General Social Insurance Act (Allgemeines Sozialversicherungsgesetz, ASVG) of 9 September 1955.

Federal Hospitals and Sanatoriums Act (Krankenanstalten- und Kuranstaltengesetz, KAKuG) of 18 December 1956 and Hospitals Acts of the Länder.

Employees:

Health Care and Sickness Benefit Compulsory Insurance Act (Loi relative à l'assurance obligatoire soins de santé et indemnités/Wet betreffende de verplichte verzekering voor geneeskundige verzorging en uitkeringen), coordinated on 14 July 1994 and Royal Decree of 3 July 1996 implementing this Act.

Act on Hospitals and other Care Facilities (Loi relative aux hôpitaux et à d'autres établissements de soins/Wet betreffende de ziekenhuizen en andere verzorgingsinrichtingen), co-ordinated on 10 July 2008.

Act of 27 June 1969 revising the Decree-Act of 28 December 1944 on the social security of workers.

Law on Health Insurance (Закон за здравното осигуряване) 1998.

Law on Health (Закон за здравето) 2004.

Law on the Medicinal Products in Human Medicine (Закон за лекарствените продукти в хуманната медицина) 2007.

Law on the Professional Organisations of Doctors and Dentists (Закон за съсловните организации на лекарите и на лекарите по дентална медицина) 1998.

Social Insurance Code (Кодекс за социално осигуряване) 1999 title amended 2003.

Law on Integration of People with Disabilities (Закон за интеграция на хората с увреждания) 2004.

National Framework Contract for Medical Activities (Национален рамков договор за медицинските дейности) between the National Health Insurance Fund (Национална здравно осигурителна каса) and the Bulgarian Doctors’ Association (Български лекарски съюз) for 2015.

National Framework Contract for Dental Activities (Национален рамков договор за денталните дейности) between the National Health Insurance Fund (Национална здравно осигурителна каса) and the Bulgarian Dentists’ Association (Български зъболекарски съюз) for 2015.

Law on the Budget of the National Health Insurance Fund for 2016 (Закон за бюджета на Националната здравно осигурителна каса за 2016 г.).

Obligatory Health Insurance Act (Zakon o obveznom zdravstvenom osiguranju) of 2013, OJ no. 80/13 as amended.

Voluntary Health Insurance Act (Zakon o dobrovoljnom zdravstvenom osiguranju) of 2006, OJ no. 85/06, as amended.

The Government Medical Institutions and Services General Regulations (Οι περί Κυβερνητικών Ιατρικών Ιδρυμάτων και Υπηρεσιών Γενικοί Κανονισμοί) of 2000 – 2013.

Mental Health Law (Ο Περι Ψυχιατρικής Νοσηλείας Νόμος) of 1997.

Act No. 48/1997 on Public Health Insurance (Zákon o veřejném zdravotním pojištění).

Act No. 551/1991 on the General Health Insurance Institution (Zákon o všeobecné zdravotní pojišťovně).

Act No. 280/19XX.XX on Health Insurance Funds (Zákon o resortních, oborových, podnikových a dalších pojišťovnách).

Act No. 5XX.XX/19XX.XX on General Health Insurance Premiums (Zákon o pojistném na všeobecné zdravotní pojištění).

Act No. 220/1991 on Czech Medical, Dental and Pharmaceutical Chambers (Zákon o České lékařské komoře, České stomatologické komoře a České lékárenské komoře).

Act No. 378/2007 on Drugs (Zákon o léčivech).

Act No. 372/2011 on Health Services (Zákon o zdravotních službách).

Act No. 373/2011 on Specific Health Services (Zákon o specifických zdravotních službách).

Consolidated Health Act No 14 November 2014 (sundhedsloven).

Health Insurance Act (Ravikindlustuse seadus) 2002.

Estonian Health Insurance Fund Act (Eesti Haigekassa seadus) 2000.

Health Services Organisation Act (Tervishoiuteenuste korraldamise seadus) 2001.

Health Care Act (Terveydenhuoltolaki) of 30 December 2010.

Primary Health Care Act (Kansanterveyslaki) of 28 January 1972.

Sickness Insurance Act (Sairausvakuutuslaki) of 21 December 2004.

Act on Specialised Medical Care (Erikoissairaanhoitolaki) of 1 December 1989.

Patient Fees Act (Asiakasmaksulaki) of 3 August 1992.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

Social Security Code (Code de la sécurité sociale), Book I, chapter 6 articles L. 160-1, et seq.

Common universal health protection between employees’ regimes and independent regimes (common rules for benefits in kind).

Social Code (Sozialgesetzbuch), Book V, introduced by the Health Reform Act (Gesundheits-Reformgesetz) of 20 December 1988, last amended by Article 4 of the Act of 21 December 2015 (BGBI. I p. 2423).

Legislative Decree (ΝΟΜΟΘΕΤΙΚΟ ΔΙΑΤΑΓΜΑ) No. 1846/51 of 14 June 1951.

Law No. 1902/92 last modified by Law No. 2676/99 of 5 January 1999.

Joint Ministerial Decision No Υ3α/Γ.Π.οικ.88618 (B, 1223) of 11 September 2002, as amended.

Law No. 3655/08 of 3 April 2008.

Law No. 3918/11 of 2 March 2011, as amended.

Unified Regulation for Healthcare Services (EKPY) of the National Organisation for Healthcare Services Provision (EOPYY): Joint Ministerial Decision F90380/25916/3294 (B, 2456) of 3 November 2011, as amended by the Joint Ministerial Decision F90380/5383/738 (B, 1233) of 11 April 2012, by Joint Ministerial Decision EMP5 (B, 3054) of 18 November 2012 and Joint Ministerial Decision 55471/10-6-2013 (ΦΕΚ 1561/Β΄).

Joint Ministerial Decision No. 55471 (B, 1561) of 21 June 2013.

Law No. 4238/14 of 17 February 2014.

Act LXXXIII of 1997 on the Benefits of Compulsory Health Insurance (törvény a kötelező egészségbiztosítás ellátásairól).

Act CXXXII of 2006 on developing the health care system (törvény az egészségügyi ellátórendszer fejlesztéséről).

Act XCVIII of 2006 on safety and efficient supply of pharmaceuticals and medical devices as well as on the general rules of pharmaceuticals distribution (törvény a biztonságos és gazdaságos gyógyszer- és gyógyászati segédeszköz-ellátás, valamint a gyógyszerforgalmazás általános szabályairól).

Act LXXX of 1997 on Persons Entitled to Social Security Benefits and Private Pensions, as well as the coverage of these services (törvény a társadalombiztosítás ellátásaira és a magánnyugdíjra jogosultakról, valamint e szolgáltatások fedezetéről).

Public Health Services Act (Lög um heilbrigðisþjónustu) No. 40/2007 of March 2007.

Health Insurance Act (Lög um sjúkratryggingar) No. 112/2008 of September 2008.

1970 Health Act.

Law No. 833 of 23 December 1978 instituting the National Health Service (Legge 23 Dicembre 1978 n. 833 - Istituzione del Servizio Sanitario Nazionale, S.S.N.).

Legislative Decree No. 502 of 30 December 1992 (Decreto Legislativo 30 Dicembre 1992 n. 502 - Riordino della disciplina in materia sanitaria).

Legislative Decree No. 517 of 7 December 1993 (Decreto Legislativo 7 Dicembre 1993 n. 517 - Modificazioni al Decreto Legislativo 30 Dicembre 1992, n. 502).

Legislative Decree No. 229 of 19 June 1999 (Decreto Legislativo 19 Giugno 1999 n. 229 - Norme per la razionalizzazione del Servizio sanitario nazionale).

Legislative Decree No. 230 of 22 June 1999 (Decreto Legislativo 22 Giugno 1999 n. 230 - Riordino della medicina penitenziaria).

Prime Minister Decree of 29 November 2001 (Decreto del Presidente del Consiglio dei Ministri 29 Novembre 2001 - Definizione dei Livelli Essenziali di Assistenza).

Law on Patient Rights (Pacientu tiesību likums) 30/12/2009.

Law on General Practitioners (Likums "Par prakses ārstiem") 24/04/1997.

Medical Treatment Law (Ārstniecības likums) 12/06/1997.

Regulations of the Cabinet of Ministers No. 1529 on Health care organisation and financing procedure (Ministru kabineta 2013.gada 17.decembra noteikumi Nr.1529 “Veselības aprūpes organizēšanas un finansēšanas kārtība”) 17/12/2013.

Regulations of the Cabinet of Ministers No. 899 on Procedures for the Reimbursement of Expenditures for the Acquisition of Medicinal
Products and Medical Devices Intended for Out-patient Medical Treatment (Ministru kabineta 2006.gada 31.oktobra noteikumi Nr.899 “Ambulatorajai ārstēšanai paredzēto zāļu un medicīnisko ierīču iegādes izdevumu kompensācijas kārtība”) 31/10/2006.

Regulations of the Cabinet of Ministers No. 330 on Vaccination (Ministru kabineta 2000.gada 26.septembra noteikumi Nr.330 “Vakcinācijas noteikumi) 26/09/2000.

Regulations of the Cabinet of Ministers No.1268 on the Medical Risk Fund (Ministru kabineta 2013.gada 5.novembra noteikumi Nr.1268 “Ārstniecības riska fonda darbības noteikumi”) 5/11/2013.

Sickness Insurance Act (Gesetz über die Krankenversicherung) LGBl. (Liechtenstein law gazette) 1971 no. 50.

School Dental Care Act (Gesetz über die Schulzahnpflege), LGBl. 1981 no. 17.

Law on Health System (Sveikatos sistemos įstatymas) of 19 July 1994 (No. I-552).

Law on Health Insurance (Sveikatos draudimo įstatymas) of 21 May 1996 (No. I-1343).

Law on Health Care Institutions (Sveikatos priežiūros įstaigų įstatymas) of 6 June 1996 (No. I-1367).

Law on Rights of Patients and Compensation of the Damage to their Health (Pacientų teisių ir žalos atlyginimo įstatymas) of 3 October 1996 (No. I-1562).

Book I of the Social Security Code (Code de la sécurité sociale) in the version resulting from the Law of 17 December 2010.

Medical and Kindred Professions Ordnance (Ordinanza dwar il-Professjoni Medika u l-Professjonijiet li Ghandhom x'Jaqsmu maghha) (Cap. 31).

Hospital Fees (Foreign Patients) Regulations (Regolamenti dwar Drittijiet ta' l-Isptar li jithallsu minn Pazjenti Barranin), 1989 (Cap. 35).

Health Care Fees Regulations (Regolamenti dwar Drittijiet Ghal Kura Tas-sahha), 2004.

National Insurance Act (folketrygdloven) of 28 February 1997, Chapter 5.

Health and Care Services Act (lov om kommunale helse- og omsorgstjenester) of 24 June 2011.

Specialised Health Services Act (lov om spesialisthelsetjenester) of 2 July 1999.

Mental Health Care Act (lov om psykisk helsevern) of 2 July 1999.

Dental Health Services Act (lov om tannhelsetjenesten) of 3 June 1983.

Patient’s and User’s Rights Act (lov om pasient- og brukerrettigheter) of 2 July 1999.

Health Enterprises Act (lov om helseforetak m.m.) of 15 June 2001.

Law on Health Care Services financed from Public Means (Ustawa o świadczeniach opieki zdrowotnej finansowanych ze środków publicznych) of 27 August 2004.

National Health Service (Serviço Nacional de Saúde): Law 56/79 of 15 September 1979.

Framework Law on Health (Lei de Bases da Saúde): Statutory Decree 48/90 of 24 August 1990, as amended on several occasions.

General scheme of State contribution towards the price of pharmaceuticals (Regime geral de comparticipação do Estado no preço dos medicamentos): Statutory Decree 48-A/2010 of 13 May 2010, amended several times.

Bye-laws of the National Health Service (Estatuto do Serviço Nacional de Saúde): Statutory Decree 11/93 of 15 January 1993, as amended on several occasions.

Scheme of co-payments in the framework of the National Health Service (Regime das taxas moderadoras no âmbito do Serviço Nacional de Saúde): Statutory Decree 113/2011 of 29 November 2011, amended by Statutory Decree 117/2014 of 5 August 2014, amended several times.

Title VIII of the Law no 95/2006 of April 2006, published in OJ No. 372 of 28 April 2006, with the subsequent modifications and completions.

Law on Health Insurance (Zákon o zdravotnom poistení) No. 580/2004.

Law on Health Care and Services Related to Health Care (Zákon o zdravotnej starostlivosti a službách súvisiacich s poskytovaním zdravotnej starostlivosti) No. 576/2004.

Law on the Scope of Health Care Covered on the Basis of the Public Health Insurance and on Reimbursement of Services Related to Health Care (Zákon o rozsahu zdravotnej starostlivosti uhrádzanej na základe verejného zdravotného poistenia a o úhradách za služby súvisiace s poskytovaním zdravotnej starostlivosti) No. 577/2004.

Law on Health Care Providers, Medical Workers and Professional Medical Associations (Zákon o poskytovateľoch zdravotnej starostlivosti, zdravotníckych pracovníkoch a stavovských organizáciách v zdravotníctve) No. 578/2004.

Law on Health Insurance Agencies (Zákon o zdravotných poisťovniach) No. 581/2004.

Law on Emergency Health Service (Zákon o záchrannej zdravotnej službe) No. 579/2004.

Governmental Regulation on Reimbursement Amounts to Insured Persons for Services Related to Health Care (Nariadenie vlády o výške úhrady poistenca za služby súvisiace s poskytovaním zdravotnej starostlivosti) No. 722/2004.

Law on the Scope and Conditions of Payment of Medicines, medical Devices and Foods Covered on the Basis of the Public Health Insurance (Zákon o rozsahu a podmienkach úh-rady liekov, zdravotníckych pomôcok a dietetických potravín na základe verejného zdravotného poistenia) No. 363/2011.

Health Care and Health Insurance Act (Zakon o zdravstvenem varstvu in zdravstvenem zavarovanju) (Official Gazette of the Republic of Slovenia, no. 72/2006 – official consolidated text, and subsequent amendments).

Health Care Services Act (Zakon o zdravstveni dejavnosti) (Official Gazette of the Republic of Slovenia, no. 23/2005 – official consolidated text, and subsequent amendments).

Pharmacies Act (Zakon o lekarniški dejavnosti) (Official Gazette of the Republic of Slovenia, no. 36/2004).

Rules on Compulsory Health Insurance (Pravila obveznega zdravstvenega zavarovanja) (Official Gazette of the Republic of Slovenia, no. 30/2003 – official consolidated text, and subsequent amendments).

Fiscal Balance Act (Zakon za uravnoteženje javnih financ (ZUJF)) (Official Gazette of the Republic of Slovenia, no.40/2012 and subsequent amendments).

Social Security General Act (Ley General de la Seguridad Social) approved by Legislative Royal Decree No. 8/2015 of 30 October 2015.

Law No. 14/86 of 25 April 1986, Health General Act (Ley General de Sanidad) amended.

Royal Decree No. 16/2012 of 20 April 2012.

Health and Medical Services Act (Hälso- och sjukvårdslagen (1982:763)) of 1982.

Federal Law on Sickness Insurance of 18 March 1994 (section 2) (Bundesgesetz über die Krankenversicherung, KVG/Loi fédérale sur l'assurance-maladie, LAMal).

Federal Law on General Provisions concerning Legislation on Social Insurances of 6 October 2000 (Bundesgesetz über den Allgemeinen Teil des Sozialversicherungsrechts, ATSG/Loi fédérale sur la partie générale du droit des assurances sociales, LPGA).

Health Insurance Act (Zorgverzekeringswet, Zvw), Law of 16 June 2005.

Long term care act (Wet langdurige zorg (WLZ)), Law of 3 December 2014.

National Health Service and Community Care Act 1990.

National Health Service (Primary Care Act) 1997.

Health and Social Care Act 2001.

National Health Service Reform and Health Care Professions Act 2002.

National Health Service (Charges to Overseas Visitors) Regulations 2011.

NHS (General Medical Services Contracts) Regulations 2004.

NHS (Primary Medical Services Agreements) Regulations 2004.

National Health Service Act 2006.

Compulsory social insurance scheme for employees and assimilated groups. Benefits-in-kind system.

Compulsory social insurance scheme mainly financed by contributions for the active population (employees and self-employed).

Rule: post-facto reimbursement.

Exception: mandatory third party payments (hospital, pharmacy, consultation with a general practitioner for the beneficiaries of an enhanced assistance).

A compulsory social insurance scheme financed by contributions for Bulgarian citizens and for residents in Bulgaria and a scheme funded by taxes providing benefits in kind, other than those provided by the contribution-funded scheme.

Compulsory social insurance scheme financed by contributions covering de facto the whole population. Benefits-in-kind system. Compulsory insurance covers the costs of treatment to varying degrees, the remaining amount must be paid by either the patient or the patient’s voluntary, supplementary insurance.

Fully tax-financed scheme based on voluntary registration providing healthcare benefits to persons and families on low income and some other categories of persons.

Civil servants are covered under a separate compulsory system.

Compulsory system financed by contributions from individuals, employers and the State.

Tax financed universal public health service for all residents.

Compulsory social insurance scheme for all persons with economic activity (employees and self-employed); large groups of the non-active population are covered on the basis of solidarity (e.g. all children and pensioners) or by contributions paid on their behalf by the State. Provides a benefit in kind system.

Public health service for all inhabitants (based on residency) operated by municipalities. Financed by taxes and patient fees.

Private health care supplements the public scheme. Private health care services are partly refunded by general sickness insurance. Supplements are financed by contributions paid by the insured and a subsidy from the State (fifty-fifty-principle).

Compulsory social insurance scheme with affiliation based on professional criteria and on residency, and financed by social security contributions and special contributions.

System of benefits in kind (refund of all or part of care).

Statutory Health Insurance:

Compulsory social insurance scheme for employees and categories of persons assimilated thereto up to a certain income limit and with income-related contributions.

Benefits-in-kind system with exceptions.

For individuals without another entitlement to coverage in case of illness, who reside in Germany or are ordinarily resident in Germany, since 1 January 2009 there is a general obligation for the entire population to become affiliated with the statutory or private health insurance.

Compulsory social insurance scheme based on a benefits-in-kind system.

Compulsory social insurance scheme for employees and self-employed, and assimilated groups, financed by employer and employee contributions.

Tax-financed universal public health service for all residents.

Tax-financed health service for all inhabitants (based on residency).

Tax-financed National Health Service for all inhabitants (based on residency).

Tax financed health care system for all inhabitants (based on residency).

Private health care supplements the public scheme.

Compulsory social insurance scheme for all persons with residence or economic activity (employees and self-employed) in Liechtenstein.

There are two different benefit schemes: the compulsory health insurance and the extended compulsory health insurance. The latter additionally covers part of the costs for non-contracted doctors.

Urgent health care is provided for all residents. Other health services are available for insured persons with the main costs of treatment covered by insurance. People who do not pay compulsory contributions and are not insured by State must cover the cost of treatment personally.

Since 2005 the mechanism for the regulation of the compensation for the damage caused to patients’ health has been set. So since 1 January 2005 health care institutions must insure their civil liability for the damage caused to patients’ health.

Compulsory social insurance scheme financed by contributions for employees and self-employed and the recipients of a social security benefit.

Universal system funded by government, employers and employees. All persons covered by the National Insurance Act of 1956 are eligible for free health care.

Mainly tax-financed public health service for all inhabitants (based on residency) in municipal or State responsibility.

Compulsory social insurance scheme providing benefits in kind to all employees and self-employed and assimilated groups (pensioners, students, farmers, members of insured persons’ families).

The right to health is ensured, amongst other things, by a universal, potentially free National Health Service (Serviço Nacional de Saúde) that takes into account the economic and social circumstances of people and families. Primary health care represents the system's "gatekeeping".

Compulsory social insurance scheme for all inhabitants financed mainly by contributions. Benefits-in-kind system.

Insured people benefit from a basic package of medical services.

Uninsured people benefit from a minimal package of medical services.

There is free competition between providers dealing with contracts with the health insurance houses.

Decentralisation and autonomy in the administration of the Health Insurance Fund.

Universal health care scheme for all inhabitants (based on residency), funded by compulsory insurance contributions and State subsidies. Benefits-in-kind system. Co-payments of insured persons required in some cases.

Compulsory social insurance scheme financed by contributions covering de facto all resident citizens and everybody legally gainfully active and their family members.

Possibility of voluntary supplementary insurance for co-payments for medical services not fully covered by the compulsory insurance, including 95% of persons in Slovenia.

Tax-financed public health service (asistencia sanitaria).

Tax financed public health service for all inhabitants (based on residence) in regional responsibility. The system is universal and compulsory.

Compulsory insurance for the entire population domiciled (under the terms of the Civil Code) in Switzerland, financed by contributions.

The social sickness insurance provides benefits in the case of sickness, accident (if not covered by an accident insurance) and maternity.

Health Insurance Act (Zorgverzekeringswet, Zvw): All residents are obliged to take out insurance. There are two main variants of health insurance policies: policies based on benefits in kind and policies based on reimbursement of medical costs.

Long term care act (Wet langdurige zorg (WLZ)) introduced a general insurance for people with severe, long-term care needs and stay in an institution, such as the frail elderly, and people with severe disabilities, chronic illness or disability that need close all day intensive care or supervision. The Long term care can be provided in an institution or at home

All residents and non-residents liable to Dutch wages and income tax are insured.

Tax financed national health service for all residents. Information in this table relates to England only. Competence for health care is devolved to Scotland, Wales and Northern Ireland.

• All employees in paid employment, trainees.
• Pensioners.
• Unemployed persons receiving benefits from unemployment insurance (Arbeitslosenversicherung).
• Participants of vocational rehabilitation.
• Persons rendering their military or civilian service.
• Family members working in the enterprises of self-employed persons.
• Persons who do not have a formal employment contract but essentially work like an employee (freie Dienstnehmer) (e.g. no own organisational structure, perform their services themselves).
• Persons voluntarily insured.
• Recipients of guaranteed minimum resources.
• Participants of a voluntary social year, a voluntary environment protection year, commemoration service (Gedenkdienst), peace and social service abroad as well as participants of the European Voluntary Service.

All salaried workers and assimilated categories, such as:

• Pensioners (including widows and widowers, orphans, and disabled persons).
• Unemployed persons.
• Disabled persons.
• Higher education students.
• Certain members of the clergy and of religious communities.
• Persons listed on the national register of natural persons.
• Certain members of the former public service in Africa.
• All self-employed persons subject to compulsory health insurance.

All permanent or long-term residents and Bulgarian nationals – for the tax funded system.

Compulsory health insurance for:

• nationals who are not simultaneously citizens of another country;
• nationals who are simultaneously citizens of another country but are permanent residents of Bulgaria;
• foreign nationals and stateless persons with a long-term or permanent residence permit;
• recognised refugees, those with humanitarian status or those with asylum;
• persons who are subject to Bulgarian law under the rules for coordination of social security.

Compulsory insurance:

• employed persons,
• self-employed persons,
• full-time salaried apprentices,
• those performing national service,
• farmers,
• pensioners,
• those receiving occupational rehabilitation,
• unemployed persons registered with the Croatian Health Insurance Fund (Hrvatski zavod za zdravstveno osiguranje),
• persons up to 18,
• full time students,
• disabled war veterans,
• disabled persons without resources for subsistence,
• persons on compulsory practical work (otherwise unemployed), and
• family members of insured persons and other persons insured under particular circumstances.

Healthcare benefits are granted to Cypriot and EU/EEA/Swiss citizens who permanently reside in Cyprus and who registered to the national health system, provided that they have contributed to the Social Insurance Scheme for a minimum period of three years (including assimilated insurance periods) and belong to one of the following categories:

• persons without dependants whose annual income does not exceed €15,400.00,
• members of families whose annual income does not exceed €30,750.00, increased by €1,700.00 for each dependent child,
• persons suffering from certain chronic diseases,
• some other specific categories of citizens.

State officials,civil servants, members of the police and the armed forces, as well as their dependants are covered under a separate compulsory system, which is contingent upon the payment of a 1.5% contribution.

All permanent residents and employees of employers with its registered office in the Czech Republic.

All residents.

• Employees on whose behalf the employer has paid Social Tax (sotsiaalmaks),
• self-employed who have paid Social Tax themselves,
• spouses of self-employed persons entered into the commercial register who participate in the business activities of the self-employed and on whose behalf the self-employed have paid Social Tax,
• persons on whose behalf the State has paid Social Tax (see Table I "Financing"),
• children up to 19 years of age,
• pregnant women from the moment pregnancy is medically determined,
• pensioners,
• persons with up to 5 years left before reaching pensionable age who are maintained by their spouses who are insured persons,
• persons legally staying and working in Estonia based on a temporary ground for stay,
• persons acquiring basic or general secondary education, formal vocational education and higher education students who are permanent residents and study in an educational institution in Estonia founded and operating on the basis of legislation or in an equivalent educational institution abroad.

Both systems: all residents.

All persons with gainfully employment or with a permanent regular residence in France.

• Persons in paid employment and those receiving vocational training, trainees.
• Pensioners with a sufficient period of insurance.
• Unemployed persons receiving unemployment insurance benefits.
• Disabled persons in sheltered employment.
• Persons participating in vocational rehabilitation and people being trained for some form of employment in special training institutions of the youth assistance (Jugendhilfe).
• Students in recognised higher education.
• Farmers and helping members of their family.
• Artists and writers.
• Persons having no other right to healthcare services in case of sickness (under certain conditions).

• Employees and persons assimilated thereto.
• Pensioners.
• Unemployed.

• Gainfully employed persons (employees and self-employed) and assimilated groups as insured persons; and
• minors;
• pensioners;
• beneficiaries of various benefits and allowances as persons entitled to health care.

All residents.

All persons "ordinarily resident" in Ireland.

Full eligibility:

(i) All persons over the age of 70 years whose gross incomes are below a certain threshold as follows:

• Single person: €500 a week;
• Couple: €900 a week.

GP Visit cards are provided to  all persons aged 70 years and over (from 5^th August 2015).

(ii) Persons under 70 years whose net incomes are below a certain weekly threshold as follows:

• Single person living alone:

Aged up to 65 years €184
Aged 66 years and over €201.50

• Single person living at home:

Aged up to 65 years €164
Aged 66 years and over €173.50

• Married couple:

Aged up to 65 years €266.50
Aged 66 years and over €298.

The above weekly amounts are increased in respect of:

• Each child financially dependent on applicant and aged under 16 by €38 (for first two children) and €41 (for third and subsequent children);
• Each child financially dependent on applicant and aged over 16 by €39 (for first two children) and €42.50 (for third and subsequent children);
• A dependent over 16 years who is in full time third level education and not grant aided by €78.

Other allowances are given for reasonable rent/mortgage payments, travel expenses and childcare costs.

Persons with limited eligibility but with income thresholds below a certain threshold (50% above the income threshold for full eligibility), receive a ‘GP Visit Card’.

Limited eligibility for remainder of population.

From 1^st July 2015 all children aged under 6 years are entitled to a GP service without fees.

From 1^st July 2015 the HSE may award a medical card to a child under the age of 18 years with a diagnosis of cancer.

A means tested Medical Card may be issued if the Health Service Executive (HSE) decides that it would cause undue hardship for a person to provide general medical services for themselves and their dependants from their own resources.

• All the Italian residents, included those detached abroad for professional reasons (law No. 398 of 3 October 1987);
• all EU residents subject to Italian law, except for those who are entitled to health care through the appropriate bodies in the other member States of the EU, according to the Regulation (EC) 883/2004;
• extra-EU citizens and their dependent family members, when holder of a residence permit issued for one of the reasons stipulated in the frame of the compulsory registration at the National Health Service (Servizio Sanitario Nazionale, S.S.N.), art. 34 of Legislative Decree No. 286 of 25 July 1998;
• Italian and EU non-residents and their dependent family, who are employed or self-employed in Italy and subject to the Italian law;
• extra-EU citizens and their dependent family members, registered at the National Health Service, according to a Social Security agreement with their Country of origin;
• extra-EU citizens without a residence permit (Temporarily Present Foreigner – STP) but only for urgent and essential clinical and hospital treatments according to art. 35 of Legislative Decree n. 286 of 25 July 1998.

• Latvian citizens,
• non-citizens of Latvia,
• citizens of Member States of the European Union, of European Economic Area States and of the Swiss Confederation who reside in Latvia in relation to employment or as self-employed persons, as well as the family members thereof,
• foreigners who have a permanent residence permit in Latvia,
• refugees and persons who have been granted alternative (subsidiary protection) status,
• persons detained, arrested and sentenced with deprivation of liberty.

The spouses of Latvian citizens and Latvian non-citizens who have a temporary residence permit in Latvia have the right to receive free of charge care for pregnant women and birth assistance paid from the State basic budget.

All persons with a legal residence in Liechtenstein;

Employed persons.

All persons insured by health insurance:

• persons in paid employment;
• those who pay contributions for themselves (self-employed, farmers and other interested persons), self-employed are compulsorily insured.

Persons who are insured by State means (State pays benefits on their behalf):

• recipients of any pension;
• unemployed persons who are registered with a local office of Lithuanian Labour Exchange (Lietuvos darbo birža) as well as persons participating in the measures of professional training organised by the local offices of Lithuanian Labour Exchange, provided that they have not concluded an employment contract;
• unemployed persons of working age who have the state social pension insurance record required for receiving the State social insurance old-age pension, as defined by law;
• employed pregnant women on Maternity Leave (Motinystės atostogos) and unemployed pregnant women during the period starting 70 days (after 28 pregnancy weeks) before birth and ending 56 days after birth;
• one of the parents (including adoptive parents) or a guardian when their child (or the child placed under guardianship) is under 8 years or one of the parents (adoptive parents) or a guardian with 2 or more children (children placed under guardianship) under 18 years;
• persons under 18 years;
• students and school children;
• persons entitled to means tested Social Benefit (Socialinė pašalpa);
• one of the parents (including adoptive parents), a guardian or a curator who provides nursing at home for: a disabled child; a person recognised as incapable of work (before 1 July 2005: a person with group I disability) before s/he reached the age of 24; a person who before the age of 26 was recognised as incapable for work (before 1 July 2005: a person with group I disability) because of an illness which occurred before the age of 24; or a person for whom a special need of permanent nursing care is established (before 1 July 2005: a person with total disability);
• disabled persons;
• those suffering from zymotic diseases which are on an official list compiled by the Ministry of Health (Sveikatos apsaugos ministerija);
• rehabilitated political prisoners, deportees and persons who suffered injuries during the events of 13 January 1991 and other events while defending Lithuania's independence and statehood;
• persons who assisted at the scene of the nuclear accident at Chernobyl;
• former inmates of the ghetto and juvenile prisoners of the fascist forced confinement institutions;
• priests of official religious communities, students of religious schools, novices of monasteries;
• persons for whom the legal status of participants of the war in Afghanistan is recognised in accordance with the procedure laid down by law;
• the spouse of the President of the Republic who has not reached the pensionable age and does not have insured income (for the duration of the term of office of the President of the Republic);
• persons involved in voluntary work in accordance with the law on Employment Support.

Health care for the following persons is covered by the National Budget:

• active servicemen from the Ministry of National Defence and servicemen from the Ministry of the Interior;
• foreign nationals who have submitted an application for asylum in the Republic of Lithuania or who are granted temporary protection in the Republic of Lithuania;
• persons detained by judicial and law enforcement institutions, who are kept in pre-trial detention facilities, and onvicted prisoners;
• persons who have committed an offence of threatening the public, in respect of which compulsory medical measures are assigned by a court ruling.

• All persons in paid employment (employed or self-employed worker).
• Pensioners.
• Persons in receipt of a replacement income from which contributions are deducted.
• Beneficiaries of a supplement to the guaranteed minimum income.

Permanent residents.

All residents.

• Employees and self-employed persons,
• pensioners,
• recipients of unemployment benefits,
• persons participating in occupational rehabilitation measures,
• farmers and farm workers,
• students involved in higher education,
• recipients of social welfare allowances,
• members of insured persons' families.

Access to the National Health Service (Serviço Nacional de Saúde, SNS) is granted to all residents, including illegal immigrants, EU citizens and non-European citizens. Portuguese citizens, EU citizens and legal immigrants pay user fees in order to benefit from the NHS at a lower price.

All Romanian citizens resident in Romania; entitled EU citizens; other citizens who live temporarily or permanently in Romania and pay contributions to the insurance fund as the law stipulates; children up to 18 years old.

All domiciled population and persons working on the territory of Slovakia.

• Employees, self-employed persons and farmers;
• recipients of cash benefits for social assistance, old-age, invalidity or for victims of war or its consequences;
• unemployed persons;
• permanent residents, not insured under any other heading;
• dependants of the above with permanent residency.

• Employees and persons assimilated thereto;
• pensioners and persons in receipt of regular cash benefits;
• unemployed persons, residing in Spain, who have exhausted the unemployment benefit or allowance and who are not covered in any other way;
• all legal residents with insufficient means of existence not covered in any other way.

All residents.

All persons domiciled in Switzerland. The government may extend the obligation to take out insurance to persons with no domicile in Switzerland.

Health Insurance Act (Zorgverzekeringswet, Zvw) and Long term care act (Wet langdurige zorg (WLZ)):

• All residents.
• Non-residents liable to Dutch wages and salaries tax in connection with employment in the Netherlands.

All persons “ordinarily resident” in the UK.

No compulsory insurance if the sum of all earnings is below the marginal earnings threshold (Geringfügigkeitsgrenze) of €415.72 per month, special voluntary insurance possible.

No exemptions.

Bulgarian nationals subject to compulsory insurance who stay abroad for more than 183 days in a calendar year are exempt from insurance contributions from the date of their departure (provided they make a prior application to the National Revenue Agency (Национална агенция за приходите)). After their return their health insurance rights are restored after 6 months of insurance or a one-off payment of 12 contributions.

Persons who are insured in another EU Member State according to the rules on coordination of social security are exempt from compulsory health insurance in Bulgaria

No exemptions.

Not applicable. Scheme based on voluntary registration.

Civil servants: no exemptions.

No exemptions.

Not applicable: universal system.

No exemptions.

Not applicable: universal system.

No exemptions.

Exemption from compulsory affiliation (Versicherungsfreiheit) to statutory sickness insurance (gesetzlichen Krankenversicherung, GKV) exists in particular for civil servants, magistrates and professional soldiers. Exemption from compulsory affiliation for employees with annual earnings exceeding the annual income limit (in 2016 €56,250, and for persons privately insured on 31/12/2002 €50,850 respectively); in case of insignificant employment (up to €450 per month); or in case of short-term employment (up to 3 months or 70 working days a year) which is not being pursued as an occupation and for which the corresponding remuneration does not exceed €450 per month. Full-time self-employed are not compulsorily insured with the statutory sickness insurance.

No exemptions.

No exemptions.

Not applicable: universal system.

Not applicable: universal system.

Provided they are covered by another Member State’s social security scheme, the following categories are exempted from compulsory insurance:

• Italian and foreign citizens residing abroad but temporarily in Italy;
• Foreign workers holding a residence permit for business and others who are not taxed in Italy;
• Foreign citizens holding a residence permit for medical reasons.

Not applicable: universal system.

No exemptions.

No exemptions.

Persons who carry out their profession occasionally and irregularly for a duration not exceeding three months per calendar year.

Not applicable: universal system.

Not applicable: universal system.

No exemptions.

Not applicable: universal system.

The following categories are exempted from paying contributions, but are entitled to benefits in kind:

• Children up to 18 years (this period is extended till 26 years for those studying or apprenticing and having no income),
• young persons with no income until the age of 26 falling under the child protection system,
• beneficiaries of special laws,
• disabled persons with no income,
• persons with no income enrolled into the national health programmes,
• pregnant women with no income or women who have just given birth.

Persons insured abroad, persons employed by employers with diplomatic privilege.

If the income per farm household is less than 25% of the minimum wage, farmers are exempt from compulsory health insurance through the provision of agricultural activities, however they can be insured through other provisions of the Health insurance and health care Act.

The Government may exclude from the compulsory insurance those persons whose salaried work is considered marginal and not a basic means to earn one’s living.

Not applicable: universal system.

The government may exclude certain categories of persons from the compulsory insurance.

Exemptions to the compulsory participation in the Health Insurance Act (Zorgverzekeringswet, Zvw) and the Long term care act (Wet langdurige zorg (WLZ)) are listed in the Decree on Extensions and Limitations of the Circle of Insured Persons (Besluit Uitbreiding en Beperking Kring Verzekerden Volksverzekeringen).

Not applicable: universal system.

All residents without compulsory insurance. For students, only stay in Austria required.

No possibility of voluntary insurance.

Not applicable.

Possibility of voluntary insurance as a complement or supplement to compulsory insurance covering de facto all residents.

Not applicable. Scheme based on voluntary registration.

Civil servants: no possibility of voluntary insurance.

Not applicable (possibility of additional insurance for certain services not provided under the system or for foreign nationals who are not eligible for the compulsory system).

Not applicable: universal system.

• Persons who prior to their voluntary membership had been insured for at least twelve months during the preceding two years,
• persons receiving a pension from a foreign State,
• persons who have paid social tax for themselves or for whom social tax has been paid for each month of  the calendar year preceding the conclusion of the social tax contract

Not applicable: universal system.

No possibility for voluntary insurance.

Voluntary insurance is possible after withdrawal from compulsory insurance or from family insurance as well as in– case of first-time employment in Germany with annual earnings exceeding –the annual income limit.

Voluntary insurance possible for persons who are no longer insured because of long-term unemployment, or because they were insured as dependants and this dependency does no longer exist due to a divorce.

Persons not insured/not entitled to health care can enter into contractual arrangements with the National Health Insurance Fund (Országos Egészségbiztosítási Pénztár) for entitlement to health care services. In case of adults, the contribution amounts to half of the minimum wage, in case of minors and students 30% of the minimum wage.

Not applicable: universal system.

Persons may take out private voluntary insurance for a wide range of health services.

Possibility to take out voluntary insurance for:

• foreign citizens holding a residence permit valid more than 3 months;
• foreign citizens studying or working au pair in Italy, despite the length of their residence permit.

Not applicable: universal system.

No possibility for voluntary insurance.

Voluntary health insurance is possible as supplementary to the compulsory one.

Possibility to subscribe to a voluntary insurance.

Not applicable: universal system.

Not applicable: universal system.

Voluntary insurance possible for persons who are not covered by compulsory health insurance, e.g. person living on his/her investment income. Rate: 9.0% of national average wage.

Entitled to the full range of benefits available under the compulsory scheme.

Not applicable: universal system.

Not applicable: universal system (but possibility of voluntary insurance as a complement or supplement to compulsory insurance).

No voluntary insurance possible.

No possibility of voluntary insurance in the context of compulsory health insurance.

Voluntary insurance possible (Convenio especial).

Not applicable: universal system.

Voluntary insurance for cross-border employees who are not required to take out insurance.

Health Insurance Act (Zorgverzekeringswet, Zvw): It is possible to take out a voluntary supplemental insurance to cover medical expenses that are not included in the legally defined coverage.

Long term care act (Wet langdurige zorg (WLZ)): No voluntary insurance.

Not applicable: universal system.

Children, with age limits. Spouse only if bringing up the children or having brought them up during at least four years; if she/he benefits from a long-term care allowance of the category 3 (at least) or if she/he provides long-term care for an insured person (category 3). Otherwise: supplementary contribution of 3.4% for the spouse.

Additional elegibility requirements for a non married partner (also same sex): no kinship with insured person, joint household for at least 10 months and housekeeping free of charge.

Spouse, cohabitant, children under 25 years of age (6 categories), ascendants (in some cases parents in law).

Income conditions: earnings, pensions, annuities, allowances or indemnities lower than €2,326.00 per quarter (amount for the 4Q 2014).

Not applicable.

• spouse or cohabitee,
• children: legitimate, illegitimate, step and foster children until 18 years of age (if parents make this choice as children can have their health insurance),
• other dependent orphaned children,
• dependent parents , if incapable to lead an independent life and work, without resources for self-support, and
• disabled grandchildren, brothers, sisters and grandparents, if dependent upon the insured person, without resources for self-support .

• Husband or wife,
• direct descendants who are under the age of 21 or are dependants of either the husband or of the wife.

Derived rights for family members according to the Regulation EC 883/2004.

Not applicable: universal system.

All residents are individually covered.

Dependent spouse.

Children are individually covered.

Not applicable: universal system. All residents are individually covered.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

Minor dependent child.

Spouse and children, income not exceeding €415 or €450 per month if employed in insignificant employment, provided they are not insured in their own right, or active as self-employed. Age limit for children. Some other exclusions.

Divorced spouses, whose non-contributory family insurance ends after the divorce, can insure themselves voluntarily after the divorce has become final subject to certain conditions).

Dependent family members of the insured person.

Flat-rate health care contribution shall be paid: HUF7,050 (€23) per month, in case of continuous residence in Hungary for a year.

Not applicable: universal system. All residents are individually covered.

Full eligibility: Dependants of persons whose incomes are below a certain threshold or who hold a discretionary medical card.

Limited eligibility for dependants of remainder of population.

Beneficiary's dependent family members.

Children (up to the age of 18).

Not applicable: universal system. All residents are individually covered.

Not applicable: all insured persons are individually covered.

Children in respect of whom the insured person obtains tax reduction; spouse; partner; a parent or relative of the 1st/2nd/3rd degree who, in the absence of a spouse, takes care of the insured person’s household.

Direct entitlement based on residence, no derived rights.

Not applicable: universal system. All residents are individually covered.

• Spouse,
• children (legitimate, illegitimate, step and adopted) up to the age of 18 (26 for full- time students),
• parents running the insured person's household (unless they are personally insured and therefore not dependent on the insured person).

Not applicable: universal system. All residents are individually covered.

Spouse.

Not applicable: universal system. All residents are individually covered.

• Spouse or unmarried partner;
• children (legitimate, illegitimate and adopted);
• stepchildren supported by the insured person;
• other persons supported by the insured person (parentless grandchildren, brothers, sisters and other children, permanently invalid parents, stepparents and adoptive parents with insufficient means for subsistence).

Spouse and partner, dependent ex-spouse, dependent descendants younger than 26 or with a degree of disability of at least 65%, residing in Spain.

Divorce, judicial separation and annulment do not forfeit entitlement to health care of dependent spouse and descendants who fulfil the requirements or of cohabitants if they are not entitled to a benefit themselves.

Not applicable: universal system. All residents are individually covered.

Not applicable. All residents are insured individually.

Not applicable: universal system. All residents are individually covered.

Not applicable: universal system. All residents are individually covered.

No qualifying period required (Exception: certain benefits which are within the insurance funds' discretion; for voluntarily insured persons the qualifying period is 6 months).

The proof of payment of minimum contributions for the past year usually opens entitlement to health care benefits for the following calendar year.

Qualifying period of 6 months in case of re-insurance and if the validity of the previous registration ended as a result of failure to comply with the contribution conditions.

Tax-funded system:

The right to health care from the tax-funded system is subject to:

• For Bulgarian nationals (and all EU nationals) and foreign students in higher schools: no qualifying period;
• For foreigners (who are not EU nationals): permanent or long-term residence.

Compulsory health insurance:

The right to a health care based on contributions is acquired:

• For newly born children: as of the date of birth;
• For recognised refugees, those with humanitarian status or those with asylum: as of the date of opening the procedure of recognising the status of the person as refugee or asylum, or humanitarian status;
• For foreign tertiary and post-tertiary students: as of the date of registration with the university; 
• For all other persons: as of the date of payment of the health insurance contribution.

Insured persons who have not made more than 3 contributions in the last 36 months shall pay the provider for medical treatment.

After the insured person pays all the due contributions for the last 60, months, their insurance rights are restored from the day of payment. The sums paid for the medical treatment previously received are not reimbursed.

No qualifying period.

Healthcare benefits are granted to persons who have contributed to the Social Insurance Scheme for a minimum period of three years (including assimilated insurance periods).

No qualifying period required.

From 1 January 2007 no qualifying period. Entitlement as from registration in the National Register of residence in Denmark.

Generally no qualifying period required.

For persons working on the basis of an employment contract, duration of the contract has to exceed one month.

For persons receiving remuneration or service fees on the basis of:

• a contract for services,
• an authorisation agreement or
• a contract under the Law of Obligations for the provision of any other services.

No qualifying period required.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

On condition of employment (in the first hour of work) or a stable and regular residency of at least 3 months.

No qualifying period. Exceptions: claimants must fulfil conditions of entitlement for receiving dentures (for certain categories of persons).

50 days of work subject to contribution over the preceding year, or in the 12 first months of the 15 months preceding the illness.

No qualifying period required.

6 months’ residency for new residents counting from the day of registration.

Must be "ordinarily resident" in Ireland.

No qualifying period required.

No qualifying period required.

No qualifying period.

No qualifying period required.

No qualifying period required, except for optional voluntary insurance where a three-month qualifying period is applicable.

No qualifying period required.

No qualifying period required.

No qualifying period required.

No qualifying period required.

No qualifying period required.

No qualifying period required.

No qualifying period except for orthopaedic equipment, spectacles, hearing medical devices, prosthetics and other aids: up to six months insurance (except for certain groups e.g. children or victims of accidents at work, occupational diseases and other listed diseases).

No qualifying period required.

No qualifying period required.

No qualifying period required.

Health Insurance Act (Zorgverzekeringswet, Zvw):

No qualifying period required.

Long term care act (Wet langdurige zorg (WLZ)):

Anyone who comes from abroad to settle in the Netherlands and consequently becomes eligible for entitlements under the WLZ is subject to a waiting time equal to one month for every year that a person was uninsured under the WLZ, up to a maximum of twelve months.

The waiting time applies to inpatient care deemed ‘indicated’ at the start of the insurance or care that will be required in the foreseeable future. Incidentally, this does not mean that these individuals will be unable to obtain care, but no claim for the associated costs can be made under the WLZ.

No qualifying period required.

No specific limits (also valid after the termination of the membership, as long as it is the same illness).

Otherwise, entitlement to health care continues for 6 weeks after the end of insurance affiliation.

No specific limits as long as the conditions for entitlement are fulfilled.

No specific limits.

No specific limits.

No specific limits.

No specific limits (as long as the person is considered to be an insured person).

No specific limits.

No specific limits. Insurance coverage for employees continues 2 months after the payment of Social Tax (sotsiaalmaks) has stopped. Coverage for persons for whom the State pays Social Tax continues 1 month after the last payment.

No specific limits.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

No specific limits.

Unlimited. When an employee withdraws from the insurance scheme, benefits cease to be paid basically at the end of membership; for compulsory members entitlement to benefits continues for maximum one month after end of membership.

No specific limits.

No specific limits.

No specific limits.

No specific limits, but medical eligibility is reviewed.

No specific limits.

No specific limits.

No specific limits.

No specific limits.

No specific limits.

If affiliation comes to an end, entitlement is maintained for the rest of the month and for the 3 following months. The right is also maintained for illnesses in the course of being treated.

Unlimited.

No specific limits.

No specific limits.

No specific limits.

As long as the insured status is proved or implicit according to the law. The insured status and the insurance rights are lost when losing the right to live or reside in Romania.

No specific limits.

Unlimited.

No specific limits.

No specific limits.

Unlimited.

No specific limits.

No specific limits.

The relationship between medical doctors or group practices and insurance funds is governed by individual contracts, the contents of which are determined to a far-reaching extent by overall contracts with the Regional Chambers of Medical Doctors (Ärztekammer).

All doctors registered with the Order of Doctors (Ordre des médecins/Orde van geneesheren) and approved by the Minister of Public Health (Ministre de la Santé publique/Minister van Volksgezondheid).

Tax-funded system:

Working in medical establishments contracted by the Ministry of Health (Министерство на здравеопазването).

Compulsory health insurance:

Contracted by the National Health Insurance Fund (Национална здравно осигурителна каса

Medical doctors may be employed by the state-owned medical institutions or may conclude contracts with the Croatian Health Insurance Fund (Hrvatski zavod za zdravstveno osiguranje). Contracted doctors have to provide their own office and equipment. Both employed and contracted doctors provide social health care based upon the standards provided for by the compulsory basic health care legislation.

Qualified doctors employed by the Government.

All doctors qualified to practice, who have been approved by the Regional Authority and are members of the Czech Medical Chamber.

All doctors qualified to practise and registered by the National Health Board (Sundhedsstyrelsen) (numbers limited by district according to number of inhabitants).

Doctors employed in State, municipal or private health institutions or private doctors with whom the Health Insurance Fund (Haigekassa) has entered into a contract.

All doctors must be approved by the National Supervisory Authority for Welfare and Health (Sosiaali- ja terveysalan lupa- ja valvontavirasto, Valvira).

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

All doctors qualified to practice.

Contract doctors who are members of the associations of sickness fund doctors (Kassenärztliche Vereinigungen) at regional and national level, health care centres, approved doctors and approved institutions (e.g. hospitals). Authorisation according to demand planning.

All doctors employed in PEDY (Primary National Health Care Network- Πρωτοβάθμιο Εθνικό Δίκτυο Υγείας-ΠΕΔΥ) Health Units (formerly EOPYY Units) and all private doctors contracted by the National Organisation for Healthcare Services Provision (EOPYY) (ΕΝΙΑΙΟΣ ΟΡΓΑΝΙΣΜΟΣ ΠΑΡΟΧΩΝ ΥΠΗΡΕΣΙΩΝ ΥΓΕΙΑΣ - ΕΟΠΥΥ).

Doctors employed by State-run health institutions; or private doctors contracted by the National Health Insurance Fund (Országos Egészségbiztosítási Pénztár).

All doctors qualified to practise. Medical licence is issued by the Directorate of Health (Embætti Landlæknis). Independent general practitioners and specialists must be a party to a contract with the Icelandic Health Insurance (Sjúkratryggingar Íslands).

General Practitioners (GPs) provide services under the General Medical Services (GMS) Scheme on the basis of a contract held with the Health Service Executive (HSE), which was negotiated between the HSE, the Department of Health and the Irish Medical Organisation (IMO).

GPs provide services in respect of children under 6 years of age under a separate contract with the HSE.

The following doctors are able to provide medical care services covered by social security:

• doctors employed either by the regional health authorities, or by the public or contracted hospitals;
• general practitioners, paediatricians and specialists approved under the contract concluded between the SISAC (Interregional Structure) and the Ministry of Health, approved in State/Regions Conference.

All doctors registered in accordance with the Medical Treatment Law (Ārstniecības likums) and contracted by the National Health Service (Nacionālais veselības dienests).

All doctors with license of medical practice from the Office of Health and a contract with the Health Insurers Association.

Doctors are employed by the State health institutions, by municipal health institutions and/or by private health care institutions.

A licence is needed to practice as a doctor in medicine which is issued by the State Health Care Accreditation Agency under the Ministry of Health.

All doctors authorised by the Ministry of Health to practice medicine.

Doctors providing health care at Public Hospitals and Health Clinics are employed by the State.

Doctors working in Malta should be registered with the Malta Medical Council and be holders of a Medical Indemnity Insurance.

All doctors qualified to practise can in principle be connected to the public system.

However, a doctor who wants to set up a practice, can only obtain refunds from National Insurance (folketrygden), if he has an agreement with the municipality, or, when a specialist, with the State owned regional health enterprise.

According to Directive 2005/36/EC, a doctor who wants to set up a general medical practice from 1 January 2006, can only obtain refunds from National Insurance (folketrygden) if he is in possession of a diploma, certificate or other evidence of formal qualification of at least three years of specific training in general medical practice.

The number of agreements depends on the need for health services in the area, as seen by municipal and regional health authorities.

Doctors contracted by a regional National Health Fund (Narodowy Fundusz Zdrowia, NFZ).

Health professionals in the National Health Service are civil servants who report to the Ministry of Health.

Doctors should be members of the College of Physicians of Romania (Colegiul Medicilor din România) and the health care providers should be evaluated by the National Commission of Evaluation (Comisia Naţională de Evaluare) in order to be included in the social health insurance system.

The health insurance agencies negotiate contracts with providers of health care, and only doctors employed by those providers or health care professionals licensed to provide medical care are authorised to provide care which will be reimbursed under social security insurance.

Approved doctors either:

• Employed by the Health Insurance Institute of Slovenia (Zavod za zdravstveno zavarovanje Slovenije), or
• with a licence from the Medical Chamber of Slovenia (Zdravniška zbornica Slovenije), a first level concession from municipalities, and for other private providers from the Ministry of Health (Ministrstvo za zdravje), and contracted by the Health Insurance Institute of Slovenia (known as doctors with a concession).

The Public Health Services (Servicios Públicos de Salud) appoint doctors to vacancies on the basis of competitive examinations.

All doctors qualified to practise can be affiliated to the county councils (landsting) or regions (regioner) and the public health care system.

Doctors with the federal diploma (or a foreign diploma recognised as equivalent) and having received practical post-graduate training. Limitation of admission to provide medical services at the insurance's expense has been introduced (needs test); applicable until 30 June 2016 at the latest.

All doctors qualified to practise.

Doctors licensed to practice by the General Medical Council (the statutory licensing body).

Local Primary Care Organisations (PCO) are responsible for the delivery of NHS primary medical services - i.e. general practitioner (GP) services - for NHS patients through four contractual routes:

• General Medical Services (GMS); traditional model of general practice delivered under a nationally negotiated contract;
• Personal Medical Services (PMS); created in 1997 and intended to deliver, through a local contract, a locally sensitive version of GMS and address needs not otherwise met by GMS. Services can be narrower through “Specialist” PMS (SPMS). PMS increasingly mimics GMS;
• Primary Care Trust Medical Services (PCTMS); directly provided as well as managed by the PCO, often to fill a perceived gap in provision or for part of a service, e.g. Out of Hours (OOHs) care;
• Alternative Provider Medical Services (APMS); created in 2004 allows primary medical services to be competed for by the private, voluntary and public sectors, sometimes in partnership, generally for a comprehensive primary medical service but can be narrower. Some OOHs providers are de facto APMS. GP practices can acquire APMS contracts.

Fees are laid down in the overall contracts between the Regional Chambers of Medical Doctors (Ärztekammer) and the insurance funds (flat-rate per person, per sick case or per medical treatment or a combination of all).

Payment on a fee-for-service basis. Scales of fees fixed by agreement between the insuring bodies and doctors' organisations or, failing this, laid down officially.

If no contract exists or for non-approved doctors, fees fixed freely by doctors (except for certain categories of patients) and the insurance refund is laid down by royal decree.

Tax-funded system:

Salaried.

Compulsory health insurance:

Primary medical care: capitation and fee-for-service. The capitation fee is fixed in the National Framework Contract between the National Health Insurance Fund (Национална здравно осигурителна каса) and the Bulgarian Doctors’ Association (Български лекарски съюз), and in the National Framework Contract between the National Health Insurance Fund and the Bulgarian Dentists’ Association (Български зъболекарски съюз).

Specialised medical care: fee-for-service.

Contracted doctors:

Capitation: the doctor is paid a fixed amount for every patient who is registered with him. Capitation payment is set up according to general acts of the Croatian Health Insurance Fund (Hrvatski zavod za zdravstveno osiguranje).

Doctors employed by state-owned medical institutions:

Salaried.

Government doctors are salaried employees.

Out-patient care paid through a contract with a health insurance fund:

• General practitioners: Paid through a combination of capitation fee (CZK 47 – CZK 52 (€1.7 – €1.9) per registered patient and the range of service) and fee for services based on a point system.
• Specialists: paid through a fee for services based on a point system.

Fees are fixed by agreement between the Danish Medical Association and the public health service. General practitioner’s (GP) fees are calculated according to the number of patients registered and of the medical services performed. Specialists are paid a flat-rate sum for each medical intervention.

Hospital doctors are, in general, paid on the basis of a monthly salary plus certain supplementary payments.

• Doctors in the State and municipal health institutions are salaried.
• Doctors can also be self-employed.
• Health Insurance Fund (Haigekassa) pays for services to health institutions or private doctors according to a fee-for-service based price list approved by the Government.

The actual payment methods, service prices and benefits package are all included and regulated in a single government-approved health service list, that is, they are not determined during the contract negotiation process.

The basis for the content of the contracts is set by the Health Insurance Act (Ravikindlustuse seadus) and the Health Insurance Fund’s Supervisory Board endorses the basic principles for contracting. The Health Insurance Fund negotiates the standard contract conditions with providers representing associations such as the Society of Family Physicians and the Hospital Association. This ensures that once the Health Insurance Fund and the provider associations agree on the contract terms, they are universal, that is, they apply to all providers. Once providers are selected and standard contract conditions are agreed with providers’ associations, further negotiations with selected providers in specialist care continue to determine the volume of services as well as the average case prices by specialty. This only applies to specialist care, as for primary care the contract volume is not subject to negotiation. These negotiations do not determine the actual payment method but constitute a planning element aimed at containing costs for each case.

Doctors working at public hospitals or health centres (Terveyskeskus) are employed and paid by the municipalities.

Doctors working in private sector are paid on a fee-for-service basis.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

Predominantly fee-for-service and partly pay for performance. Scales of fees fixed by agreement.

The health insurances always pay the total remuneration due to morbidity with liberating effect to the respective association of sickness fund doctors (Kassenärztliche Vereinigungen): Consequently, the higher the need for treatment the higher is the total remuneration to be agreed annually for the subsequent year.

In addition to this, health insurances pay for agreed special services a remuneration outside of total remuneration due to morbidity. The share of this service is increased continuously.

The contract doctors bill their services to the association of sickness fund doctors according to a fee distribution scale (Honorarverteilungsmaßstabs).

The fee distribution scale is set by the association of sickness fund doctors in consultation with the associations of sickness funds.

Next to the remuneration of the association of sickness fund doctors, it is possible for doctors to gain more Income through individual contracts with the sickness funds, such as for primary care.

Private doctors contracted by the National Organisation for Healthcare Services Provision (EOPYY) (ΕΝΙΑΙΟΣ ΟΡΓΑΝΙΣΜΟΣ ΠΑΡΟΧΩΝ ΥΠΗΡΕΣΙΩΝ ΥΓΕΙΑΣ - ΕΟΠΥΥ) are paid per visit (€10 per visit, with a monthly ceiling of 200 visits). Doctors employed in PEDY (Primary National Health Care Network Πρωτοβάθμιο Εθνικό Δίκτυο Υγείας-ΠΕΔΥ) Health Units are salaried.

• Employed doctors: salaried.
• Contracted doctors: capitation (per capita financing), fee-for-service, paid by the National Health Insurance Fund (Országos Egészségbiztosítási Pénztár) on a contractual basis, and lump sum provided by public authorities.

General practitioners employed in health care centres are salaried. Independent general practitioners and specialists receive a fee-for-services fixed by a contract with the Icelandic Health Insurance (Sjúkratryggingar Íslands). Doctors employed in public hospitals are salaried.

The vast majority of GMS Scheme contracted GPs are paid an annual capitation fee per eligible patient in accordance with a scale of fees agreed under conditions of the contract. Payments are also made under the contract for "out of hours" and a range of special services. Less than 1% of GPs continue to provide GMS services under the fee-per-item contract, which pre-dated the capitation contract. Fees and payments payable to GPs under the GMS scheme are set out in Regulations.

Payments are also made to general practitioners for certain other non GMS Scheme services provided by them and not covered by the capitation scheme.

Employed doctors and hospital doctors: variable monthly wages, determined by the government according to professional categories.

General practitioners  and paediatricians of free choice (family doctors):

Flat-rate yearly amount per capita.

Approved specialists:

Flat-rate amount per hour.

• General practitioners' monthly salary is composed of a fee calculated according to the number of registered patients, the distribution of registered patients into age groups (capitation), the medical services performed, additional payments (for example, for the care of chronically ill patients, additional payment depending on the distance from the GP practice to the nearest hospital, etc.) and of patient contributions. In addition GPs are entitled to receive a performance payment based on a number of quality points once a year.
• Specialists’ monthly salary is composed of the fixed sum for one health care episode of one patient (30 days), of a fee-for-service (there is a list of additionally paid services) and of patient contributions.
• Hospitals: combination of two methods, i.e. fee-for-service and DRGs (diagnosis related groups under which there is a fixed reimbursement for particular types of diagnoses), as well as fixed monthly additional payments for certain hospitals. Hospital doctors are, in general, paid on the basis of a monthly salary.

Remuneration is regulated in a tariff agreement between the Chamber of medical doctors and the association of sickness insurers (remuneration per service) and approved by the government.

Doctors employed by the State and municipal health care institutions are salaried. The Territorial Health Insurance Funds (teritorinės ligonių kasos) pay for the provided health care services to contracted health care institutions:

• Primary health care: according to the risk-adjusted capitation plus fee for service for preventive health care measures and bonuses for achievement of certain indicators;
• Out-patient specialist care: payment per consultation (for the episode of treatment including up to 3 visits);
• In-patient care: DRG (Diagnosis Related Group) method and original case mix method;
• Long-term in-patient health care: per bed day.

Fees according to collective agreements negotiated between the sickness insurance and the representative professional organisations. List of services and fees. Scales of fees are indexed according to changes in the cost of living and annually adapted after fee negotiations. Fee for service.

Doctors are paid a fixed salary irrespective of how many patients are treated.

Some doctors are in public employment in municipal primary health service (primærhelsetjenesten).

Others are private practitioners in part remunerated through municipal or State grants, in part by National Insurance (folketrygden) through direct settlement arrangements.

Fee rates for private practitioners are negotiated between the government and the doctors' organisations. The patient pays cost-sharing charges directly to the doctor in both cases.

Capitation basis. The doctor is paid a fixed amount for every patient that is registered with him/her, regardless of how many times that patient visits the doctor. Fees are set up by negotiations between doctors and the regional National Health Fund (Narodowy Fundusz Zdrowia, NFZ).

Monthly salary, varying according to professional category.

Family doctors/general practitioners: capitation and fee for service provided.

Specialists in hospital and in outpatient services of the hospitals: salaried.

Specialists in outpatient services: fee for service provided.

Doctors are paid by the health insurance institutions. Their payment is a combination of a per-capita payment (number of registered insured patients) and the evaluation of special medical out-patient performance (in points). The price is the result of negotiations process between the health insurance agencies and organisations of health care providers. Doctors without contracts with a health insurance agency are paid in full by the patient.

Public health care services:

• Publicly employed salaried doctors: salary defined by law and collective agreement;
• Private doctors with a licence: payment for programme for health services (capitation and fee-for-service), defined in the doctor's contract with the Health Insurance Institute of Slovenia (Zavod za zdravstveno zavarovanje Slovenije).

Private doctors:

Fee-for-services.

General practitioners and specialists working outside hospitals are, in general, paid on the basis of a lump sum (fixed by decree) determined by the number of insured persons entered on their list, thereby guaranteeing a minimum level of earnings.

Hospital doctors are, in general, paid on the basis of a monthly salary plus certain supplementary payments.

Doctors employed by the public health authorities are salaried.

Affiliated private practitioners are paid according to a tariff fixed after negotiations between the county councils (landsting) or regions (regioner) and the doctors' organisation.

Uniform tariff structure at federal level setting the number of points per medical service (TARMED); the point value is negotiated in each canton.

The Netherlands has divided the costs of specialist medical care into 3 segments: fixed, regulated and free:

• Fixed: paid by the National Health Care Institute (Zorginstituut Nederland)) directly to healthcare providers,
• Regulated: maximised tariffs paid by the private health insurance companies (case mix A or A-DBCs),
• Free: free tariffs paid by the private health insurance companies (case mix B or B-DBCs Free Segment).

Hospitals are only allowed to make a declaration of expenses for the performances that are determined in advance by the Dutch Health Care Authority (Nederlandse Zorgautoriteit).

GMS contracts are between practices (contractors) and PCOs. GMS contractors are entitled to payments as set out in the Statement of Financial Entitlement (SFE). Responsibility for funding the contract lies with PCOs.

In order to ensure treatment in public hospitals (non-profit institutions), state health funds (Landesgesundheitsfonds) were set up in the 9 Länder. These funds are responsible for the handling of treatment in each individual case. The costs of treatment are usually determined according to achievement-oriented criteria. The sickness insurance contributes to the expenses through a flat-rate contribution independent of the individual case. Private law contracts financed by a separate fund were concluded with those hospitals (in most cases profit-oriented) which do not belong to the state health funds (Landesgesundheitsfonds). The state health funds receive that portion of their expenses which is not covered in the flat-rate contribution by the health insurance through taxes.

Health care institutions approved by the Minister of Public Health (Ministre de la Santé publique/Minister van Volksgezondheid), Fees fixed by agreements or, failing this, by the public authorities.

Financing: budget of financial resources (budget des moyens financiers/budget van financiële middelen) and doctors’ fees ceded in part to the hospitals.

Tax-funded system:

Hospitals contracted by the Ministry of Health (Министерство на здравеопазването).

Compulsory health insurance:

All hospitals contracted by the National Health Insurance Fund (Национална здравно осигурителна каса).

There are no differences in payment between public and private hospitals. The payment is based on the monetary value of the so-called “clinical path” (system of requirements and guidelines for behaviour of different types of medical specialists applicable to different medical procedures and patients with particular diseases requiring hospitalisation). The monetary value of each clinical path is fixed by the National Framework Contract. The National Health Insurance Fund transfers to the hospitals a sum, equal to the value of each realised clinical path. Hospitals can receive funds only for one clinical path per hospitalised patient.

Public and private institutions contracted by the Croatian Health Insurance Fund (Hrvatski zavod za zdravstveno osiguranje).

State hospitals and institutions. Limited use of private hospitals that entered into agreements with the Ministry of Health (Υπουργείο Υγείας).

State hospitals are financed by the State.

In-patient institutions (may include the out-patient part) established by the State, regional administration, municipal administration, private person or a legal body obtain financial resources on the basis of a contract concluded with the health insurance institutions:

Hospitals providing acute treatment:

• individually contracted part of reimbursement based on classification of hospitalised patients,
• lump sum payments for hospital care,
• fee for out-patient care services based on a point system.

Institutes for long-term patients:

• lump sum payments per 1 day of hospitalisation.

Public hospitals are the responsibility of the regional health authorities and are financed by taxes.

Private hospitals: the regional health authorities may conclude agreements with private hospitals. Private hospitals are only financed by taxes when providing services instead of public hospitals (e.g. in case of excess waiting time, see “Benefits, 2. Hospitalisation, Choice of and access to hospital”).

Health institutions contracted with Health Insurance Fund (Haigekassa) on fee-for-service basis.

Primary health care is given in local health centre (Terveyskeskus) units and specialist treatment is given in public hospitals. These services are provided by municipalities and funded by taxes. There are only a small number of private hospitals.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

Public hospitals and private institutions: payments linked to activity.

The sickness funds pay in-patient care in university clinics and hospitals included in the respective Land's hospital requirement plan or with which the Länder associations of sickness insurance funds have concluded agreements (approved hospitals). The basis for the amount of remuneration is a service related hospital-budget, which is aligned to a single price level per Land in case of a diagnosis-related flat-rate per case (DRG). The settlement towards the sickness funds takes place through a diagnosis-related flat-rate per case in case of acute in-patient services. Services in psychiatric, psychosomatic and psychotherapeutic facilities were settled through daily care charges. As of 1 January 2013, a performance-related flat-rate remuneration system based on per diem remuneration is gradually introduced, initially on a voluntary basis.

All National Health System (ESY) (ΕΘΝΙΚΟ ΣΥΣΤΗΜΑ ΥΓΕΙΑΣ- ΕΣΥ) hospitals. EOPYY concludes tariff agreements with private clinics. The insured person has to pay a co-payment in contracted private clinics.

Hospitals are contracted and financed by the National Health Insurance Fund (Országos Egészségbiztosítási Pénztár).

Public hospitals are established by the State and financed by taxes, via the State budget.

Public health care is provided by hospitals run by the Health Service Executive (HSE) and by those run on a voluntary basis (e.g. by religious orders).

Funding is predominantly from Central Government and co-payments from patients and also funding from private health insurers.

HSE receives funding from Central Government and allocates funding to hospitals directly under its control and to Joint Board and Voluntary Hospitals in accordance with arrangements made with them.

Private hospitals do not provide public health care, unless contracted to do so through a service level agreement with the HSE.

Except for those acting as a hospital trust with a proper legal status in each region (i. e. highly specialised and/or University hospitals) hospital structures are the responsibility of the Local Health Authority (Aziende sanitarie locali - ASL).

The following structures are able to provide hospital care services covered by social security:

• public hospitals set up by the regional health authorities;
• private clinics contracted by the regional authorities.

They are financed on the basis of a price scale for benefits provided.

State owned hospitals and municipal hospitals contracted with the National Health Service (Nacionālais veselības dienests).

Private hospitals may also enter into contractual relations with the National Health Service.

The hospitals with which the National Health Service concludes contracts about the delivery of inpatient services are listed in annex 17 of the Regulations of the Cabinet of Ministers No. 1529 "Health care organisation and financing procedure" 17/12/2013.

All domestic hospitals.

The government concludes tariff agreements with foreign hospitals.

Upon request of the contracted hospital, the sickness funds guarantee the assumption of the relevant costs. This refund commitment can be limited in time by the funds.

State- or municipality-owned hospitals or private hospitals. All these hospitals may be under contract with the Territorial Health Insurance Fund (teritorinė ligonių kasa).

Contracted hospitals are paid by the Territorial Health Insurance Funds for the health care services they provide. In general, hospitals are financed from the State budget, from municipal budgets, by the National Health Insurance Fund under the Ministry of Health (NHIF) (Valstybinė ligonių kasa prie Sveikatos apsaugos ministerijos) and from private sources.

Each hospital negotiates a separate budget with the sickness insurance on the basis of its predicted activities. Doctors in hospitals are remunerated on a fee-for-service basis.

Health care provided in public hospitals/clinics is free of charge at the point of care.

Hospitals are owned and run by the State through four regional health enterprises. They are financed through block grants and activity- based funding.

Private hospitals exist; some have agreements with the regional health enterprises. Some private hospitals are financed partly through State block grants and activity-based funding, and others are partly financed through the agreements with the regional health enterprises.

Public and private hospitals contracted by a regional National Health Fund (Narodowy Fundusz Zdrowia, NFZ).

Reimbursement of the costs of medicines and benefits in kind by the National Health Fund according to the one-year-contracts concluded with public and private benefit providers.

The National Health Service (Serviço Nacional de Saúde, SNS) includes hospitals, local health services, health centres and groups of health centres, which fall under the responsibility of the Ministry of Health.

There are five regional health administrations on the continent, as well as two regional independent health administrations on the islands of Madeira and the Azores, which manage hospitals, healthcare units and centres. There are also reference hospital networks.

Public or private hospitals authorised/advised by the Ministry of Health and contracted by the National Health Insurance House (Casa Naţională de Asigurări de Sănătate).

Public (State or regional), non-profit and private health care institutions which are contracted to provide medical care, are financed from the public health insurance system.

Hospitals can achieve preferred status for the purposes of contracting with health insurance agencies if they are listed as part of the public minimal net of health care providers (with defined minimum numbers of physician posts, nurse posts and hospital beds).

Public hospitals and clinics.

Private hospitals with a licence from the Ministry of Health (Ministrstvo za zdravje) and a contract with the Health Insurance Institute of Slovenia (Zavod za zdravstveno zavarovanje Slovenije).

Hospitals of the National Health System (Sistema Nacional de Salud).

Public or private hospitals operating under agreement with the Autonomous Communities (Comunidades Autónomas) or with the National Institute for Health Management (Instituto Nacional de Gestión Sanitaria, INGESA).

Public financing in case of hospitals of the National Health System. In case of private institutions, financing through agreements with the competent public body.

Public hospitals established and financed by the county councils (landsting) or regions (regioner).

Private hospitals: the county councils or regions may conclude agreement with private hospitals.

Public and private hospitals on the cantonal list of approved hospitals.

All hospitals in the Netherlands are private entities. Payments to hospitals depend on the type of performance:

• Fixed: paid by the National Health Care Institute (Zorginstituut Nederland,
• Regulated: maximised tariffs paid by the private health insurance companies,
• Free: free tariffs paid by the private health insurance companies.

Public hospitals are in the main administered by the National Health Service. Most of their funding comes from local health bodies (Primary Care Trusts, or PCTs) which are responsible for commissioning health services for local people. The PCTs receive their funding from the Government.

Free choice of doctors or group practices under contract (Vertragsärzte bzw Vertragsgruppenpraxen).

Free choice of doctor.

Direct payment of provider of care by the insurance body, if beneficiary is hospitalised.

Patients must register with a general practitioner (GP) who has a contract with the National Health Insurance Fund (Национална здравно осигурителна каса). Re-registration is possible twice a year (during the periods 1-30 June and 1-31 December).

Free choice of primary health care doctor (general practitioner, paediatrician, gynaecologist and dentist). The patient registers with his/her family doctor for a period of one year, after which they are free to register with the same doctor or go elsewhere. There are provisions for changing doctor within the one-year registration period, for example if the patient moves or there are communication problems with the doctor.

Free choice of government doctors. Patients are not obliged to register with one general practitioner.

Insured persons have the right of free choice of a primary health care physician who has a contract with his/her insurance company. They can re-register with a new physician every 3 months. There are no restrictions on the patient's choice of health care provider.

Every resident can choose once a year between two groups:

Group 1 entitles to free medical treatment by a GP who has joined the collective agreement with the Public Health Service.

Group 2 entitles to free choice of medical practitioner - also among GPs who have not joined the collective agreement. The Public Health Service in this group only pays a part of the doctor's fee.

Free choice of general practitioner.

Public hospital and health centre:

Patients have the right to choose among the health centre (Terveyskeskus) units for primary health care services. No more than once a year, they may transfer from one health centre unit to another by giving a written notification.

Each person may only be registered with one health centre unit at a time. Persons who stay outside of their municipality of residence for extended periods, for example at their summer houses, may also seek the treatment prescribed in their treatment plans from health centres located in their municipality of temporary residence.

A person who needs specialised medical care services can also choose to use any of the specialised medical care units. The treatment facility will be selected together with the referring physician or dentist.

Insofar as possible, the patient also has the right to choose the physician or other health care professional treating him or her.

The patients can choose the health centre unit and specialised care unit among all public health centres and hospitals in Finland.

Private doctor: Free choice.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

Free choice of doctor.

Free choice among contracted specialists.

Article 5 of Law 4238/2014 introduced the institution of family doctor, who will provide services of primary health care.  Decisions of the Minister of Health are going to determine:

1) the number of recipients who can choose their own family doctor,

2) the required number of Family Physicians per Local Services Network (Τοπικό Δίκτυο Υπηρεσιών Π.Φ.Υ.) of To.P.F.Y. (Τομέα Πρωτοβάθμιας Φροντίδας Υγείας),

3) the procedure of choice,

4) the content of services,

5) the continuing education of Family Physicians and

6) all other necessary details.

The Ministerial Decisions have not been issued yet.

Alternatively, free choice of private doctors contracted by the National Organisation for Healthcare Services Provision (EOPYY) (ΕΝΙΑΙΟΣ ΟΡΓΑΝΙΣΜΟΣ ΠΑΡΟΧΩΝ ΥΠΗΡΕΣΙΩΝ ΥΓΕΙΑΣ - ΕΟΠΥΥ), subject to availability.

Free choice of (employed or contracted) general practitioners. Patients have to register with one general practitioner. There are no geographical restraints. Patients are allowed to change a doctor once a year, more than once a year only for a good reason.

Free choice of general practitioners and specialists. Generally, residents are registered with a general practitioner employed in a health care centre or with an independent general practitioner.

Persons with full eligibility (medical card holders) and persons with limited eligibility (GP visit card holders) must choose from a list of local general practitioners who are contracted by the HSE to provide services under the GMS Scheme.

Persons with limited eligibility attending a GP in a private capacity choose their own GP.

Free choice of general practitioner and paediatrician among those contracted with the Region and operating in the insured residence area. The choice is confirmed as long as the insured does not decide otherwise.

The patient has a right to freely register with a chosen general practitioner (GP). S/he may freely change and register with a new GP.

A GP may refuse the registration of a person on his/her patient list if:

• the person’s residence is outside the working area of the GP’s practice, as set in the agreement between the National Health Service (Nacionālais veselības dienests) and the GP in accordance with the GPs’ working area plan approved by the National Health Service and the municipalities.
• there are already 1,800 registered persons or 800 children in the GP’s patient list, unless the persons applying for registration are: 
  • parents, children and spouses of already registered persons, or
  • persons who live in the working area of the GP’s practice.

The patient can freely choose a health care institution and specialist.

Free choice among all licensed contracted doctors. Under the extended compulsory health insurance, additionally access to non-contracted doctors, however with limited cost coverage.

Free choice of doctor at all health care levels. All persons have to choose a general practitioner (GP), (family doctor), to be enrolled in the GP list.

Free choice of doctor for each case of sickness.

Patients can be referred to a specialist - working in the public sector – of their choice in the relevant field of specialisation by his/her GP.

All residents are individually linked to a regular primary doctor of their own choice, where possible. Change of regular primary doctor can be made up to twice a year. Opt-out possibility exists.

Free choice among doctors contracted by the regional National Health Fund (Narodowy Fundusz Zdrowia, NFZ).

Free choice of doctor in the National Health Service.

Free choice of any general practitioner/family doctor.

Free choice of registration with any doctor contracted by the health insurance agencies. The insured persons negotiate a contract on health ambulatory care with the doctor (provider of health care) for a term of 6 months at least.

Free choice of "personal doctor" (general practitioner, gynaecologist, paediatrician and dentist).

Free choice of general practitioner, paediatrician and several specialists within area, provided choice would not bring number on doctor's list above maximum permitted.

Free choice of doctors in the public health care system and private practitioners affiliated to a county council (landsting) or region (region).

Free choice. The insurer pays the costs up to the tariff applicable in the place of residence or work of the insured person or in the surrounding area (except in emergencies or for medical reasons).

The insurer may offer the insured person a form of insurance involving a limited choice (primary care physician, HMO) in return for a reduction in the premium.

Free choice of doctor.

Free choice by patient (or parent/guardian), subject to acceptance by the practice of an application to join its list of NHS patients. Patient usually has to reside within geographical practice boundary. Where a practice refuses such an application, it may offer to treat the person on a private, paying basis.

If a person, who should be able to register as a NHS patient, cannot find a practice willing to accept them, the Primary Care Organisation has the power to assign a patient to a practice's list.

In general, referral required by a general practitioner.

Free choice for patients and free access to doctors.

Upon referral from the general practitioner.

As a rule a patient has to go to the nearest contracted specialist, with referral from a general practitioner. In case they go to another specialist, they pay the transport costs themselves.

Upon referral from their practitioner.

Patients are given direct access, which is not restricted by a gate-keeping system. The only restriction is in case they want to have a non-urgent treatment covered by public health insurance; the provider has to have a contract with the health insurance company of the person concerned.

Group 1: The GP refers each particular case to the specialist.

Group 2: Free choice.

As a rule, access to specialists upon referral of the general practitioner (GP).

GP referral is not required in the following cases:

• for patients suffering from tuberculosis;
• for access to psychiatrists, gynecologists, dermatovenereologists, oculists, traumatologists or for access to surgeons in case of emergency surgery;
• for patients who, due to their medical condition, are referred by a specialist for further treatment or monitoring.

Access to public sector specialists upon referral of a (public or private) doctor.

No referral needed for access to private sector specialists.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

Upon prescription of the general practitioner. Otherwise, the patient's co-payment is higher. Free access to certain specialities or in case of urgency or of displacement.

Free choice among contracted specialists. Certain specialists may, however, only be consulted upon referral. This relates in particular to the field of diagnostic medicine, in which the doctors, as a rule, fulfil an advisory and supporting function in the treatment and diagnosis of illnesses and their causes by other doctors (e.g. radiologists, pathologists and nuclear medicine specialists).

The insured may visit the specialists in PEDY (Primary National Health Care Network- Πρωτοβάθμιο Εθνικό Δίκτυο Υγείας-ΠΕΔΥ) Health Units by appointment according to a waiting list. They may also have access to a private specialist contracted by the National Organisation for Healthcare Services Provision (EOPYY) (ΕΝΙΑΙΟΣ ΟΡΓΑΝΙΣΜΟΣ ΠΑΡΟΧΩΝ ΥΠΗΡΕΣΙΩΝ ΥΓΕΙΑΣ - ΕΟΠΥΥ).

In general, upon referral by the general practitioner, except in cases of emergency. Direct access is provided to dermatology, gynaecology, laryngology, ambulatory surgery and accident/emergency surgery, ophthalmology, oncology, urology, psychiatry. The referral is addressed to the type of specialty and to a service provider who is geographically obliged to the maintenance of the care, patients can enjoy the free choice of specialist. Maintenance of the care can only be refused if it would endanger the care of those patients who are living in that geographical area which the specialist is bound to.

Direct access.

Referral via general practitioner.

It is necessary a prescription made out by a general practitioner or by a specialist employed or contracted with the National Health Service (SSN).

Referral from the general practitioner (GP) required except for:

• dentists for children,
• oncologists in case of oncological diseases,
• gynaecologists,
• psychiatrists in case of psychiatric diseases,
• pneumonologists in case of tuberculosis,
• endocrinologists in case of diabetes,
• dermatologists in case of sexually transmitted disease,
• narcologists in case of alcohol, drug or  psychoactive and toxic substances dependence, 
• ophthalmologists,
• pediatricians,
• child surgeons,
• infectologists in case of HIV,
• sports doctors,
• in case of emergency medical assistance.

No referral needed to a specialist working in the private sector.

Free access to licensed contracted specialists. Under the extended compulsory health insurance, additionally access to non-contracted specialists, however with limited cost coverage.

With referral of the general practitioner, except dermatovenerologist.

The referral is not necessary if the patient suffers from a chronic disease which is in the list approved by the Ministry of Health and is undergoing long-term monitoring.

No restriction for seeing a specialist.

Patients can be referred to a specialist either by their private GP or by a doctor at health Centres.

Regular primary doctor referral. If the patient consults a specialist directly, s/he must pay higher cost-sharing charges, and the specialist may get a lower refund.

Free choice of and direct access to certain specialists (e.g. gynaecologists, dermatologists, psychiatrists, oncologists) working in contracted health centres. In other cases a referral from the general practitioner.

Primary health care is under the "gatekeeping" of the National Health Service. Therefore, access to specialists in a hospital depends on the general practitioner's decision.

Upon referral from the general practitioner or family doctor. No referral needed in emergency cases and for a list of chronic diseases.

Insured persons attend medical specialists by their own choice or upon referral by a general practitioner. This referral is not required in well-defined cases (e.g. the provision of outpatient psychiatric care, of care in a dispensary etc.).

Referral by a general practitioner.

Referral via general practitioner.

Direct access is possible for some diagnosis/treatments. Referral via the general practitioner is most common.

Free choice. See "choice of doctor".

Access via the general practitioner.

Through a general practitioner. There is no direct access to specialists.

No fees paid by the insured person, the payment is made by the insurance fund (system of benefits in kind).

Fees advanced by the insured person. In certain cases, (hospital, pharmacy, odontology, therapy…) the third-party payment system is applicable for all insured persons.

Certain groups of insured persons (beneficiaries of an increased reimbursement, such as unemployed for more than 6 months, and persons with a chronic sickness) may benefit from the third-party payment system when they visit or consult with a general practitioner.

Benefits in-kind system.

Citizens of other countries and persons having dual citizenship, who are not insured under the Bulgarian legislation, should pay the doctor or dentist for the health services received, unless they are covered by the rules on coordination of social security or by an international agreement to which Bulgaria is a party.

Benefits in-kind system.

Benefits-in-kind system.

Benefits in-kind system.

Regulatory charges for health care covered by the public health insurance: CZK 90 (€3.33) for a visit of emergency service doctor.

The public health service at a regional level pays the public health service’s contribution directly to the doctor.

Benefits in-kind system.

Public hospital and health centre:

Benefits-in-kind system.

Private doctor:

Reimbursement system. The insured person receives normally a reimbursement for charges right at the medical clinic when the clinic has a contract with the Social Insurance Institution (Kansaneläkelaitos, Kela). Otherwise the patient is afterwards partially reimbursed

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

Advance on fees by insured person, except of 1/3 paying. Refund based upon agreed or official rates.

System based in principle on benefits in kind. No fees paid by insured; fees are paid by the respective association of sickness fund doctors (Kassenärztliche Vereinigung) or by the health insurances(Krankenkassen).

The insured can choose the reimbursement of costs.

Doctors and specialists of PEDY (Primary National Health Care Network- Πρωτοβάθμιο Εθνικό Δίκτυο Υγείας-ΠΕΔΥ) (former EOPYY Units).

Benefits-in kind system. No fees.

Private specialists:

The patient pays the private doctor at his/her own expense. No refund by EOPYY.

Benefits-in-kind system.

General practitioners and specialists bound by a contract with the Icelandic Health Insurance (Sjúkratryggingar Íslands):

Benefits in kind. Partial payment by patient. Remaining costs paid directly by the Icelandic Health Insurance (Sjúkratryggingar Íslands).

Persons with full eligibility: General Practitioners are paid a capitation fee by HSE. Medical Card holders receive GP services and prescribed approved medicines & appliances without charge under the GMS Scheme.

Persons with limited eligibility: Pay fees directly to the GP. Persons with a GP Visit Card receive GP services without charge. Specialists in public hospitals are employed on a salary basis and are also free to engage in private practice.

There is no payment made by the insured person for treatment received from a doctor employed or contracted with the National Health Service (SSN).

Benefits-in-kind system.

The insured person pays no fee to a doctor contracted by the federation of health insurers; the doctors are paid directly by the insurance. In case of non-contracted doctors, the patient pays the full costs.

Benefits in-kind system.

Fees first paid by the insured person who are in turn refunded by sickness funds. In some cases direct payment by the sickness funds.

Public health care is provided for free to all those entitled. Patients who are not covered by the Maltese scheme will have to pay the expense for the treatment received.

Benefits-in-kind system. The patient pays cost-sharing charges directly to the doctor. For private practitioners, the part falling to National Insurance (folketrygden) is paid through the direct settlement arrangement. As for municipal and State grants, see above “Organisation, 1. Doctors: Remuneration”.

Benefits-in-kind system. Fees are paid by the National Health Fund (Narodowy Fundusz Zdrowia).

Fees are paid directly by the National Health Service (Serviço Nacional de Saúde, SNS) and not to the healthcare professional.

Benefits-in-kind system. The costs of treatment are paid by the health fund.

The costs of treatment are covered by the health insurance system (benefits-in-kind system). The salary of the doctor is paid by the health insurance agencies.

Benefits in-kind system.

Benefits-in-kind system. No fees are due.

Benefits-in-kind system, but the patient pays a part of the cost him- or herself. The doctor, if a private practitioner, is paid the rest from the county councils (landsting) or regions (regioner).

Unless otherwise agreed, payment by the insured person and reimbursement by the insurer: "third party guarantee" system.

Payment is done (indirectly) by the private health insurance company via the hospital.

For hospital treatment:

Treatment is free to those people who are ordinarily resident in the UK or exempt from charges under the NHS (Charges to Overseas Visitors) Regulations 2011. Anyone else is liable for the full cost of any treatment provided.

The entitlement is proven towards the doctors by e-card, an electronic sickness insurance card. The annual fee is €11.10 (with the exception of relatives, pensioners and the needy).

A contribution of 20% of the agreed fee is required for benefits provided by psychotherapists or clinic psychologists.

Patient charges must not exceed 25% for general medical care. Charges are of €12 (+€6 for Saturday, Sunday and holidays) for consultation with medical specialists.

In excess of a certain annual amount paid by the insured themselves, the so-called maximum ceiling, certain categories of insured and will benefit from this point onwards from free health care services.

Basic criteria:

• being part of a specific social category;
• being part of a household with income under certain levels;

In concrete terms, the following ceilings are applicable according to annual income:

• up to €17,780.17: €450 (€350 for chronic diseases);
• between €17,780.18 and €27,333.69: €650 (€550 for chronic diseases);
• between €27,333.70 and €36,887.24: €1,000 (€900 for chronic diseases);
• between €36,887.25 and €46,042.70: €1,400 (€1,300 for chronic diseases);
• from €46,042.71: €1,800 (€1,700 for chronic diseases).

Any person covered under the contribution-funded scheme pays the physician, dentist or health-care facility (providing medical care) for each visit a user fee of an amount determined by an ordinance of the Council of Ministers (Министерски съвет). This user fee currently stands at BGN 2.90 (€1.48).

Co-payment of 20% of the health expenses. However, the  co-payment cannot be lower than the following amounts :

• specialist-consultation health protection, including polyclinic and surgical interventions in daily hospital and rehabilitation – HRK 25 (€3.27);
• specialist diagnostic procedures which are not on the level of primary health care – HRK 50,00 (€655).

Insured persons are obliged to participate to the amount of HRK 10 (€1.31) for health protection in primary health care (for general-practitioner visits/examinations).

The cap of  co-payments is HRK 2,000 (€262) per issued health bill.

Patients entitled to healthcare benefits (see "Field of application, 1. Beneficiaries" above) make no contribution toward fees but do have to pay €3.00 and €6.00 per visit to a general practitioner and specialist doctor respectively.

Everybody else pays €15.00 and €30.00 per visit to a general practitioner and specialist doctor respectively.

Out-patient health care: Co-payments only for medicaments and medical devices.

Group 1: No charges (treatment by the chosen GP or a specialist to whom he refers the patient).

Group 2: The part of expenses which exceeds the amount fixed by the public scheme for Group 1.

Up to €5 per home visit or for a visit for out-patient specialised medical care (set by the Board of the Hospital).

Health centre:

Doctor visit maximum  €14.70 for the first three visits in a calendar year or an annual fee of maximum €29.30 for 12 months depending on the municipality; most other services free of charge. However, €20.20 may be charged for an on-call-visit to a health centre at night-time and on weekends.

Private doctor:

The system allows the patient to directly know the reimbursement amount. The patient is reimbursed part of the private doctor’s fee and the examination and treatment charges according to a schedule of fixed charges. The maximum reimbursable fee is often smaller than the fee charged by the doctor.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

Share borne by insured person:

• 30% for ambulatory treatment (GP or specialists, in consulting room or in hospital),
• 20% for hospital treatment,
• flat-rate co-payment of €1 per medical intervention within a limit of €50 per person and per year,
• flat-rate co-payment of €18 for serious medical intervention (of a minimum rate of €120).

The patient participation for aids (e.g. massages, baths or physiotherapy) which are part of the medical treatment is 10% and €10 per prescription.

Visits to the health centres of PEDY (Primary National Health Care Network Πρωτοβάθμιο Εθνικό Δίκτυο Υγείας-ΠΕΔΥ) are free of charge.

Visits to private doctors contracted by the National Organisation for Healthcare Services Provision (EOPYY) (ΕΝΙΑΙΟΣ ΟΡΓΑΝΙΣΜΟΣ ΠΑΡΟΧΩΝ ΥΠΗΡΕΣΙΩΝ ΥΓΕΙΑΣ - ΕΟΠΥΥ) are free of charge.

For paraclinical examinations, a co-payment of 15% applies.

Co-payments are charged in the following cases:

• unnecessarily changing the contents of prescription treatment, causing extra costs,
• extra services (better room, meal condition etc.),
• accommodation, nursing, pharmaceuticals and meal costs for those suffering from designated ailments, confirmed by primary health care provider,
• using sanitary provisions,
• certain dental prosthesis, orthodontic braces provided for persons under the age of 18,
• change of external sex organs with the exception of developmental abnormality.

The amount of the co-payment is fixed by the service provider.

Health care centres and general practitioners:

The insured person pays between ISK 1,200 (€8.47) and ISK 3,100 (€22) per visit.

Specialists:

The insured person pays ISK 5,700 (€40) + 40% of the remaining costs, but max. ISK 35,200 (€248) per visit to a specialist working under a contract with the Icelandic Health Insurance (Sjúkratryggingar Íslands).

Persons with full eligibility enjoy a full range of general practitioner services without charge (see above).

Persons with a GP Visit Card are entitled to the services of a GP without charge (see above).

Persons with full eligibility can avail of specialist services in public hospitals free of charge. While persons with limited eligibility are subject to nominal charges as set out below (see “2. Hospitalisation, Patient Charges”). There are a number of schemes which provide assistance towards the cost of medication.

Any patient who opts for private treatment, even in a public hospital, is liable for the specialist fees and hospital charges.

Insured persons pay up to €36.15 per prescription (this amount can vary slightly from Region to Region) for health services in specialist outpatient clinics. Each prescription may include up to 8 different health treatments within the same specialty and up to 6 rehabilitation cycle of treatments. Health services are listed in the official tariff nomenclature (Annex to Ministerial Decree of 22 July 1996).

An additional fixed amount of €10 is requested for each prescription, to be paid to the National Health Service (SSN.).

Patient contribution system (for adult patients):

• Out-patient visit to the general practitioner: €1.42.
• Out-patient visit to the specialist: €4.27.
• Home visits are generally not paid from the State budget (doctor can set the price), except: 
  • GP’s home visits to flu patients during flu epidemic (patient contribution is €2.85);
  • GP’s home visits to children under 18, persons older than 80, disabled persons (only category I disability), persons who need palliative care, persons receiving permanent artificial lung ventilation in home settings (no patient contribution);
  • Specialists’ home visits to persons receiving permanent artificial lung ventilation in home settings (no patient contribution);
  • Psychiatrists’ home visits to those with mental disorders (no patient contribution);
  • Rehabilitation doctors’ home visits to children receiving palliative care and patients who have certain cerebrovascular diseases and need health care at home (no patient contribution).

• Treatment in day hospital: €7.11 per day plus patient contribution for some outpatient diagnostic examinations (between €1.42 and €35.57 depending on the procedure) and patient contribution for each surgical procedure of €4.27.
• For some outpatient diagnostic procedures: between €1.42 and €35.57 (depending on the procedure).
• For assisted reproductive procedures: €21.34.

The total annual patient contribution for inpatient and outpatient treatment in one calendar year should not exceed €569.15 (excluding the cost of drugs, spectacles and dental services).

Patients' participation in the costs for services in the form of a franchise and a percentage paid by the individual. The deductible (franchise) is CHF 200 (€185) each year. Voluntary deductible of a maximum of CHF 1,500 (€1,387) each year. Maximum excess is CHF 600 (€555) per year.

Under the extended compulsory health insurance, reimbursement of the costs of non-contracted doctors up to the tariff applicable in Liechtenstein.

Basically, health care is free of charge. There is a list of health care services, which are approved as paid services that are financed entirely from the person's own resources according to a set price list.

Co-payment for visits: 20% of the ordinary tariff for visits. For other interventions and services: co-payment of 12%.

This measure does not concern haemodialysis, chemotherapy, radiotherapy treatments nor preventive medical tests.

No co-payment or other patient charges.

• Up to a ceiling of NOK 2,185 (€227) a year, the patients pay cost-sharing charges for consultation of doctors, psychologists, for important medicines and nursing articles, radiological examinations/ treatment, laboratory tests and travel expenses;
• For a standard GP consultation NOK 141 (€15) is paid by the patient, for a specialist consultation NOK 320 (€33);
• A second ceiling of NOK 2,670 (€278) applies to cost-sharing charges for physiotherapy, reimbursable non orthodontic dental treatment, organised health travels and stays in medical rehabilitation centres.

No patient participation.

Patient’s contributions for Portuguese citizens, EU citizens and legal immigrants in the units and health centres of the National Health Service are variable, depending on the type of medical visit:

• consultation with a general practitioner - €5
• consultation with a nurse - €4
• Emergency consultation at an NHS hospital - €15.45
• consultation with a specialist - €7.75
• NHS consultation at home - €10.30.

The list of medical services for which there is a co-payment as well as the modalities of the co-payments (including their amounts) are established by the framework-contract and its implementing rules.

No limit to co-payment.

For services related to health care the patient's participation is:

• €1.99 for each visit at the emergency service;
• €0.17 for each prescription;
• €0.07 for each km of transport.

Patients make co-payments of between 10% and 90%. Voluntary supplementary insurance for co-payments is available. Medical services like cosmetic surgery and homeopathy are paid entirely by patients.

No charges.

Patients pay between SEK 100 (€11) and SEK 300 (€33) per visit to a doctor.

For specialist care, patients pay between SEK 200 (€22) and SEK 350 (€38).

Emergency cases: between SEK 200 (€22) and SEK 450 (€49).

• Fixed amount per calendar year (excess, deductible, “franchise”): CHF300 (€277).
• In addition, share of costs: 10% of costs above the excess up to CHF700 (€647) per year.
• The insurer may offer the insured person a form of insurance with a higher excess - CHF500 (€462), CHF1,000 (€925), CHF1,500 (€1,387), CHF2,000 (€1,849) or CHF2,500 (€2,312) for adults, CHF100 (€92), CHF200 (€185), CHF300 (€277), CHF400 (€370), CHF500 (€462) or CHF600 (€555) for children (< 18 years) - in return for a reduction in the premium.

Health Insurance Act (Zorgverzekeringswet, Zvw):

Compulsory deductible: all insured persons aged 18 years or older pay a maximum of €385 per year. Care from a general practitioner, obstetric care, maternity care, care related to certain chronic illnesses (Diabetes type 2, COPD, CVR), district nursing services, care and travel costs related to organ donation and dental care for children are exempt from the compulsory deductible.

Insured persons can opt for a voluntary deductible of €100, €200, €300, €400 or €500 to top up the compulsory deductible. In return the insured person receives a discount on the nominal health care premium.

Long term care act (Wet langdurige zorg (WLZ)):

For certain types of care under the Act, insured persons over 18 are required to make personal contributions towards the costs.

No charges to patients ordinarily resident in the UK or charge-exempt overseas visitors for NHS hospital services, but see below for prescription and other charges.

No charges for children, pensioners and the needy.

The increased reimbursement system (l’intervention majorée/de verhoogde tegemoetkoming) is automatically granted to the following persons:

• beneficiaries of the integration income (revenu d'intégration/leefloon) or of an equivalent benefit (over a period of three full months without interruption),
• recipients of the guarantee of income for elderly persons (garantie de revenus aux personnes âgées/inkomensgarantie voor ouderen - IGO),
• beneficiaries of a disabled persons’ allowance,
• children with a physical or mental disability of at least 66%,
• unaccompanied foreign minors,
• orphan children having lost both parents.

After the means-tested: when the annual household income does not exceed the ceiling of €16,965.47 + €3,140.77 per additional member.

But, if the revenues are stable and the household situation is stable, as in the case of widow(s) , widower(s), long-term unemployed, and single parent families, etc., in that case, the monthly revenue is the factor taken into consideration (revenues of the month , preceding the request or revenues from the current month). The annual ceiling has been established in €17,303.80 + €3,203.40 (for requests introduced in 2015).

Exemption from payment of the fees is granted to:

• persons with diseases specified in the annex to the National Framework Contract;
• minors and unemployed family members;
• victims of, or connected with, the country’s defence;
• war veterans and war invalids;
• detainees and prisoners;
• poor people receiving state aid;
• people without income, living in care homes;
• health professionals;
• pregnant and young mothers, up to 45 days after birth;
• insured persons with severe invalidity who in addition are suffering from specified diseases;
• patients with malignant neoplasm

Patient under the age of 18 are exempt from fees. The same applies for regular students, persons suffering from certain listed diseases (for those diseases only), persons with a disability needing constant assistance and organ donors.

No exemptions or reductions.

No exemptions from co-payments.

Exemption from regulatory charges: some groups of patients, e.g.

• persons placed in children’s homes,
• persons placed in homes for disabled persons or for elderly persons if their minimum income remainder (as specified by another legal provision) is less than CZK 800 (€30),
• persons proved to be in material need, etc.

No exemptions or reductions.

In case of a specialised doctor, the fee shall not be demanded from:

• children under 2 years of age;
• pregnant women from the moment pregnancy is medically determined;
• people who will receive stationary medical care after inevitable ambulant care.

In case of a home visit of doctor (or specialised doctor), the fee shall not be demanded from:

• children under 2 years of age;
• pregnant women.

Health centre:

Patients under the age of 18 are exempt from fees.

Public sector:

An overall ceiling of €679 per year for public sector fees (excluding e.g. fees for dental care).

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

Costs completely covered at 100% of the responsibility rate, in particular:

• Beneficiaries of a disability pension (pension d'invalidité),
• beneficiaries of a work injury pension (rente accident du travail) at a rate > 66.66%, together with their family members,
• people with long-term conditions,
• persons with resources below a certain limit.

Exemption from the €1 flat-rate co-payment for:

• Children under 18 years of age,
• persons with resources below a certain limit.

No co-payment for children (with the exception of travel costs).Exemption of participation for expenses above 2% (1% in case of chronic diseases) of the gross income. Reduction of co-payment for early-detection measures or a choice of rate concerning special health care systems.

No exemptions or reductions.

No exemption or reduction of patient charges.

Health care centres and general practitioners:

Pensioners aged 67 to 69 receiving reduced pension pay between ISK 960 (€6.78) and ISK 2,400 (€17) per visit. Other old-age and invalidity pensioners pay between ISK 600 (€4.24) and ISK 1,500 (€11) per visit. There is no charge for children under the age of 18.

Specialists:

Pensioners aged 67 to 69 receiving reduced pension pay ISK 4,400 (€31) + 13.33% of the remaining costs, but max. ISK 28,200 (€199), per visit to a specialist working under a contract with the Icelandic Health Insurance (Sjúkratryggingar Íslands). Other old-age and invalidity pensioners pay ISK 2,100 (€15) + 13.33% of the remaining costs, but max. ISK 8,900 (€63), per visit to a specialist working under a contract with the Icelandic Health Insurance. Children under the age of 18 pay 1/9 of ISK 5,700 (€40) + 40% of the remaining costs, which is the general charge, but at least ISK 890 (€6.28).

Maximum yearly payment for all insured persons:

For a single person ISK 35,200 (€248); for children of the same family ISK 10,700 (€76); for old-age and invalidity pensioners ISK 8,900 (€63), except for pensioners aged between 67 and 69 receiving reduced pension for whom the maximum yearly payment is ISK 28,200 (€199).

After this ceiling is reached, a person is entitled to a discount card to use for the remainder of the year.

Persons with full eligibility are not required to pay a contribution.

Tests, visits to a consultant and medication of group A are free of charge, based on the household income and disability, for:

• civil disabled (more than 2/3 of invalidity;
• service disabled (categories 1 to 5);
• war disabled (cat. 1 to 5);
• children up to 6 years and persons aged over 65 whose family income is below  €36,151.98;
• recipients of minimum pensions (pensione minima) aged over 65 and unemployed persons with an annual family income of less than €8,263.31: this limit amounts to €11,362.05 for a couple and is increased by €516.46 for each dependent child;
• recipients of the welfare-based social allowance (assegno sociale) and their dependent family;
• blind and deaf mute.

Are partly free of charge for:

• those suffering from a chronic illness and inducing a disability;
• service disabled (categories 6 to 8);
• war disabled (cat. 6 to 8);
• in the case of pregnancy and maternity.

No contributions required from:

• Persons having the annually preventive health check by GP;
• children under 18 years,
• pregnant women and women in the period following childbirth up to 42 days for health care services related to the medical supervision of the pregnancy and during the period following childbirth, as well as to the course of pregnancy,
• victims of Chernobyl,
• those persecuted for their political beliefs,
• those who suffer from TB and who are examined for TB,
• those who suffer from AIDS, syphilis and other infectious diseases (only for the treatment required for these diseases),
• those with mental disorders (only for psychiatric treatment),
• those who receive chronic haemodialysis, haemodiafiltration, and peritoneal dialysis,
• those who require emergency treatment,
• residents of State and municipality social care centres,
• all persons for whom vaccination or passive immuno-therapy (within the framework of the State immunisation programme) as well as vaccination against influenza is performed,
• organ donors,
• persons receiving permanent artificial lung ventilation in home settings,
• persons who receive inpatient palliative care and palliative care provided by GP at home;
• persons who receive health care at home,
• persons being tested within the framework of the national screening programs,
• disabled persons (only category I disability),
• needy persons,
• those working in Emergency Medical Service.

Half contributions for: insured persons who have reached regular retirement age.

No contributions for: children under the age of 20.

No contributions for benefits relating to maternity and preventive medical check-up.

No contribution for chronically ill persons according to the list of indications.

No exemptions or reductions.

In a whole year, participation cannot exceed 2.5% of the yearly income subject to contributions.

Maltese nationals and persons insured under the Maltese scheme and their dependents are entitled to free public health care. EU citizens staying in Malta are entitled to free health care upon presentation of relevant documentation according to EU legislation on the coordination of social security. Refugees, members of religious orders and persons staying in Malta as consultants to Government are also entitled to free healthcare upon presentation of relevant documentation.

• Children under 16 are exempt from charges;
• Special exemptions from cost-sharing charges apply to a limited number of diseases and groups of patients;
• No charges in the case of occupational injury or disease.

Not applicable: no patient charges.

Exemption for certain categories: e.g., pregnant and post-partum women and, children up to age 18, people with a degree of disability preventing working of at least 60%, people in situations of insufficient economic resources (whose income is not more than 1.5 times the Social Support Index (IAS) (reference Social Support index, indexante dos apoios sociais = €419.22) and their dependants.

• All children up to 18 years old; youngsters aged between 18 and 26 who are high-school students, high-school graduates for up to three months after graduation, students or apprentices, provided they do not have income from work;
• youngsters up to 26 years old covered by the children’s protection system and who do not have income from work or are not Social Aid (ajutor social) beneficiaries;
• the husband, wife and parents without any income who are supported by an insured person and who are co-insured;
• pensioners whose income does not exceed RON740 (€163) per month;
• beneficiaries of special rights under the Decree-law No.118/1990 regarding the granting of rights to persons persecuted for political reasons by the dictatorship established with effect from 6 March 1945, and those deported abroad or prisoners, as amended.
• disabled persons who do not have any income from work, pension or from other sources with the exception of those incomes obtained on the basis of Emergency Ordinance No. 102/1999 on the special protection at employment of the disabled persons, as amended;
• sick persons covered by the national programmes of the Ministry of Health, for the medical services related to their main disease, provided they are deprived of income of any source;
• pregnant women and women who have just given birth;
• women who are without any income or whose income is below the minimum gross wage.

No co-payment for transport for disabled patients, for patients in dialysis programme, in oncological treatment or cardio-surgery cure.

No patient contribution for:

• Preventive examinations, treatment and rehabilitation of children, students and minors with development deficiencies;
• treatment of war invalids and civilian invalids of war;
• urgent treatment of seriously physically or mentally disabled persons, persons over 75 years of age, recipients of social assistance etc.;
• health care of women, including family planning advice, contraception, pregnancy and childbirth;
• prevention, detection and treatment of communicable diseases (including AIDS);
• treatment and rehabilitation of occupational diseases and accidents at work and some other diseases (malignant illnesses, epilepsy, cerebral paralysis, multiple sclerosis);
• emergency medical treatment (including emergency transportation);
• nursing care visits, home treatment and nursing in social care institutes.

Not applicable.

Most county councils do not charge any fees for children/youth.

Limitations for high costs. When a person within a 12-month period has costs for public health and medical care the limit is a maximum of SEK 1,100 (€120). For pharmaceutical products, see “4. Pharmaceutical products”.

Certain county councils (landsting) or regions (regioner) apply lower rates to some groups, e.g. people over 65 years old.

• Children do not pay the excess.
• Maximum amount of the share of costs for children: CHF350 (€324).
• Several children from the same family insured by the same insurer pay together a maximum of CHF1,000 (€925).
• No participation in the case of maternity benefits, nor in the case of medical treatment to women between the 13^th week of pregnancy and the 8^th week following delivery.
• No excess for certain prevention measures carried out under national or cantonal programmes (especially cantonal programmes of breast cancer screening by mammography or colon cancer screening and cantonal human papillomavirus vaccination programmes).
• In the case of insurance with a limited choice of service suppliers (HMO, for example), the insurer may give up charging wholly or partly the share of costs and the excess.
• The beneficiaries of supplementary benefits to old-age, survivors' and invalidity insurance (Ergänzungsleistungen zur Alters-, Hinterlassenen- und Invalidenversicherung, EL/prestations complémentaires à l'assurance-vieillesse, survivants et invalidité. PC) (non-contributory benefits subject to means testing) are reimbursed for the costs of participation referred to in the KVG/LAMal (up to a ceiling).

No exemption or reduction of patient charges

Not applicable: no patient charges.

Free choice among public hospitals, if no additional costs arise.

In general, referral required by a general practitioner or a specialist.

In principle, free choice among, and free access to approved hospitals.

Patients are allowed to select any health care hospital in the country if they have a referral from their general practitioner (GP). GP referral is not necessary in case of urgent need of health care

As a rule the patient has to go to the nearest contracted hospital. In case they go to another hospital, they pay the transport costs themselves.

In private hospitals without contract with the Croatian Health Insurance Fund (Hrvatski zavod za zdravstveno osiguranje), patients pay all the costs of health care.

Referral by the treating doctor is needed for State hospitals and institutions. The patient is referred to the hospital at which the treating doctor is employed.

Free choice of contracted hospitals after referral by primary doctors or specialist.

Access to hospital upon referral of a general practitioner or specialist, except in case of emergency.

Free choice of public hospital. Patients can also choose a private hospital in Denmark or abroad with agreement with the regional health authorities if the waiting time after referral to treatment in a regional public hospital is more than two months.

In case of severe illness the free choice is possible after only one month.

In addition to this, the patient has a right to receive a diagnosis within one month or, if this is not possible for medical (not capacity-related) reasons, to get a plan within that month for how a diagnosis will be achieved (i.e. which examinations and test the patient will undergo).

Referral by general practitioner or specialist.

Public hospital:

A person who needs specialised medical care services can choose to use any of the specialised medical care units. The treatment facility will be selected together with the referring physician or dentist.

Insofar as possible, the patient also has the right to choose the physician or other health care professional treating him or her.

The patients can choose the specialised care unit among all hospitals in Finland.

Private hospital:

Free choice. No referral required.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

Free choice among public and private contracted hospitals. Access to the hospital upon medical prescription, except in emergency cases.

Free choice of licensed hospitals.

Hospital treatment requires the admission by a medical doctor (except for emergencies).

The insured has the right to hospitalisation in a public hospital of the National Health System (ESY) (ΕΘΝΙΚΟ ΣΥΣΤΗΜΑ ΥΓΕΙΑΣ- ΕΣΥ), or in a contracted private clinic.

In general, upon referral by the general practitioner, except in cases of emergency and for some specialties (see "Benefits, 1. Medical treatment, Access to specialists"). The referral is addressed to the type of specialty and to a service provider who is geographically obliged to the maintenance of the care.

Hospitalisation upon referral by a doctor. In case of planned treatment the patient may have some choice.

Every person ordinarily resident in the State is eligible for services provided in public acute hospitals. A general practitioner is involved in the referral of a patient to a specialist in a public hospital. No referral is required in the case of an emergency.

Free choice of a public or private hospital under contract. Access upon prescription of the general practitioner or of the specialist employed or contracted with the National Health Service (SSN), except in emergency cases.

For hospitalisation, referral is required from a GP or specialist (except for emergencies). Patients can choose from hospitals which are contracted by the National Health Service (Nacionālais veselības dienests) (there are no regional constraints).

Free choice of hospital.

Full coverage of the costs of examinations, treatments, meals and accommodations in the general section of a hospital under contract. Limited coverage of costs in hospitals not under contract.

Free access to licensed hospitals.

If a licensed doctor refers an insured person on medical grounds to a hospital which is not licensed, these medical grounds have to be notified to the responsible sickness fund by means of the appropriate form.

The patient is referred to the hospital by a general practitioner (family doctor) or a specialist except in emergency cases where the referral system is not applicable. The patient having a referral has a free choice between hospital care providers but if the patient would like to get reimbursed for hospital care his or her choice is limited between hospital care providers contracted by the Territorial Health Insurance Funds (teritorinės ligonių kasos) as services provided in private hospital without such a contract are not reimbursed.

Free choice of hospital. Access upon prescription of the attending physician (hospital abroad subject to authorisation by the sickness fund).

There is one acute hospital in Malta and another one in Gozo. There are other specialised hospitals including: Oncology, Rehabilitation, Mental and a hospital for elderly patients.

There are also a number of private inpatients and outpatients services.

To access services in the public sector patients need a referral from a doctor.

Free choice of hospital (does not apply in cases of emergency). Regular primary doctor referral or referral from specialist (except in cases of emergency).

Free choice of contracted hospital. Hospitalisation upon referral by a contracted doctor.

In the NHS there are reference regional hospital networks for treatment.

Access by patients upon referral from a general practitioner, except in emergency cases.

There is no free choice of the hospital network.

Free choice of hospital, upon referral from the family doctor or the specialist doctor. Direct access in case of emergency.

Free choice of hospital. Doctor's referral or prescription needed unless emergency treatment is required.

Free choice of any public hospital or any private hospital with a licence and contract with the Health Insurance Institute of Slovenia (Zavod za zdravstveno zavarovanje Slovenije). Patients need a referral from a general practitioner (except in cases of emergency; when a parent is staying with a child in a hospital).

No choice. Patients have a hospital assigned to them according to their place of residence except in case of emergency.

In some Autonomous Communities (Comunidades Autónomas) there is free choice of hospital.

Access to hospital upon referral of a specialist, except in case of emergency.

Free choice of regional public hospitals and approved private establishments. Access upon referral from a general practitioner or a specialist, except in emergency cases.

Free choice amongst hospitals on the hospital list of the canton where the insured person resides.

Payment by the insurer: "third party payment" system.

Free choice among hospitals or institutions approved by the Minister of Health, Welfare and Sports.

Access to the hospital upon referral from a general practitioner or a specialist.

On referral by the general practitioner, who normally chooses hospital best suited to the patient's needs, subject to the following changes:

• Since January 2005, all patients needing cataract surgery have been offered the choice of 2 or more providers at the point of referral from the GP;
• Since December 2005, all patients requiring a coronary artery bypass graft, angioplasty, or heart valve operation, have been offered the choice of 4 or more hospitals at the point of referral by the cardiologist;
• Patients needing a referral for elective care will be offered the choice of 4-5 providers for their treatment when referred by their GP and a booked appointment for a date and time which suits them. These providers may include NHS trusts, NHS and IS treatment centres and private hospitals.

Full coverage of expenses in the general scale of fees of a hospital funded by a state health fund (Landesgesundheitsfonds), with the exception of a minor participation of an amount of approximately €10 per day (different in each federal state (Bundesland)).

For the hospitalisation of a dependant a 10%-contribution is charged.

Complete refund (public ward).

Patient charges:

• admission fee: €42.58,
• subsequently €15.31 per day.

When hospitalised within a psychiatric home for more than 5 years: €25.52 per day.

Services charged for: accommodation costs, pharmaceutical costs, medical fees, other supplies (e.g. blood), miscellaneous costs (e.g. use of telephone) and any supplements (single room).

Lump sums: €0.62 per day for pharmaceutical costs, €16.40 per admission for medico-technical services, €7.44 for clinical biology and €6.20 for radiology.

Fixed contribution by the insurance for approved homes for the aged, protected homes, nursing homes and psychiatric homes, day-care centre.

In case of hospitalisation of less than 10 days per year, any person covered under the contribution-funded scheme pays a user fee of an amount determined by an ordinance of the Council of Ministers (Министерски съвет). This user fee currently stands at BGN 5.80 (€2.97) per day of hospitalisation. After the 10th day, the patient is not required to pay the user fee.

Patients  contribute to the costs  of the health care with  a co-payments of 20% of the costs, but no less than HRK 100 (€13) per day and with a ceiling of HRK 2,000 (€262) per issued health bill.

Inpatient treatment is provided free of charge to persons entitled to healthcare benefits (see "Field of application, 1. Beneficiaries" above)

Everybody else pays €95.00, €135.00 and €160.00 per inpatient day respectively for 3rd, 2nd and 1st class accommodation and €265.00 for the intensive care unit.

No co-payments.

Public hospitals approved private establishments and private hospitals with agreement with the regional health authorities: No charge.

Non-approved private establishments: patients pay all costs.

Daily fee for inpatient services (in standard accommodation conditions) up to €2.50, for a maximum of 10 calendar days per hospitalisation.

Fee for inpatient nursing care is €9.75 per day.

Public hospital:

The fee for an out-patient visit is €29.30, for day surgery €96.40. The fee for in-patient care is €34.80 a day. Patients receiving long-term institutional care at a ward (over three months) are charged a fee in accordance with their means. Such a fee, however, may be no more than 85% of the patient´s net monthly income (if a person has a spouse who has lower income, the fee may be no more than 42.5% of their combined net monthly income).

Irrespective of this, minimum €99 per month must be left for patient´s personal use.

Private hospital:

Part of the doctor's fee and costs for examination and care are refunded by the sickness insurance.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

20% of costs.

Hospitalisation allowance (forfait hospitalier): €18 (€13.50 in a psychiatric unit) per day, including the day of discharge.

Flat-rate co-payment of €18 for serious medical intervention (of a minimum rate of €120).

Free hospitalisation in a shared room with exception of participation of €10 per calendar day during a maximum of 28 days per year.

Free of charge in public hospitals of the National Health System (ESY) (ΕΘΝΙΚΟ ΣΥΣΤΗΜΑ ΥΓΕΙΑΣ- ΕΣΥ).

The amount of contribution in contracted private clinics depends on the financing system: when Diagnosis-related Groups (DRGs) (Κλειστό Ενοποιημένο Νοσήλειο- KEN) apply, insured pay 30% contribution. When daily fees apply, they pay 10% contribution.

For insurees of Agricultural Insurance Organisation (OGA) the costs are between 20% and 50%.

Full charge in private clinics not contracted by the National Organisation for Healthcare Services Provision (EOPYY) (ΕΝΙΑΙΟΣ ΟΡΓΑΝΙΣΜΟΣ ΠΑΡΟΧΩΝ ΥΠΗΡΕΣΙΩΝ ΥΓΕΙΑΣ - ΕΟΠΥΥ).

See "Benefits, 1. Medical treatment, Patient charges".

Public hospitals: no patient charges for hospitalised patients (in-patient treatment).

For out-patient hospital visits same charges apply as for visits to specialists. Charges for out-patient treatments are applied according to tariffs and regulations.

• Persons with full eligibility: No charge while in receipt of acute in-patient care. Long-stay in-patient charges (see below) may apply upon discharge from acute care;

Persons with limited eligibility: Charge of €75 per night in a public ward up to a maximum of €750 in any 12 month consecutive period subject to exemptions;

A charge of €100 applies for attendance at accident and emergency departments, subject to certain exemptions e.g. where the person does not have a referral note from his/her doctor;

For non-acute long-term in-patient hospital stays, “long-stay” in-patient services greater than 30 days (within a 12 month reference period), including hospital stays, maximum charges of €175 per week (where 24 hours nursing care is provided) or €130 per week (where 24 hours nursing care is not provided) may apply to adults with full eligibility and limited eligibility. This charge applies to those in non-acute hospitals and may also apply to those who remain in acute hospitals after being discharged from acute care;

Private hospitals/homes: Patient is liable for all costs. However, individuals can apply for financial support towards the cost of their nursing home fees under the Nursing Homes Support Scheme;

• Infectious diseases treatment: Free of charge to all persons.

Direct assistance free without choosing a room.

The amount of the patient’s contribution varies according to the type of hospital and/or treatment:

• In all hospitals (except nursing hospitals): €10.00 per day,
• in nursing hospitals and for treatment in hospitals’ nursing units: €7.11 per day,
• for treatment due to oncologic and oncohaemotologic diseases: malignant neoplasms, in situ neoplasms, neoplasms of uncertain or unknown behaviour and other aplastic anaemias: €7.11 per day,
• for treatment of addiction to alcohol, drugs, psychoactive and toxic substances €7.11 per day,
• for some inpatient diagnostic examinations: between €14.23 and €35.57 (depending on the procedure).

Maximum patient contribution for board and lodging is €355.72 for any one period of hospitalisation in one hospital.

The total annual contribution for inpatient and outpatient treatment in one calendar year should not exceed €569.15 (excluding the purchasing of drugs, spectacles and dental services).

In addition to the patient contribution, the hospital may ask for a co-payment (up to €31.00) for specific surgical operations performed in operating room during the hospitalisation. Patients who are exempted from patient contribution are also exempted from co-payment for surgical operations. The surgical operations to which the co-payment can be applied are defined by the Cabinet of Ministers.

See Point 1. "Medical treatment".

Patients' participation in the costs for services in the form of a franchise and a percentage paid by the individual. The deductible (franchise) is CHF 200 (€185) each year. Voluntary deductible of a maximum of CHF 1,500 (€1,387) each year. Maximum excess is CHF 600 (€555) per year.

Basically, health care is free of charge. There is a list of approved health care services that are financed entirely from the person’s own resources according to a set price list.

Participation in maintenance costs: €20.93 per day of hospitalisation and for a maximum period of 30 days.

No patient charges.

No cost-sharing charges for patients admitted to hospital.

For outpatients' departments at hospitals normal cost-sharing charges apply, see above.

For treatment in a private clinic with no arrangement with the public health system, the full cost falls on the patient him- or herself.

No patient charges.

No participation in hospitalisation fees by National Health Service. beneficiaries

Co-payment between RON5 and RON10 (€1-2) depending on the decision of the hospital board.

No patient participation.

Up to 30% of costs in case of hospitalisation as a continuation of hospital treatment (services connected to asserting and treating reduced fertility, non-medical part of care).

No patient charges.

The patient will be charged maximum SEK 100 (€11) per 24 hours.

Same participation as for out-patient care. In addition, a contribution to the costs of board and accommodation of CHF15 (€14) per day.

Compulsory deductible: all insured persons aged 18 years or older pay a maximum of €385 per year. Care from a general practitioner, obstetric care, maternity care, care related to certain chronic illnesses (Diabetes type 2, COPD, CVR), district nursing services, care and travel costs related to organ donation and dental care for children are exempt from the compulsory deductible.

Insured persons can opt for a voluntary deductible of €100, €200, €300, €400 or €500 to top up the compulsory deductible. In return the insured person receives a discount on the nominal health care premium.

No charge to patients ordinarily resident in the UK or charge-exempt overseas visitors, except where the patient asks for special amenities or for extra treatment which is not clinically necessary.

The participation in case of hospitalisation is limited to a maximum of 28 days per calendar year.

Notably for dependent children, beneficiaries of the increased reimbursement system (bénéficiaires de l’intervention majorée /rechthebbenden op de verhoogde tegemoetkoming) and the assimilated unemployed: €5.44 per day.

For the beneficiaries of increased reimbursement: no flat rate applicable for medical-technical services but in the case of other services a €5.44 up-front payment must be made.

When hospitalised within a psychiatric home for more than 5 years:

• For those benefiting from the preferential scheme, for the assimilated unemployed with no dependent person or without the obligation of paying an alimony by legal decision or by notarised deed: €15.31 per day.
• For normal beneficiaries, for those benefiting from the preferential scheme with dependants or obligation of paying an alimony by legal decision or by notarised deed and their dependants: €5.44 per day.

See also “1. Medical treatment, Exemption or reduction of patient charges”.

Exemption from payment of the fees is granted to:

• persons with diseases specified in the annex to the National Framework Contract;
• minors and unemployed family members;
• victims of, or connected with, the country’s defence;
• war veterans and war invalids;
• detainees and prisoners;
• poor people receiving state aid;
• people without income, living in care homes;
• health professionals;
• pregnant and young mothers, up to 45 days after birth;
• insured persons with severe invalidity who in addition are suffering from specified diseases;
• patients with malignant neoplasm

Patient under the age of 18 are exempt from fees. The same applies for regular students, persons suffering from certain listed diseases (for those diseases only), persons with a disability needing constant assistance and organ donors.

No exemptions or reductions.

Exemption from regulatory charges:

• persons placed in children’s homes,
• persons placed in homes for disabled persons or for elderly persons if their minimum income remainder (as specified by another legal provision) is less than CZK 800 (€30),
• persons proved to be in material need, etc.

Non-approved private establishments: In the case where a public hospital refers a patient to a private establishment: no charge.

In-patient fee shall not be demanded for:

• Periods of intensive care;
• in-patient specialised medical care in connection with pregnancy or delivery;
• in-patient medical care to a minor.

Public hospital:

An overall ceiling of €679 per year for public sector fees. €16.10 per day is charged for in-patient care in the hospitals after reaching the ceiling.

Patient under the age of 18 may be charged only for the first seven treatment days in a calendar year.

The fee for in-patient care in psychiatric units is €16.10.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

Suppression of participation from 31^st day of hospitalisation and for certain severe surgery treatments.

Beneficiaries of a disability pension covered 100% of the  insurance ceiling.

Beneficiaries of a work injury pension (rente accident du travail) at a rate of 66.66%, covered 100%, together with their family members,

Persons with resources under a certain ceiling.

Persons suffering from certain diseases (only for those diseases).

Victims of an act of terrorism.

In case of a 100% financing, the person concerned must pay the daily lump-sum and the flat-rate co-payment (subject to exceptions).

No charge for insured persons under the age of 18 (exception: travel costs) and patients who already exceeded the expenses limit of 1% or 2% of the gross income.

No patient charges for heart surgery (for both adults and children).

See "Benefits, 1. Medical treatment, Exemption or reduction of patient charges".

Not applicable: no patient charges.

Exemptions from charges mentioned above (excluding charges for non-acute long-stay in-patient services) include:

women receiving services in respect of motherhood;

children up to the age of six weeks;

children suffering from prescribed diseases and disabilities, (the exemption applies only to treatment for the prescribed condition);

children referred for treatment from child health clinics and school health examinations;

persons receiving services in respect of prescribed infectious diseases;

medical card holders and their dependants;

long stay patients who are already being charged under other specific regulations;

persons deemed to be eligible by the Health Service Executive (HSE) where undue hardship would be caused.

Exemptions from charges for non-acute long-stay in-patient services greater than 30 days (including hospital stays) mentioned above include:

children (under age 18);

women receiving services in respect of motherhood;

persons detained  involuntarily under mental health legislation;

acute hospital in-patients who require acute care;

certain persons who have contracted Hepatitis C.

The Health Service Executive (HSE) may reduce or waive “long-stay” charges where necessary to avoid undue hardship.

Not applicable: no charges.

No contributions required from:

• children under 18 years,
• pregnant women and women in the period following childbirth up to 42 days for health care services related to the medical supervision of the pregnancy and the postnatal monitoring,
• victims of Chernobyl,
• those persecuted for their political beliefs,
• those who suffer from Tuberculosis and who are examined for Tuberculosis,
• those who suffer from AIDS, syphilis and other infectious diseases (only for the treatment required for these diseases),
• those with mental disorders (only for psychiatric treatment),
• those who receive chronic haemodialysis, haemodiafiltration, and peritoneal dialysis,
• those who require emergency treatment,
• residents of State and municipality social care centres,
• organ donors,
• people receiving permanent artificial lung ventilation in home settings,
• people who receive inpatient palliative care,
• people with disabilities (only category I),
• people in need,
• those working in Emergency Medical Service;
• those having annual health check;
• those having vaccination in accordance with the vaccination calendar, emergency prophylaxis of tetanus or post-exposure immunisation against rabies.

Half contributions for: insured persons who have reached regular retirement age.

No contributions for: children under the age of 20.

No contributions for benefits relating to maternity and preventive medical check-up.

No contribution for chronically ill persons.

No exemptions or reductions.

Not applicable: no exemption nor reduction of user charges.

Not applicable: no patient charges.

Outpatients:

• Children under 16 are exempt from charges;
• Special exemptions from cost-sharing charges apply to a limited number of diseases and groups of patients;
• No charges in the case of occupational injury or disease.

Not applicable: no patient charges.

Not applicable: no exemption or reduction of patient charges.

The following categories of insured persons are exempt from co-payments:

• children up to 18 years old; youngsters aged between 18 and 26 who are high-school students, high-school graduates for up to three months after graduation, students or apprentices, provided they do not have income from work;
• sick people covered by the national programmes of the Ministry of Health, for the medical services related to their main disease, provided they are deprived of income of any source;
• pensioners whose income does not exceed RON740 (€163) per month;
• pregnant women and women who have just given birth, for medical services related to pregnancy and those who have no income or have incomes below the minimum gross wage for all medical services.

Not applicable: no patient participation.

Persons with at least 70% physical disability, disabled entitled to Assistance and Attendance Allowance (dodatek za pomoč in postrežbo), recipients of Social Assistance.

Not applicable: no patient charges.

Patient's charge may be reduced according to an income test or if the patient is over 64 years old. The charge may also be reduced if the patient receives certain types of benefits.

In general, patients under 18, 19 or 20 years of age pay no charge.

• For children (< 18 years) and young adults (< 25 years) in studies or apprenticeship: no contribution to the costs of board and accommodation in the case of hospital stays.
• For the rest, see above "medical treatment".

No exemption or reduction of patient charges

Not applicable: no patient charges.

Dental treatment is granted according to the statues. Medical treatment includes conservative, surgical and orthodontic treatments. The patient's or family member's contribution towards orthodontic treatment is between 25% and 50%.

The entitlement is proven towards the dentists by e-card, an electronic sickness insurance card. The annual fee is €11.10 (with the exception of relatives, pensioners and the needy).

Comprising preventive and conservative treatment, extractions, dental prosthesis, and orthodontic treatment.

Refund:

• of cost of treatment: see medical care,
• of cost of dental plates, etc., subject to sickness fund doctor's approval, up to 100% if patient is over 50, or if younger, affected by specific complaints justifying the intervention of the insurance.

Children under 18 years of age: free dental care (except orthodontic treatment and non-reimbursable care).

Patient charges of up to 25% for ordinary insured persons over 18 years of age.

All health insured persons are entitled to receive the following dental treatment:

• Persons under 18: 1 diagnostic examination and up to 4 dental interventions per calendar year;
• Persons over 18: 1 diagnostic examination and up to 2 dental interventions per calendar year.

The National Health Insurance Fund (Национална здравно осигурителна каса) pays for this treatment fully or partially as contracted in the National Framework Contract and depending on the kind of the treatment and the age of the person.

For the "visit fee" see “Benefits, 1. Medical treatment, Patient charges".

Preventive and curative dental treatment:

Insured persons are obliged to participate to the amount of HRK 10 (€1.31) for health protection (examination and issued drugs) at contracted dentists.

They participate in specialist-consultation dental protection to the amount of HRK 25 (€3.27).

Patients entitled to free dental care (see field of application 1, Beneficiaries above) still have to pay a fixed fee of €3.00 per visit for a dentist and €6.00 per visit for a maxillofacial surgeon at outpatients departments regardless of the treatment. Everybody else has to pay fees according to the hospital price list.

Dental services are reimbursed according to a special price list and a patient does not bear the costs himself, unless the law provides otherwise. The law determines frequencies of the prophylactic dental examinations which are not paid by a patient so these are reimbursed by the public health insurance system. However there are regulatory charges: see Table II, Benefits “Payment of doctor” and “Exemption or reduction of patient’s participation”. Procedures using materials above the standard in accordance with patient wish that are not reimbursed by the public health insurance system as well as procedures which are laid down by the law as a non-reimbursable are paid entirely by patient.

Residents are entitled to public subsidies covering expenses for dental care. These subsidies comprise prevention as well as certain treatments.

For residents below the age of 18 all dental care is provided free of charge.

Special subsidies are provided to groups of patients with extraordinary needs for dental care as a result of certain diseases.

The municipalities are bound to provide and extensively subsidise dental care for residents who, as a consequence of reduced mobility or considerable physical or mental disabilities are having difficulties using the regular dental care services.

Special subsidies are provided to residents who cannot afford to pay the expenses.

For pensioners: depending on their financial situation and medical condition, the municipalities can cover 85% of the participation to the expenses by means of the Health allowance (Helbredstillæg).

Health Insurance Act (Ravikindlustuse seadus) guarantees free dental care for children and adolescents up to 19 years old, including preventive and curative services. Adult dental care must be paid for out-of-pocket, but is subject to partial reimbursement by the Health Insurance Fund (Haigekassa) for certain pensioners and for insured persons aged over 63 (€19.18 per year).

A higher rate of benefit (€28.77 per year) shall be established by a regulation of the Minister of Social Affairs (sotsiaalminister) for:

• Pregnant women;
• mothers of children under one year of age;
• persons who have an increased need for dental treatment services as a result of health services provided to them (e.g. surgical treatment of face traumas).

Nevertheless, the Health Insurance Fund covers the costs of adult emergency dental care, such as abscess incision and excision of teeth or root treatment in case of periodontitis or abscesses.

Health centre:

The patient normally pays a fee according to a basic fee and a fixed tariff for each intervention. Health centres are allowed to fix their tariff within certain limits. They are all lower than those by private dentists. Persons under the age of 18 and war veterans receive dental treatment free of charge.

Sickness insurance:

Dental expenses are partly refunded. The system allows the patient to directly know the reimbursement amount. The patient is reimbursed part of the private dentist’s fee and the examination and treatment charges according to a schedule of fixed charges. No refund is provided in respect of ortho- and prosthodontic treatment.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

Comprising preventive and conservative treatment, extractions and (submit to approval) orthodontic treatment.

Refund according to fixed rate as for medical care. Share borne by the insured person: 30%.

Full compensation of medically necessary conservative and surgical dental treatment. Full compensation of necessary orthodontist care for insured persons aged less than 18.

A system for persons up to 18 years of age of prophylactic measures designed to prevent dental disease.

In PEDY (Primary National Health Care Network- Πρωτοβάθμιο Εθνικό Δίκτυο Υγείας-ΠΕΔΥ) Health Units (formerly EOPPY Units), the following services are provided free of charge:

• prevention and treatment services for all insured persons;
• orthodontic treatment for minors up to 13 years old.

Co-payments made with respect to the costs of certain materials used and to certain treatments.

Treatment is free of charge for:

• Patients under 18 years of age,
• patients studying at secondary school or training school,
• pregnant patients (from the date of recognition of pregnancy until 90 days after the birth), except: technical costs, e.g. dental prosthesis,
• patients above 18 years: emergency treatment; dental surgery; plaque removal and treatment of gum deformity,
• patients above 62 years: emergency treatment; dental surgery; plaque removal and treatment of gum deformity plus full scale of basic and specialised treatment, (except: technical costs),
• without age limit: dental and dental surgical treatment relating to a basic medical problem and search for the origin of dental infection (referral is required),
• dental protection (according to a special regulation).

Co-payments are charged in the following circumstances:

• orthodontic brace (under age 18),
• dental prosthesis (needed to restore the patient's ability to chew).

Amounts are fixed by service providers.

Dental care is fully or partially covered for children under the age of 18 as well as for national old-age and invalidity pension recipients.

Dental care is not covered for the rest of the population except for treatment due to serious consequences of congenital defects, accidents or illness.

A new system for children under the age of 18 is gradually being implemented and will be fully in force as from January 2017 for all age groups. From 2016 the following age groups are covered:  Children aged 3 and children aged 6-17.  According to the new system, apart from an annual co-payment of ISK 2,500 (€18) paid at the beginning of the 12-month period, dental care provided to children under the age of 18 will be paid in full by the Icelandic Health Insurance (Sjúkratryggingar Íslands) provided the dentist works under a contract with the Icelandic Health Insurance and the child is registered with that dentist.

Partial reimbursement for pensioners. Pensioners receiving national old-age or invalidity pension supplement are entitled to 75% refund and other pensioners are entitled to 50% refund of costs. The reimbursement is calculated according to a tariff of the Icelandic Health Insurance (Sjúkratryggingar Íslands).

In case of serious consequences of congenital defects, accidents or illness, the rate of reimbursement   is 80% of costs. The reimbursement is calculated according to a tariff of the Icelandic Health Insurance (Sjúkratryggingar Íslands).

No charge for persons with full eligibility, children under 6 years of age and persons up to the age of 16 years who are attending or have attended primary school or who are/have been taught at home. For adults with full eligibility the range of treatments is limited since April 2010 due to the introduction of measures to contain expenditure on dental treatment under the Dental Treatment Services Scheme.

For persons who pay pay-related social insurance contributions and their spouses the range of treatments provided are now limited due to the introduction of measures to contain expenditure on dental treatment.

Patients in neither of the above categories pay full fees.

Dental care is free of charge only for people with serious economic difficulties or serious illnesses (health or social vulnerability).

In all other cases, care is fully paid by the insured.

• Free of charge (covered by State) for children up to 18;
• Free of charge for children (up to 22) with orofacial clefts orthodontic treatment;
• For victims of the Chernobyl accident, 50% is covered by State.

Treatments

necessary because of serious and unavoidable chewing problems or because of other serious disease or its consequences;

necessary to treat a serious illness or its consequences;

for persons whose chewing system have lesions due to an accident not covered by the injuries insurance.

For children of compulsory school age: educational and investigative measures, treatment of cavity damages and jawbone corrections.

General: voluntary insurance possible.

Dental treatment is partially covered for adults. Treatment is free for children under 18 years.

Comprising preservative treatment, extractions, orthodontic treatment, and prostheses. Reimbursement according to tariffs set by collective agreements.

88% reimbursement in excess of an annual sum of €60 which is fully covered.

Dental care is free to all in case of emergency. In all other cases, it is free for certain categories of patients:

• On means-tested social benefits*;
• Children under the age of 16 years;
• Members of religious orders;
• Inmates;
• Member of police force and armed forces.

*Asset Test: The total capital assets of the applicant should not exceed €14,000 for a single person and €23,300 for a married or cohabiting couple. If the head of household is self-occupied or employed, the capital assets of the whole household are assessed. However, half of the property belonging to children is excluded. If the children's property is the future home of any child who is about to marry, it is totally excluded. If the head of the household is not in insurable employment or self-occupation, any member of that household who has means of his/her own are excluded from the composition of the household providing that such assistance is not required. In this case the assets of the whole household are taken into account. The assets do not include the house of permanent residence, the summer residence, a car and garage for personal use.

Means Test includes the

• total income from employment of the head of the household and his/her spouse (excl. social security contributions);
• 15.7% of the net wages of children;
• any income derived from any investments or rents (less the first €95 per annum) and estimated income from property, which is not being made use of (estimated using 5% per annum after deducting €585 from such capital).

Social Assistance (Ghajnuna Socjali), Sickness Assistance, Tuberculosis Assistance, Leprosy Assistance, Milk Grant, and the equivalent to the rate of National Minimum Pension are exempt from the means test.

Children up to 20 years of age are entitled to public basic dental care, free of charge up to 18, and against a limited charge for the remaining 2 years. Orthodontic treatment can be paid for fully or partially according to the gravity of the condition.

For adults the dental care coverage is limited. Some coverage exists for dental surgery and treatment of patients carrying certain diseases or in particular need of free treatment (nursing home and long term hospital patients).

Surgical interventions and cleansing in the case of gum disease/periodontitis are covered.

Basic treatment and materials included in the official list drawn up by Minister of Health (Minister Zdrowia) are free of charge for all insured persons.

Free choice within the NHS system. The National Programme for the Promotion of Oral Health enables access to such care for four population groups:

• Children up to 16 years old;
• pregnant women who are cared for by the NHS;
• recipients of the solidarity supplement;
•  the elderly;
• patients suffering from HIV/AIDS.

The program aims to assess and reduce the incidence and prevalence of oral diseases through "dentist cheques", which are guides enabling access to different types of dental care in areas of prevention, diagnosis and treatment.

Each dentist cheque is worth €35.

100% coverage for children aged under 18 and 60-100% for adults, depending on the medical dental service provided. 100% coverage for the special laws beneficiaries.

Free choice among contracted doctors. Dental services are reimbursed according to prices agreed between health insurance agencies and providers. Dental examination is not paid for by the patient. The use of materials above the prescribed standard is paid for entirely by the patient.

Dental care provided by a non-contracted doctor is paid for by the patient him-or herself.

Free dental treatment for children and students, for others 20% additional payment.

Dental prosthetic treatment of adults: 90% additional payment.

Voluntary supplementary insurance for co-payments is available.

Comprising extractions and certain types of treatment. In case of an accident or illness, oral and facial surgeries are also covered.

Up to and including the calendar year in which a person reaches the age of 19, the person receives free dental care, which is financed by the county councils or regions (landsting or regioner).

From the calendar year in which a person reaches the age of 20, the person is covered by dental care insurance.

The insurance includes a high-cost protection scheme combined with a dental care voucher to encourage regular dental care check-ups. The compensation in the high-cost protection scheme is based on “reference prices” - 50% of the patient’s costs between SEK 3,000 (€327) and SEK 15,000 (€1,633) and 85% of the patient’s costs exceeding SEK 15,000 (€1,633).

Payment limited to cases:

• Caused by a serious and unavoidable disease of the mastication system,
• caused by any other serious illness or its after-effects (e.g. leukaemia, AIDS),
• necessary for the treatment of a serious illness or its after-effects,
• where injuries of the mastication system are caused by an accident not covered by the accident insurance.

Dental care for children up to 18 years of age including preventive maintenance work, fluoride applications up to twice a year from the age of six, sealing, periodontal care and surgical treatment are included in the legally defined coverage;

Adult dentures and specialist surgical treatments are only covered if it concerns a serious development disorder, growth disorder or an acquired defect of the dental/jaw/mouth system. Other dental treatments are only covered through voluntary supplemental insurance.

There are three standard charges for NHS dental treatment – GBP 18.80 (€25), GBP 51.30 (€70) or GBP 222.50 (€301), depending on treatment required.

No charge for:

• women who are pregnant, or who have had a baby in the preceding 12 months, when the course of treatment starts;
• people under 18;
• those aged 19 or under and in full-time education;
• people and their partners who are receiving Income-related Employment and Support Allowance (ESA), Income Support or Income-based Jobseekers' Allowance, or Pension Credit Guarantee Credit;
• people named on a Tax Credit NHS Exemption Certificate or a valid HC2 certificate.

People on a low income may be able to get help with the cost of treatment.

Dental treatment in the hospital and Community Dental Services may incur a charge depending on the type of treatment carried out.

(Indispensable) dental prosthesis is granted according to the statutes. The patient's or family member's contribution towards removable dental prosthesis such as braces is between 25% and 50%.

Health insurance does not cover removable dental prosthesis except for patients aged at least 50.

Exceptions are possible, notably as regards the age limit of 50 years.

Reimbursement of 75% for ordinary insured persons and of 95% for beneficiaries of the preferential scheme (beneficiaries of the increased reimbursement system (bénéficiaires de l’intervention majorée, /rechthebbenden op de verhoogde tegemoetkoming).

Not covered.

Partially covered. Coverage of stomatological aids depends upon the age of the insured persons. Patient co-payment of 20% of the cost, but minimum HRK 1,000 (€131) for patients aged 18 to 65 and HRK 500 (€65) for patients aged 65 or over.

The ceiling is HRK 2,000 (€262) per issued health bill.

Dental prosthesis is provided for certain low-income groups, as follows:

• transitional removable full or partial dentures (acrylic), at €100 per item,
• casted framework removable full or partial dentures, at €100 per item, and
• interocclusal appliances (splints) at  €100 per item.

Partial metallic dentures are offered to persons entitled to healthcare benefits(see "Field of application, 1. Beneficiaries" above), at the cost of €100 per item.

Additionally, the patients have to pay €100 per item at a dental laboratory for the construction of the metallic frame.

Dental prostheses are available to all insured persons. The law defines the amount of reimbursement by the public health insurance system according to the use of various materials. Selected materials may be fully reimbursed from the public health insurance system.

All the costs above the standard amount of a reimbursement from the public health insurance system are borne by patient.

Regulatory charges: see “Benefits, Medical treatment, Payment of doctor” and “Exemption or reduction of patient charges”.

For pensioners: depending on their financial situation and medical condition, the municipalities can cover 85% of the participation to the expenses by means of the Health allowance (Helbredstillæg).

In the case of dentures, the Health Insurance Fund (Haigekassa) compensates, once every three years, the amount paid for dentures by insured individuals who are at least 63 years old or who receive an old-age pension. The amount is up to €255.65.

Health centre:

Only for war veterans (full coverage).

Sickness insurance:

Refunded for war veterans.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

Refund according to fixed rates. Share borne by the insured person: 30%.

The insured person is entitled to receive diagnosis-related fixed subsidies, which correspond to 50% of the costs of the fixed standard care determined by the Joint Federal Committee (Gemeinsamer Bundesausschuss). No contribution for medically conservative treatment and for denture radiography. When the insured person takes measures to maintain healthy teeth, the benefit is increased by a bonus of 20% or 30% respectively.

In PEDY (Primary National Health Care Network- Πρωτοβάθμιο Εθνικό Δίκτυο Υγείας-ΠΕΔΥ) Health Units: partial dentures and complete dentures are provided free of charge every five years, as well as intermediary services whenever they are needed.

For dental prosthesis necessary to restore the patient's ability to chew, co-payments are charged.

Amounts are fixed by service providers.

Partial reimbursement of costs of fixed prostheses and implants and full and partial dentures up to a certain amount  for old-age and invalidity pensioners according to the same rules as those applying to dental treatment for pensioners subject to certain conditions

Prosthetics will only be allowed in emergency circumstances approved by the Health Service Executive (HSE) due to the introduction of measures to contain expenditure on dental treatment.

Paid by the beneficiary.

Full price. Exception: prosthetics of partial acrylic dentures for victims of Chernobyl accident is free of charge (covered by State).

According to the law on sickness insurance: same conditions as for treatments (see above).

Dental prosthesis expenses are covered for children, disabled persons and retired persons. The level of coverage depends on the status of the patient and may vary from €335 to €1,031.

Prostheses are 100% covered, unless the insured person did not regularly consult a dentist as a matter of prevention, in which case 80% is covered. Supplements for prostheses and benefits which go beyond what is useful and needed are not covered.

Dental care is free to all in case of emergency. Free for certain categories of patients:

• On means-tested social benefits;
• Children under the age of 16 years;
• Members of religious orders;
• Inmates;
• Member of police force and armed forces.

Persons in receipt of social benefit are issued with the Pink Card /Medical Aids Grant (Ghajnuna Medika bla Hlas) under the Social Security Act (Att dwar is-Sigurta' Socjali) in order to certify the entitlement, amongst others, to free dental care. The issuance of the Pink Card is based on an assessment of total household income which must fall below a certain threshold.

School children are offered preventive care, restorative dentistry and orthodontic care.

Generally not covered.

Some coverage for persons not developing teeth as they grow up and for persons having lost their teeth traumatically as a consequence of certain diseases.

Replacement of teeth lost in periodontitis is paid for according to fixed tariffs.

The cost of dental prosthesis is covered by insurance once every 5 years.

Elderly people who have insufficient funds are entitled to the reimbursement of dentures, drugs, glasses and contact lenses.

Acrylic prosthesis every 5 years.

The percentage covered by health insurance is 60% and for categories of insured beneficiaries under special laws is 100%.

Certain additional co-payments (according to list of health devices). The average patient's participation is about 35%, depending on the type and the material of the dental prosthesis. The cost for a complete dental prosthesis ranges between €165 and €829.

See "Benefits, 3. Dental care: Treatment".

Certain financial aids for dental prosthesis.

Dental care includes dental prosthesis. See above “Treatment”.

Under the same conditions as treatment (see above).

Dentures: Patient's participation of 25%.

See dental treatment.

Coverage of expenses for medically prescribed registered pharmaceutical products included in the List of Pharmaceutical Products (others: approved by medical superintendent or supervisory medical doctor). The charge amounts to €5.70 per item prescribed.

Free of charge for notifiable infectious diseases or in case of need.

Patient charges depend on the category to which the pharmaceutical belongs (A, B, C, Cx, Cs, Fa and Fb):

• A (medicines of vital importance): co-payment set at 0% of the reimbursement base (ex-factory level),or free of charge;
• B (therapeutically important medicines): co-payment set at €2.50 increased by 27% of the reimbursement base. If the reimbursement base is less than €14.38, co-payment is set at 44.20% of the reimbursement base; however, a ceiling of €11.80 (€14.70 for a large box) applies;
• C (medicines for symptomatic treatment): co-payment set at €5 increased by 54% of the reimbursement base. If the reimbursement base is less than €14.38, co-payment is set at 88.39% of the reimbursement base; a ceiling of €14.70 applies;
• Cs: co-payment set at €6 increased by 65% of the reimbursement base. If the reimbursement base is less than €14.38, co-payment is set at 106.07% of the reimbursement base; no co-payment ceiling;
• Cx (so-called transition category): co-payment set at €8 increased by 86% of the reimbursement base. If the reimbursement base is less than €14.38, co-payment is set at 141.43% of the reimbursement base; no co-payment ceiling;
• Fa: Co-payment set at 0% of the reimbursement base, i.e. free of charge;
• Fb: see medicines of category B.

Patients in hospital: €0.62 per day.(€0.80 in psychiatric hospitals). No flat-rate for day care hospitals.

Refund of cost of preparations by pharmacist: Maximum share of insured person €1.20 or €2.40.Exemption made for long lasting treatments.

Charge reduced for beneficiaries of the increased reimbursement system (bénéficiaires de l’intervention majorée/rechthebbenden op de verhoogde tegemoetkoming).

The Minister of Health determines by an ordinance a list of the diseases for the home treatment of which the National Health Insurance Fund (Национална здравно осигурителна каса) (NHIF) shall pay for medicines, medical products and dietary foods for special medical purposes in full or partially.

The NHIF pays fully or partially for up to 3 listed pharmaceutical products per listed illness. The NHIF together with the associations of the doctors and of the dentists determine the prices of the products with the producers and wholesalers. The extent of NHIF payment towards listed products is included in the annual National Framework Contracts.

The conditions and the procedure for payment for medicinal products, included in the Positive Medicine List under Art. 262 of the Law on Medicinal Products in Human Medicine (ЗАКОН за лекарствените продукти в хуманната медицина), for medicinal products and the dietary foods for special medical purposes are regulated by an ordinance of the Minister of Health.

Drugs on the basic list are fully paid for by the Croatian Health Insurance Fund (Hrvatski zavod za zdravstveno osiguranje).

Participation in the cost is required for drugs on the additional lists.

Participation of HRK 10 (€1.31) per prescription is required for drugs on  both basic and additional list.

All drugs used for hospital treatment are fully covered by compulsory health insurance.

Pharmaceutical products are provided by the pharmacies of hospitals/institutions. The prescribed pharmaceutical products are included in an approved list which is updated regularly. Persons entitled to healthcare benefits (see "Field of application, 1. Beneficiaries" above) are charged €0.50 per prescribed pharmaceutical product.

Additionally, there is a co-payment scheme for 79 pharmaceutical products which are dispensed by private pharmacies and patients are required to pay apre-defined cost difference referring to each individual pharmaceutical product.

Act No. 48/1997 in its Annex 2 defines a total of 300 groups of medical matters that can be reimbursed by the health insurance funds and establishes specific conditions for reimbursement in each group.

At least one medicament is free of charge and fully reimbursed by the health insurance funds in each group. It means the cheapest effective option of all essential drugs.

The other medicaments are partly or fully paid by patients. The amount of co-payment varies between 0 and 100%.

Participation of the insured person dependent on the expenditure for medicines on list during the year:

• Expenditure under DKK 935 (€125): 100% of cost (persons under the age of 18: 40%);
• Expenditure between DKK 935 (€125) and DKK 1,535 (€206): 50% (persons under the age of 18: 40%);
• Expenditure between DKK 1,535 (€206) and DKK 3,325 (€446): 25%;
• Expenditure over DKK 3,325 (€446): 15%.

The public health service can in special cases:

• contribute for medicines not on the list;
• raise the contribution when an expensive medicine is necessary;
• contribute fully to medicine for terminally ill persons;
• determine that for persons with an extensive, permanent and professionally well-documented need for medicinal products the reimbursement rate shall be 100% of the part of the total co-payment which is in excess of DKK 3,880 (€520) per year.

Special subsidies are provided to residents who cannot afford to pay.

For pensioners: depending on their financial situation and medical condition, the municipalities can cover 85% of the participation to the expenses by means of the Health allowance (Helbredstillæg).

Pharmaceuticals for HIV, tuberculosis and opioid dependence treatment and also list of certain vaccines are free for all patients.

Pharmaceuticals that are used in hospitals are integrated into healthcare services with no additional patient participation.

Over-the-counter pharmaceuticals are generally not reimbursed.

Prescription-only medicines are generally reimbursed, based on a reimbursement (“positive”) list. Reimbursement levels are 50% (for all listed pharmaceuticals), 75% (based on indication) and 100% (based on indication).

The prescription fee is €3.19 for pharmaceuticals reimbursed at 50% and €1.27 for pharmaceuticals reimbursed at a higher level. There are additional advantages for certain social groups: 75% reimbursement is increased to 90% for children below 16 years, disabled and retired people, and 50% or 75% are increased to to 100% for children below the age of 4 years.

Public hospitals:

Costs included in fee.

Sickness insurance

40% of the costs of the refundable product are reimbursed provided it was prescribed by a qualified person after exceeding the initial deductible, also known as excess, of €50 per calendar year. In case of serious and chronic diseases a number of listed pharmaceutical products qualify for refund of 65% of the costs or for refund of 100% of the costs exceeding €4.50 per pharmaceutical product. If patient’s own costs for refundable pharmaceutical products during one calendar year exceed €610.37, the excess of €2.50 per pharmaceutical product purchased on the basis of a prescription is refunded.

Certain pharmaceutical products belong to a reference price system.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

For certain specialities the reimbursement is made on the basis of a lump-sum calculated from the generic medicine price.

Co-payment for the insured:between 0 and 85% depending on the recognition of the medical service provided plus flat-rate co-payment of €0.50 per package of medicine within a limit of €50 per year and per person.

Insured person's participation:

A 10%-share of the pharmacy sales price, at least €5 and a maximum of €10 and not more than the price of the product, except for insured persons up to completing and insured persons once the expenses limit has been exceeded.  If there are fixed-price pharmaceutical products, the amount of contribution payable depends on this fixed price. If the price of the product exceeds the fixed price, the patient must pay the difference between the fixed price and the prescribed product, in addition to the set prescription charge.

The National Association of Statutory Health Insurance Funds (GKV-Spitzenverband) can set participation exemption limits for pharmaceuticals. Pharmaceuticals priced up to this amount are always free of participation. The statutory requirement for a participation exemption limit is that the manufacturer’s delivery price without VAT is at least 30% lower than the fixed price on which it is based, and that a cost reduction can be achieved with that.

Furthermore, an individual sickness insurance fund can halve or forego the participation of a pharmaceutical in respect of which they signed a rebate contract.

The sickness insurance funds and the pharmaceutical companies may negotiate rebates on pharmaceuticals whose price is higher than the fixed price in order to compensate for the additional costs.

Drugs which are not subject to prescription are not paid for by the insurance. children up to the age of 12 showing developmental disability as well as for pharmaceuticals which, according to the guidelines of the Joint Federal Committee (Gemeinsamer Bundesausschuss), constitute the therapy standard for the treatment of serious diseases. Insured persons must pay themselves for life-style drugs and pharmaceuticals for minor ailments, e.g. for the treatment of common colds or travel-sickness symptoms.

Certain uneconomical drugs are not paid for by the insurance.

Family members: like insured persons.

As a general rule, a charge of 25% applies for medicines prescribed by a doctor. However, the percentage of cost participation varies depending on the illness for which the medicament is prescribed.

10% contribution to the cost of medication prescribed for certain illnesses (Parkinson's disease, valvulopathy, myasthenia, tuberculosis etc.) and for retired persons receiving the Solidarity Benefit for Pensioners (ΕΠΙΔΟΜΑ ΚΟΙΝΩΝΙΚΗΣ ΑΛΛΗΛΕΓΓΥΗΣ ΣΥΝΤΑΞΙΟΥΧΩΝ - ΕΚΑΣ).

No charges payable in the event of an accident at work, for medication during pregnancy and for chronic illnesses (cancer, quadriplegia, paraplegia, hemodialysis patients, psychosis, thalassaemia etc.).

In case of the price of a medicine being higher than the reimbursed price, the difference is paid by the patient up to €50 per pack of the pharmaceutical product. When the medicine has no generic equivalent, the patient pays, in addition to statutory participation, half the difference between the reimbursed price and retail price. The remaining amount is charged to the pharmaceutical company or the marketing authorisation holder in the form of a rebate.

No charges for specific high cost drugs dispensed by pharmacies that are part of Public Hospitals or part of the National Organisation for Healthcare Services Provision (EOPYY) (ΕΝΙΑΙΟΣ ΟΡΓΑΝΙΣΜΟΣ ΠΑΡΟΧΩΝ ΥΠΗΡΕΣΙΩΝ ΥΓΕΙΑΣ - ΕΟΠΥΥ), or by private pharmacies.

The pharmaceuticals subsidised by the National Health Insurance Fund (Országos Egészségbiztosítási Pénztár) are divided as follows:

• Pharmaceuticals provided during inpatient care are free of charge;
• Pharmaceuticals, provided by outpatient care, are normatively subsidised by 80%, 55%, 25%;
• Other special, increased or indication-related subsidy categories: 100%, 90%, 70% or 50%;
• in case of certain chronic diseases, or other heavy diseases the subsidy is 100%. In this case HUF300 (€0.96) packing fee is to be paid.

The percentage is fixed to the price of the reference pharmaceutical.

Elderly or disabled persons with low income receive a special card providing entitlement to free medicine.

When the insured person buys pharmaceuticals for the first time, a payment period of twelve months starts. For the first time the insured person pays for the pharmaceuticals in full, then the subsequent payments are gradually lower. The general maximum payment of the insured person in each period of 12 months is ISK 62,000 (€438). The maximum payment of elderly persons, invalidity pensioners, children and youth under the age of 22 in each period of 12 months is ISK 41,000 (€289). All children under the age of 18 in the same family pay as one. After this ceiling is reached a doctor can apply to the Icelandic Health Insurance (Sjúkratryggingar Íslands) for a full coverage of the costs for the remainder of the period.

Persons with full eligibility pay a prescription charge of €2.50 per prescribed item, up to a maximum of €25 per person or per family per month.

No charge for persons with a specified long-term illness in respect of drugs prescribed for the treatment of the specified illness.

Drugs Payment Scheme: No individual or family is required to pay more than €144 per month for approved prescribed medicine and medical devices.

Classification of authorised and registered medicines:

• Group A: Medicines termed "essential" or for chronic illness, free for all insured persons except for a fixed prescription charge (so called “ticket”) that may differ in each Region. Each Region can define the amount and the categories that are exempt;
• Group C: Other medicines (including those for which a prescription is not required) whose cost is borne fully by the insured person.

Reimbursement is made according to the disease, its character and severity. There are 3 reimbursement categories: 100% (or 100% of the reference price if the pharmaceutical is in list A), 75% (or 75% of the reference price if the pharmaceutical is in list A) and 50% (or 50% of the reference price if the pharmaceutical is in list A).

The pharmaceuticals eligible for reimbursement are listed in the positive list. The positive list consists of 3 parts:

• List A: pharmaceuticals are grouped in clusters of interchangeable pharmaceutical products. The reference price for each cluster is the price of the cheapest product. Products are clustered according to the presentation form, dosage and package size.
• List B: contains pharmaceutical products which are considered not to be interchangeable.
• List C: contains expensive pharmaceutical products (if treatment is considered to exceed €4,268.62 a year); extra restrictions for prescription are established.

Moreover, there is the List M, which includes prescription drugs (which are not included in the list of pharmaceuticals eligible for reimbursement) for pregnant women, women in the period following childbirth up to 42 days and children up to the age of 24 months. Drugs in the List M have 2 reimbursement categories:

• 50% reimbursement for children up to the age of 24 months (except when the diagnosis is eligible for other reimbursement categories (100% or 75%)),
• 25% reimbursement for pregnant women, women in the period following childbirth up to 42 days (except when the diagnosis is eligible for other reimbursement categories (100%, 75% or 50%)).

Exception:

Reimbursement of pharmaceuticals for individual persons in the following cases:

• if the patient’s disease (diagnosis) is not included in the list of diagnoses for which pharmaceuticals are eligible for reimbursement and if the patient’s life is endangered without the particular pharmaceutical;
• the disease (diagnosis) is included in the list of diagnoses for which pharmaceuticals are eligible for reimbursement but there are no reimbursable drugs or medical devices for the treatment of the disease.

The reimbursement of pharmaceuticals for individual persons cannot exceed €14,228.72 per person per 12 months.

Patients have to pay €0.71 for each prescription of pharmaceuticals or medical devices with 100% reimbursement. Exemptions: needy persons, children, or in case the price for the pharmaceutical or medical device prescribed does not exceed €4.27. For children under 18 the pharmaceuticals and medical devices eligible for reimbursement are covered in full (100% reimbursement category) with some exceptions, (for example when non reference A list drugs are prescribed the patient covers the difference between the price of non-reference and reference drug or medical device, when the drugs listed in List M are prescribed, etc.).

Medications prescribed by the doctor according to a speciality list (including medications therapeutically equivalent to these medications).

Participation: See Point 1. "Medical treatment".

Full coverage of pharmaceutical products for:

• children under 18;
• persons recognised as incapable of work or persons who reached the pensionable age, for whom a level of major special needs is established.

100%, 90%, 80% or 50% reimbursement levels for those suffering from specific illnesses (special list).

50% of the price of pharmaceuticals covered for:

• old-age pensioners;
• those receiving the social assistance pension (Šalpos pensija);
• those with a loss of capacity for work of 60% -70%.

Reimbursement according to the classification of drugs:

• Normal reimbursement: 80%
• Preferential reimbursement: 100%
• Reduced reimbursement: 40%
• Non-reimbursable products and drugs.

Free of charge during hospitalisation and for the first 3 days after discharge.

Pharmaceuticals are also provided free of charge for people suffering from an established list of chronic diseases and for eligible individuals who pass the means test.

• Less important medicines: The patient pays the full cost, even when they are prescribed by a doctor. A 90% refund of annual costs exceeding NOK 1,775 (€185) is possible under certain conditions;
• Important medicines: For prescribed medicines on the important medicines list, the patient pays 39% of the cost up to a ceiling of NOK 520 (€54) for each 3-months period of consumption. National Insurance (folketrygden) pays, normally through direct settlement with the pharmacies, up to the full cost. Pensioners in receipt of a minimum old-age or disability pension and children under 16 are exempt from cost-sharing charges on important medicines and nursing articles.

Official list of medicines divides pharmaceuticals into 3 categories:

• Basic medicines: fixed price of  PLN 3.20 (€0.75) or PLN 8.80 (€2.08) determined by the Minister of Health (Minister Zdrowia);
• special additional medicines: 30% to 50% of price paid by the insured person;
• other medicines: 100% of the price paid by the insured person.

Medicines free of charge in hospitals.

Depending on the type of illness, the State contributes 90%, 69%, 37% or 15% of the cost of medicines on the official list drawn up by the health services.

Medicines considered as being essential for maintaining life (insulins and immunomodulators) are fully reimbursed).

The State contribution is 95%, 84%, 52% or 30% for pensioners whose total annual income does not exceed the equivalent of 14 times the guaranteed minimum retribution (Retribuição Mínima Mensal Garantida) for the previous year or, if this is higher, the equivalent of 14 times the reference social support index (indexante dos apoios sociais) in force.

For pensioners, the State contribution is 95% for all medicines whose retail price is equal to or higher than the average retail price of the five cheapest medicines on the market.

In addition, there are special co-payment schemes for medicines used for certain defined pathologies or by particular groups of patients, which are determined on the appropriate legal grounds. Therefore, certain medicines (such as those to treat hepatitis C), which are distributed at a hospital clinic, are totally covered by the State, while other are only partially covered (such as those to treat Alzheimer's disease).

There are four lists of pharmaceutical products. The National Health Insurance House (Casa Naţională de Asigurări de Sănătate) pays:

List A: 90% of the reference price costs.

List B: 50% of the reference price costs.

List C:

• C1: 100% of the reference price costs;
• C2: 100% of the reimbursement  price (HIV/AIDS, oncology);
• C3: 100% of the reference price costs for children, pregnant women, women who have just given birth and other special categories of citizens such as war survivors, political prisoners or those who are totally or partially incapable of work.
• D: 25% of the reference price costs.

There is also a subsidy programme to help pensioners with pension under RON700 (€154) buy medicine. It compensates 90% of the reference price costs for pharmaceutical products from list B.

Free of charge or on partial reimbursement for insured persons (full or partial refund according to the lists of medicaments). The average patient's participation to pharmaceutical products is about 10%-14%.

Patient charges on pharmaceutical products cannot exceed €25 per quarter for disabled citizens or elderly and cannot exceed €8 per quarter for children under 6 years of age (total exemption for severely disabled children). Otherwise no exemption or reduction of patient charges applies.

Pharmaceuticals are listed into three lists contained in a positive, an interim:

• positive list: 70% reimbursement and 100% reimbursement for children and some other categories (see Table II, "Patient's participation");
• intermediate list: 10% reimbursement.

Voluntary insurance is available for co-payments.

For pharmaceutical products not contained on the lists: full costs are born by the patient.

All drugs used during hospital treatment are free.

Beneficiaries pay between 40% and 60% of the price of medicaments depending on their income level.

Pensioners pay 10% of the price of medicaments, provided their income is below €100,000.

For certain special medicaments (long treatments), there are specific limits.

No charge whatsoever for: disabled persons in certain cases; patients undergoing inpatient hospital care; beneficiaries of non-contributory pensions; unemployed persons who have exhausted the unemployment allowance; and victims of accidents at work and occupational diseases.

• The patient pays the whole cost up to and including SEK 1,100 (€120) during a period of 12 months from the first purchase;
• Costs between SEK 1,100 (€120) and SEK 2,100 (€229) are subsidised by 50%;
• Costs between SEK 2,100 (€229) and SEK 3,900 (€424) are subsidised by 75%;
• Costs between SEK 3,900 (€424) and SEK 5,400 (€588) are subsidised by 90%;
• Costs above SEK 5,400 (€588) are subsidised totally.

If patients have paid over SEK 2,200 (€239) for subsidised pharmaceutical products within the previous 12-month period, they are exempt from paying for subsidised medicines for the remaining duration of this 12-month period (counting from the first day of purchase).

The Dental and Pharmaceutical Benefits Agency (Tandvårds- och läkemedelsförmånsverket) decides which products will be subsidised within this scheme.

Pharmaceutical products prescribed and registered on the list of reimbursed drugs.

Same participation as for medical care (however share of costs of 20% for drugs whose price exceeds by more than 20% the average price of the cheapest third of the drugs with the same active substance).

The compulsory deductible of €385 also applies to pharmaceuticals included in the basic coverage. Besides this, pharmaceuticals can be supplied and charged to the private health insurance companies up to the average price per standard drug dosage that belongs to a certain classified medical package, with an additional payment to be paid by the insured person.

Charge of GBP 8.05 (€11) per prescribed item.

An annual (or 3 months) prescription prepayment certificate can be bought which offers considerable savings to those who need regular medication. The cost of the certificate is GBP 104.00 (€141) (England) for one year and GBP 29.10 (€39) (England) for 3 months.

There is no charge for children under 16, people aged 16-18 and still in full-time education, people aged 60 or over, pregnant women and women who have given birth in the last 12 months, War Pensioners (for their accepted disability), people and their partner receiving Income Support or income-based Jobseekers' Allowance, income-based Employment and Support Allowance, Pension Credit Guarantee Credit, or Tax Credit (and named on a Tax Credit NHS Exemption Certificate), or named on valid HC2 certificate, some other people on low incomes, and people suffering from specified conditions.

Participation of the insured person is 10%, at least €32.40 (free of charge in case of need), for glasses at least €97.20, with the exception of glasses for children.

The maximum amount to be covered by the insurance funds is limited differently according to the statutes of the insurance funds.

Reimbursement of hearing aids: 100% for beneficiaries under 18 years of age, minor contributions towards the cost of hearing aids for other beneficiaries.

Reimbursement of spectacles and contact lenses:

• Frames and spectacle lenses for persons under 19 years of age;
• Contact lenses: beneficiaries aged 19 to 65;
• Spectacle lenses: beneficiaries aged 19 to 65 (as of ca.8.25 dioptres) and beneficiaries aged over 65 (as of +/- 4.25 dioptres).

Disabled persons receive cash allowances for the purchase or repair of supporting devices according to a list set annually by the Minister of Labour and Social Policy (Министър на труда и социалната политика).

Orthopaedic and other aids defined by law are partially covered. Patient co-payment of 20% of the cost, but minimum HRK 50 (€6.55).

Subsidy for hearing-aids is provided to:

• children until 18 years of age,
• adults with congenital deafness,
• persons with hearing problems up to the age of 10,
• persons over 65 years of age.
• Full subsidy is provided to persons entitled to healthcare benefits (see "Field of application, 1. Beneficiaries" above), whereas a 50% subsidy is provided to beneficiaries entitled to care at reduced rates.

Subsidy is given every 4 years, or in case where there is permanent damage of the hearing aid.

For people above the age of 65, a subsidy of €170 is provided for one or two hearing-aids. For the rest of the beneficiaries funding is given up to €1,367 per hearing-aid.

Artificial limps are provided:

• Free of charge for persons entitled to healthcare benefits (see "Field of application, 1. Beneficiaries"),
• 25% charge for beneficiaries entitled to care at reduced fees.

Prostheses, eye-glasses and hearing aids may be partially or fully reimbursed. A price list of health aids establishes the level of co-payment.

Medical aids and remedies are provided free of charge to patients in hospitals if they are part of the treatment given in the hospitals.

Hearing aids are free of charge if provided by a hospital. They may also be obtained from approved private providers with a subsidy of up to DKK 6,385 (€856).

Temporary prosthesis after amputation, internal prosthesis and stoma aids are paid for by the Health Insurance Fund (Haigekassa). Further technical appliances are provided in the framework of social assistance and financed from the State Budget.

Health centre:

Prosthesis and hearing-aids are in most cases free of charge.

Sickness Insurance:

Not refundable.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

Reimbursement at 60% of set fees, which may vary according to age and disability. For major fittings, reimbursement at 100% of set fees after prior approval of the sickness fund.

The prices for medical supplies are agreed between the sickness funds and the care providers. If there are fixed amounts determined for medical supplies, these constitute the ceiling for the contract prices.

Insured person's participation:

10% of the cost for aids, at least €5, €10 at most, not more than the price of the product. Co-payment for aids intended for consumption is 10% of the total amount the health insurance must take over, but no higher than  €10for the requirements of an entire month. 10% of the costs for remedies plus an additional €10 per prescription; insured persons up to the age of 18 are exempted from the co-payment.

The entitlement to vision aids is limited to children and young persons up to the completion of the age of 18 and to insured persons with severe vision impairments. Therapeutic vision aids used for treatment of eye injuries or eye diseases are excluded from this restriction.

25% co-payment with the exception of specified categories of patients (e.g. persons suffering from diabetes, paraplegia-quadriplegia, renal insufficiency etc.).

Spectacles: insured persons are granted glasses every 4 years or contact lenses every 2 years. Children up to 12 years old are granted glasses every 2 years.

The compensation amount for glasses is €100 and for each contact lens €25.

Hearing aids are compensated up to the amount of €600, every 4 years for adults and every year for children (under conditions).

The National Health Insurance Fund (Országos Egészségbiztosítási Pénztár) subsidises 0%, 45%, 50%, 60%, 70%, 80%, 90% or 98% of the price or 0%, 50%, 70%, 80%, 90% or 98% of the rental fee depending on the type of the prosthetic device in question. 100% coverage for all victims of accidents at work and occupational diseases.

Elderly or disabled persons with low income receive a special card providing entitlement to free medical aids.

The acquisition of aid apparatus made necessary by physical impairment or missing limbs is covered or subsidised. In some cases a certain amount is awarded, in other cases a certain percentage of the cost is paid or refunded.

The cost of spectacles is subsidised in special cases, and for children under the age of 18 up to a certain amount. The Institute for the Blind, Visually Impaired and Deaf-Blind administers all services for the blind and purblind.

The cost of hearing aid is subsidised. The Hearing and Speech Institute administers all services for the deaf.

Spectacles, hearing-aids:

No charge for persons with full eligibility and for children under 6 years of age or for primary school / taught at home pupils.

Reduced charges levied on insured persons who satisfy certain contribution conditions.

Prosthesis: supplied to the different categories of disabled by the Local Health Authority (Azienda Sanitaria Locale – ASL)

Spectacles and hearing-aids are free of charge only for specific visual and hearing impairment (DM n. 332 del 27 agosto 1999).

Expenses sustained in relation to prosthesis and medical aids supplied to insured persons who need to recover from an accident at work or occupational disease are covered by the National Insurance Institute for Employment Injuries (Istituto Nazionale contro gli infortuni sul lavoro - INAIL).

Not provided by the national health care system. Exception:

• cochlear implants for children, for persons who are likely to become disabled and for long-term sick persons from the age 18 until reaching the legal retirement age;
• spectacles for children who suffer from specific vision impairments as stated in regulations of the Cabinet of Ministers;
• and all types of endoprosthesis.

Aid is prescribed by the doctor according to the list.

Participation: See Point 1. "Medical treatment".

Prostheses and other orthopaedic technical devices are reimbursed at 50%, 80%, 95% or 100% for insured patients suffering from illnesses included in special lists approved by the Ministry of Health. Full coverage for:

• patients suffering from illnesses included in the special list with 100% reimbursement level (including all prostheses);
• disabled children;
• persons recognised as incapable of work;
• persons receiving the social assistance pension (Šalpos pensija);
• persons who reached the pensionable age, for whom a level of major special needs is established.

The period of reimbursement of expenses for prostheses varies from 3 to 5 years, whereas for other orthopaedic technical devices it varies from 6 months to 2 years.

Prostheses, intraocular lenses and hearing aids which are purchased by the National Health Insurance Fund under the Ministry of Health (NHIF) (Valstybinė ligonių kasa prie Sveikatos apsaugos ministerijos) are free of charge for insured persons. If a person wishes a different device from what the NHIF can offer, s/he has to pay the full price and obtains compensation from the NHIF equal to the price of the device offered by the NHIF.

Expenses for the acquisition of spectacle lenses according to medical prescription are reimbursed to children with a better eye correction not exceeding 0.3 visual acuity – not more than once per year (the rate is up to 1 MSL) and to adults with better eye visual acuity after full correction not exceeding 0.1 – once every 2 years (the rate is up to 2 MSL).

Subject to prior authorisation by the sickness fund: reimbursement according to the tariff rates set by collective agreements.

Prosthesis, spectacles, hearing aids and dentures are provided free to:

• Those on means-tested social benefits;
• Children under the age of 16 years;
• Members of religious orders;
• Inmates;
• Member of police force and armed forces.

Technical aids are provided by Assistive Technology Centres (NAV hjelpemiddelsentraler) under the Labour and Welfare Administration (Arbeids- og velferdsetaten). Each of the 19 counties (fylker) has a centre, with the exception of Oslo and Akershus which have a joint centre. Durable appliances are considered property of the National Insurance Scheme, and must be handed in after use.

Aids related to medical treatment are provided by the Regional Health Enterprises.

The Minister of Health (Minister Zdrowia) determines costs of equipment and the insured person's contribution.

Free or part payment (once every 3 or 5 years); prostheses, hearing aids and wheelchairs are free, but 30% to 50% of the price of spectacle frames and lenses is paid by the insured person.

Elderly people who have insufficient funds are entitled to the reimbursement of dentures, drugs, glasses and contact lenses.

Insured persons are entitled to a list of medical devices (except for spectacles) based on the medical prescription. They are required to contribute to the cost (as defined by an annually reviewed price list of medical devices) to different extents according to the cost of the medical devices. 

Limited coverage, the rest to be paid by the patient (according to the price list of health devices).

For example: the patient's participation for a lower limb prosthesis or hearing-aid may be partly or totally covered by the health insurance, depending on the diagnosis, the doctor's decision and the patient's choice of aid.

Free for children, students and others entitled to 100% coverage of costs.

70% for medical devices related to the treatment of injuries outside work; 80% for other cases.

Voluntary supplementary insurance for co-payments is available.

Provision and normal replacement of prosthesis, orthopaedic apparatus and wheel-chairs.

Certain helps with purchase of spectacles, hearing aids and other special types of prosthesis.

The county councils or regions (landsting or regioner) provide appliances on certain conditions.

Prosthesis: in principle paid by the invalidity insurance (1^st pillar, basic scheme), but contribution for certain specific prosthesis.

Spectacles/contact lenses: contribution of CHF180 (€166) per year for children under 18.

Hearing aids: paid by the invalidity insurance (1^st pillar, basic scheme).

Subject to prior approval of health insurer. No cost sharing except for:

• Orthopaedic shoes: share in cost of €68.50 per year for those aged up to age 16; and €36.50 per year for those aged 16 and over;
• Hearing appliances: share in cost of 25% of the purchasing price. Costs of replacement, batteries and maintenance are at the insured’s expense.

As of 2016 no compulsory deductible will apply for hearing-aids for childeren under the age of 18 years. This also applies for tinnitus mask aids.

Vouchers available to help with purchase of spectacles for certain groups: to children under 16 or under 19 and still in full-time education, or people (and their partner) getting Income-related Employment and Support Allowance (ESA) or Income Support or Income-based Jobseekers' Allowance or Pension Credit Guarantee Credit or receiving Tax Credits and meet qualifying conditions, or those on a low income and named on a valid HC2 (full help) or HC3 (partial help) certificate and those who require complex lenses.

No charge for sight tests for the above categories, plus people aged 60 or over, those registered blind or partially sighted, those diagnosed with diabetes or glaucoma, those aged 40 or over and the brother, sister, parent or child of a person diagnosed with glaucoma, and those advised by an ophthalmologist that they are at risk of glaucoma. Others pay privately.

Hospital Eye Service patients get free sight tests and possible help towards the cost of glasses or contact lenses. War Pensioners can claim back the cost of treatment (for their accepted disability).

Prosthesis, sight testing, spectacles and hearing aids. No charge for provision and fitting of National Health Service appliances.

• Examinations of young persons;
• preventive examinations;
• mother- and child examinations;
• medical care at home (medical benefits following the doctor's orders, provided by qualified staff, for a maximum of 4 weeks);
• psychotherapy;
• expenses for transport, refund of travel expenses.
• Thermal Cure: May be granted if necessary (in institutions of the insurance funds, contract institutions or in the form of supplements). Participation amounts to between €7.78 and €18.90 per day. The needy are exempt from participation.
• Medical rehabilitation measures may be granted if necessary. Participation amounts to €7.78 and €18.90 per day and is granted for a maximal of 28 days per calendar year. The needy are exempt from participation.
• As of July 2015, the sickness insurance fund will cover the costs of orthodontic braces, if medically required, for children and young people up to their 18th birthday.

As laid down in by-laws of insurance fund. Flat-rate contribution from a special solidarity fund of the National Institute for sickness and invalidity insurance (Institut national d'assurance maladie-invalidité, INAMI/Rijksinstituut voor ziekte- en invaliditeitsverzekering, RIZIV), for certain expensive treatments not provided in the official list of reimbursable services.

Obligatory health insurance:

• Preventive examinations of children,
• dispensary observation of pregnant women,
• dispensary observation of other persons subject to dispensary registration.

Tax funded treatment:

• working capacity/ degree of disability expertise,
• medical transportation,
• compulsory immunisations,
• anti-epidemiological activities,
• access to activities under national regional and municipal health care programmes.

No other benefits.

• Internal prosthesis (pacemaker) and transport of the patient are provided free of charge for persons entitled to healthcare benefits (see "Field of application, 1. Beneficiaries").

Treatment for accidents and emergency cases at the "Accident and Emergency Departments of the Government Hospitals" at a standard fee of €10.00.

Preventive medical examinations for infants, children, teenagers and adults including:

• mass screening for breast cancer for women aged  50-69 ,
• screening of schoolchildren up to the age of 16,
• hearing test for infants aged 7 to 9 months ,
• hearing and sight tests for school children aged3, 4, 6, 10, 13 and 16,
• colour vision test for school children aged  11 and 12 ,
• mandatory national Thalassaemia carrier screening,
• screening test for the detection for chromosomal abnormalities in all pregnant women,
• annual screening of scoliosis for school children aged between 10 and 16
• Preventive dental examinations for schoolchildren aged 5,6,11 and 15.

Preventive services including:

• Preventive medical care for children, teenagers and adults,
• vaccinations following the recommended immunisation calendar,
• prophylactic dental treatment,
• prophylactic gynaecologic health check.

Fertility treatment, rehabilitation and psychotherapy can be obtained under the public health system.

Spa treatment may be reimbursed partially or fully by the Health Insurance Companies.

Free assistance and treatment given by nurse at home if recommended by a doctor.

Share of cost for transport to doctor or hospital for pensioners who are insured in Group 1, and in certain other cases and circumstances.

For both categories of insured persons, share of cost is met for dietetic nutrition prescribed by a doctor, treatment by chiropractor, physiotherapist, chiropodist or psychologist to whom the general practitioner has referred the insured.

For both categories of insured persons, share of cost is met for treatment by chiropractor without prescription from the general practitioner.

In special cases (e.g. lack of specialists or medical equipment), the patient may be referred to medical treatment abroad with the approval of the board of the Health Insurance Fund.

• Travel and transport costs are compensated from the sickness insurance after deduction of patient's own liability of €25. Compensation is usually based on the cost of reaching the nearest health centre or hospital and the least expensive mode for transportation;
• If the patient's share of travel costs during the same calendar year is more than €300, the excess amount is fully refunded;
• Patients with an illness which entitles them to travel by taxi must call the central dispatch number. If the ride is not booked through the centralised dispatch service, the co-payment will be double the normal amount and it will not count towards the annual maximum limit;
• If the patient needs to stay overnight when travelling to medical examination, accommodation is refunded up to a maximum of €20.18 per night.

General health insurance scheme for employees (Régime général d’assurance maladie des travailleurs salariés, RGAMTS):

• Medical aids.
• Transportation in case of hospitalisation.
• Preventive benefits etc.
• Supplementary benefits and aid benefits which may be granted by the sickness insurance fund for social and medical treatment.
• Treatments: prior authorization of the fund: refund of medical fees and cost of treatment in a thermal centre. No cash benefits (indemnités journalières) in principle (except for social and medical treatment provided by the sickness fund).

Other benefits of sickness insurance:

• Home care: Basic nursing and treatment as well as household assistance. Participation: 10% of the daily costs for the first 28 days in the calendar year, plus €10 per prescription, insured persons up to the age of 18 are exempted from the co-payment.
• Household aid, i.e. replacement in the household, or payment of cost of household assistant. Participation: 10%, at least €5 and €10 at most. Never more than the actual cost.
• In certain cases the cost for rescue and transport to the hospital or the doctor are covered; Participation per journey: 10%, at least €5 and €10 at most. Never more than the actual cost.
• Payment of medical services for ambulatory preventive or rehabilitative services; contribution to the other costs of ambulatory preventive services (accommodation, nursing, transportation) up to €16 or €25 for chronically ill infants per day.
• Full compensation with a €10 co-payment by the insured patient per day (max. 28 days per year) for preventive and curative services for mothers, except for children and insured persons, once a critical limit has been exceeded.
• Full compensation for institutional preventive or rehabilitative services, except for co-payment of insured person of €10 per day (max. 28 days per year), except for children.
• Specialised outpatient palliative care: compensation of medical and care related services for specialised outpatient palliative care with special considerations for the needs of children.
• Residential and outpatient hospice services: Since 1 August 2009, full compensation of additional costs with deduction of benefits of the long-term care insurance. The minimum contribution payment was raised from 6 to 7% of the monthly reference amount. In case of outpatient hospice services, fixed labour cost subsidies are awarded.
• Special benefits of farm and household assistance of the agricultural sickness insurance.
• Benefits of long-term care insurance: see Table XII "Long-term care".

• Free transport to public hospitals in case of an emergency;
• free home help service, subject to certain conditions;
• reimbursement of transport expenses to hemodialysis and thalassaemia patients.

• Prophylactic medical examinations (cancer, pulmonary etc. medical examinations),
• transportation and costs of travel,
• medical rehabilitation,
• obstetrical measures,
• ambulance transport.

• Travel and transport costs partly reimbursed;
• Contribution towards the unavoidable cost of stay of parents according to certain rules when a child under the age of 18 is hospitalised far from home;
• Physiotherapy partial reimbursement upon referral by a doctor;
• Nursing in the patient's home upon referral by a doctor, free of charge for the patient.

• Hospital in-patient and out-patient services are provided free of charge for children suffering from certain long-term diseases and disabilities, women receiving Maternity Services, children up to six weeks of age and children referred from child health clinics and school health examinations;
• Free transport to hospital, subject to certain condition;
• Health examination service for pre-school children and pupils of primary school age;
• All necessary follow-up services for defects discovered at such examinations;
• A national screening service for scoliosis;
• Immunisation, diagnostic and hospital services for infectious diseases available without charge to all.

One cycle of thermal treatment per year, only for pathology listed in  DM of 12 August 1992 and subject to prior approval of the Local Health Authority (Azienda Sanitaria Locae - ASL).

Participation: €3.10 for the prescription, plus €50 for each cycle of treatment.

Some categories of insured persons (exempted due to low income or severe disability) only pay the fixed amount of €3.10.

Totally disabled are entitled to full exemption.

Thermal treatment and health resort stays prescribed in relation to specific occupational diseases are entirely covered by the National Insurance Institute for Employment Injuries (Istituto Nazionale contro gli infortuni sul lavoro - INAIL).

Insured persons who suffer from an accident at work or an occupational disease are entitled to reimbursement from the National Insurance Institute for Employment Injuries (Istituto Nazionale contro gli infortuni sul lavoro, INAIL) (according to Circular No. 62 of 11 November 2012) in relation to the medical treatments needed for their psychophysical recovery, as prescribed by their doctors.

1) National cancer screening services:

• Gynaecological examination and screening for cancer of cervix uteri (every three years for women aged 25-70);
• Intestinal cancer screening (one test per year for persons aged 50-74);
• Breast cancer screening with mammography (one examination per two years for 50 to 69 years old women).

2) Health care at home provided by nurse or doctor’s assistant for certain groups of patients (See Table XII “Long-term care”, “Benefits in kind, 1. Home care”).

3) 100% reimbursement of reimbursable pharmaceuticals for needy persons.

4) Preventive health check-ups:

• for adults: health check-ups by a general practitioner (GP) once a year free of charge;
• for children during the first month after birth: 
  • preventive health check-up at the child’s home by a GP (once during the first 3 days after discharge from hospital or once during the first 6 days after birth if the child was born at home (planned delivery) and once in the 3^rd week after birth);
  • preventive health check-up at the child’s home by a midwife or GP’s nurse (once during the first 3 days after discharge from hospital or once during the first 6 days after birth if the child was born at home (planned delivery) and afterwards once every 10 days);
  • 3-4 days after birth – a hearing test with otoacustic emission method;
  • 3-5 days after birth – phenylalanine and thyrotropin screening;

• for children (aged 1 to 6 months): health check-up by a GP once per month;
• for children (aged 7 to 11 months): health check-up by a GP or nurse twice during that period;
• for children at the age of 12 months: health check-up by a GP;
• for children aged 13 to 24 months: 
  • health check-up by a GP twice a year;
  • health check-up by an ophthalmologist;

• for children aged 2 to 6 years: 
  • health check-up by a GP once a year;
  • visit to a dental hygienist: once a year;
  • health check-up by an ophthalmologist at the age of 3 years;
  • health check-up by an ophthalmologist before school (at the age of 6-7);

• for children aged 7 to 18 years: 
  • health check-up by a GP once a year;
  • visit to a dental hygienist once a year (at the age of 7, 11 and 12 twice a year).

5) Vaccination for children within the framework of the State immunisation programme.

6) 100% of flu vaccine price covered by the State for children aged 6 to 23 months.

7) 50% of flu vaccine price covered by the State for pregnant women, adults (> 65 years), and high-risk group patients.

8) Vaccination against diphtheria for adults free of charge.

Preventive examinations.

Treatment benefit for cures at a spa prescribed by the doctor: CHF 10 (€9.25) per day for max. 21 days per calendar year.

Expenses for transport.

Individual special medical measures (including those for specific birth defects) are covered by the Act on Supplementary Benefits for Old-age, Survivors' and Invalidity Insurance (Gesetz über Ergänzungsleistungen zur Alters-, Hinterlassenen- und Invalidenversicherung), LGBl. 1965 no. 46.

The cost of medical rehabilitation, including health-restoring treatment, is compensated in full to the following insured persons:

• children under 18 years of age;
• persons recognised as incapable of work or persons who reached the pensionable age, for whom a level of major special needs is established;
• persons who are referred to complete treatment after a serious illness or injury that is specified in the list approved by the Minister of Health.

90% of the cost of sanatorium (secondary prevention) treatment is compensated to the following insured persons:

• children under 7 years of age;
• children under 18 years of age who are recognised as disabled in accordance with the procedure laid down by legal acts.

Travel costs reimbursable under certain conditions.

• Emergency medical transport;
• Non-emergency transport for hospital appointments.

Necessary costs exceeding NOK 146 (€15) (return NOK 292 (€30)) for transport to the nearest place where the relevant health services can be obtained are reimbursed, and the part not reimbursed counts toward the cost-sharing charge ceiling. No charges for children under 16.

When a patient is exercising his free choice of hospital, only transport costs exceeding NOK 400 (€42) (return NOK 800 (€83)) are reimbursed.

In case of delivery at home a birth allowance of NOK 1,765 (€184) is paid.

• Regular medical check-ups for children;
• transport to treatment centre free of charge (under certain conditions for example for prescribed medical conditions or patients on low income);
• home nursing care free of charge.

Non-emergency transport of NHS patients is free, according to clinical criteria, especially regarding long-term care. The following health care is free in the NHS, amongst other care:

• family planning consultations and additional acts provided within the acts referred to;
• contraception is provided free of charge in health centres and public hospitals;
• abortion up to 10 weeks after conception;
• medically assisted procreation;
• consultations, hospital day sessions and additional acts provided under these in the context of mental health and infection with HIV/AIDS;
• urgent appeals and additional acts resulting from services provided to victims of domestic violence;
• treatment programs for alcoholics and other chronic drug addicts;
• Immunisation provided according to the national vaccination program in force and persons covered by vaccination against seasonal influenza.

• Insured persons aged 18-39 are entitled to a health check-up every year, for the prevention of diseases with major consequences in morbidity and mortality;
• Insured persons aged 40 and over are entitled to a health check-up every 3 years, for the prevention of diseases with major consequences in morbidity and mortality;
• Emergency services (including transport) for some diseases;
• Recuperation services and spa treatment (without or with co-payment of the insured);
• Home health care services;
• Free transport to and from medical institutions.

• Preventive examinations for children, teenagers and adults;
• Vaccination;
• dispensary care;
• convalescence;
• spa cures (patient's co-payment between €1.66 and €7.30 per day).

• Free preventive medical examinations for children, students, women, insured persons who are older than 25 years and sportsmen;
• immunisation and vaccination services;
• treatment and nursing at home, in institutions for elderly and other social institutions;
• refund of transport and travel expenses to an insured person and his attendant.