i.e.  any medical care, which depending on the individual's health condition and duration of stay cannot be postponed pending his/her planned return to his/her country of residence), the provisions of the Bulgarian health insurance legislation apply.

·       Pursuant to Decision № S3 of the Administrative Commission for the Coordination of Social Security Systems, health care includes compensation payments provided in connection with chronic or existing conditions, as well as in connection with pregnancy and childbirth. To receive such health care, it is sufficient to provide a valid EHIC.

·       Any essential medical treatment which is only provided in specialized medical wards and/or may only be provided by specialised personnel and/or using special equipment, is generally subject to prior agreement between the health insured individual and the ward providing such treatment so it can be guaranteed that the treatment will be accessible during the stay of the health insured individual in a Member State other than the competent Member State or the Member State of residence. The types of treatment meeting these criteria include:

?  haemodialysis

?  oxygen therapy

?  specialised treatment of asthma

?  echocardiography in the event of chronic autoimmune diseases

?  chemotherapy

·       Public health insurance in the Republic of Bulgaria is provided by a single health-insurance fund – the National Health Insurance Fund (NHIF). It is a public institution in charge of mandatory health insurance in the country and has 28 divisions in regional centres, called Regional Health Insurance Funds (RHIFs).

·       If a citizen of a EU/EAA Member State/Switzerland wishes to benefit from the  entitlements of mandatory health insurance, he/she should only deal with  healthcare establishments working on contract with the National Health Insurance Fund.

·       Citizens of  EU/EEA Member State/Switzerland are not required to pay for  health services provided from the NHIF and Ministry of Health package, with the exception of the user fee normally paid by Bulgarian insured citizens. In case of hospital treatment where additional payments are made by Bulgarian citizens for  expensive medicines or other consumables, citizens of EU/EEA/Switzerland pay the same price as that for Bulgarian health-insured citizens.

·      When visiting a doctor, in cases in case of temporary residence (short-term stay) in Bulgaria, you should provide the doctor with proof of entitlement to in-kind compensation (i.e. right to medical assistance from the range of mandatory health insurance (NHIF) and medical assistance financed from the national budget (Ministry of Health). Such proof is a valid European Health Insurance Card (EHIC) or a certificate temporarily replacing the EHIC (hardcopy). These documents will serve as proof that you are entitled to medical assistance at the expense of your own national health insurer.

·           If you are not in a position to produce any of the above two documents, you are not stripped of the right to medical assistance. In this case, however, the healthcare facility providing you with health care, will request the EHIC certificate from your competent health insurer – with your personal mediation or mediation from the contact institutions for Bulgaria - NHIF/RHIF, to ensure that, at the time you received emergency care, you were indeed health- insured and your Health Insurance Fund will cover the cost for any  urgent/immediate health care provided to you.

·           If your condition renders waiting for a confirmation from your insurer impossible, then you will pay for the healthcare received at NHIF, respectively MoH prices, at the rate used for Bulgarian health-insured citizens. In this case you must be issued with an invoice containing a detailed description of the medical services provided  and their respective contracted (according to NFA or MoH) price. The invoice can be later used to request reimbursement of any costs from your health insurance institution when you return to your country of residence.    

The price-list for medical services covered by NHIF should be visibly displayed in each healthcare establishment.

Who to turn to if you have a health problem or concern:

If you have a health problem or concern, you should consult a General Practitioner working at a healthcare establishment for primary outpatient healthcare under contract with NHIF.

If you are posted in Bulgaria and you wish to benefit from the entire package of health services in the country, you will need to be registered with the appropriate Regional Health Insurance Fund. You will be issued with a Certificate of Registration with  NHIF/RHIF, and will then be able to choose a General Practitioner in the area you reside in. To be enrolled in the Patients' List of a General Practitioner, you will need to provide a copy of the Certificate of Registration and a filled-in form for choice of General Practitioner. Where specialised or hospital  treatment should become necessary, your General Practitioner will  refer you for specialised or highly specialised examination, tests and/or hospitalisation. The package of medical and dental care activities covered from the National Health Insurance Fund budget is guaranteed for all Bulgaria citizens holding valid mandatory health insurance and for citizens insured in other EU Member States residing in the Republic of Bulgaria and registered with RHIF/NHIF.

·       NHIF covers, fully or partially, the cost of medicinal products and medical equipment and diet food for special medical purposes in case of treatment at home

Information about registered General practitioners in Region Dobrich, working on contract with NHIF can be found at your hotel reception desk and the RHI website

The General Practitioner will examine you, and may, at his or her own discretion:

·    Chris cried medicines for treatment at home fully or partially covered by NHIF;

·  advise you about medicines which the NHIF fully or partially covers, as well as the difference you might need to pay at the pharmacy;

·   issue a “Referral for Consultation or Jointly Treatment” to the appropriate specialist;

·  refer you to medical diagnostic tests by issuing a “Referral for medical diagnostic activities”;

·   issue you with a “Referral for Hospitalisation” - in case the treatment cannot be provided in outpatient settings and hospital treatment is necessary. It

User fee for medical and dental healthcare

For each visit with a General Practitioner, specialist in outpatient healthcare or dentist, citizens of EU/EEA Member States have to pay a user fee in the amount of 1% of the minimum national wage for Bulgaria.

Where tests are necessary as advised by a General Practitioner,  specialist or dentist, a sample-taking fee is also charged (the amount may not exceed BGN 2.00 for each visit to the laboratory, regardless of the number of tests)

For each day of hospital treatment a citizen of the EU/EEA/ Switzerland will be required to pay a user fee in the amount of 2% of the national minimum wage. If your condition requires you to stay in hospital for more than 10 days within the same year, you will not be required to pay the user fee for your stay after the tenth day. 

For each user fee or medical service fee paid, you should be issued with (request) proof of payment (payment slip or invoice).

More information about your rights as a health insured individual is available

- by visiting the RHIF office in person  Dobrich 9300, 5, Nezavisimost St. , at (address) or calling the public help line at  058/654-500;

- calling the Health Information Centre on NHIF at  0800 14 800.

Outside this procedure, you can turn for medical assistance to all healthcare establishments registered under Bulgarian law, and pay the cost of the medical services received as per the price list of the relevant treatment facility.

 

Complaints related to healthcare service and patient's rights can be lodged at:

The Regional Health Inspectorate – Dobrich 9300, 57 Kiril and Methodius, St.  address, e-mail rzi-dobrich@linkbg.com

The Executive Agency «Medical Audit» at:

Address: 3, Georgi Sofiyski Blvd, Sofia 1606

Telephone:  (02) 8050433, 8050435, 8050465

е-mail: delovodstvo@eama.bg

 

INFORMATION ABOUT THE RULES GOVERNING FOREIGN NATIONALS’ ACCESS TO MEDICAL ASSISTANCE

 

IN A MEDICAL EMERGENCY

 

If you find yourself in a situation where you need emergency medical assistance, please dial the toll-free number 150 or the single EU emergency line 112. You can call 112 in all sorts of accidents and emergencies. You can reach this number even if you have no credit on your phone credit or you are outside the coverage of your mobile network. 112 operators speak foreign languages.

The Republic of  Bulgaria provides emergency care to everyone on the country's territory regardless of their nationality, address or health insurance status.

You should know that emergency medical care is provided in case of conditions creating a risk of:

1. death;

2. grave or irreversible morphological and functional impairment of vital organs and systems;

3. complications with pregnant women endangering the life of the mother or fetus.

If you find yourself in such a situation, in addition to dialing 150 or 112, you can also seek assistance in the nearest Emergency Healthcare Services Centre or another healthcare establishment. There, you will be given emergency healthcare and if your condition so requires, you will be transported in a specialised medical vehicle to the properly equipped hospital.

 

WHERE MEDICAL ASSISTANCE IS NEEDED FOR DISEASES AND CONDITIONS WHICH ARE NOT A MEDICAL EMERGENCY:

 

If you are the citizen of a country other than a European Union Member State, the European Economic Area or Switzerland, please be advised that:

You can be provided with medical assistance at any healthcare establishment in the country. The terms and procedure for providing medical assistance or a different for foreign nationals  whose rights are equal to those of Bulgarian citizens, and other aliens.

Aliens at belonging to the first category are entitled to access to medical assistance, but are required to pay the mandatory health insurance contributions. They may choose  a General Practitioner  and dentist. Aliens whose rights are equal to those of Bulgarian citizens, are foreign nationals with permanent residency in the Republic of Bulgaria.

The second category of aliens are required to pay for medical  services at the price listed by the appropriate treatment facility. Healthcare establishments may stipulate the manner and time-limits for payment of medical services; they are also obligated to display prominently and in generally accessible areas of the treatment facility any information about the price of medical services; the cases, when  patients are required to pay for medical assistance and the manner and time-limits for such payments.

Exceptions are only provided for citizens of countries  with which the Republic of  Bulgaria has signed cooperation agreements in this area. Some of these agreements provide for free access to medical assistance only for diplomatic agents, while others also cover the right to immediate medical care,  and others still involve a wide range of social security  and health insurance issues.

Information about agreements between the Republic of  Bulgaria and other countries can be found on the Ministry of Health website www.mh.government.bg

 

Aliens holding short-term residence permits or transiting through the country's territory, must have a health insurance policy covering the costs for treatment and hospitalisation for the time they spend in the country, inasmuch as no other arrangements are provided for in an international treaty to which the Republic of  Bulgaria is party.

Complaints related to healthcare service and patient's rights can be lodged at:

The Regional Health Inspectorate – Dobrich 9300, 57 Kiril and Methodius, St.  address, e-mail rzi-dobrich@linkbg.com

The Executive Agency «Medical Audit» at:

Address: 3, Georgi Sofiyski Blvd, Sofia 1606

Telephone:  (02) 8050433, 8050435, 8050465

е-mail: delovodstvo@eama.bg

 


[Назад] [Обратно горе]