Health care

Friday, 31 January 2014

A number of Health Institutions Not Acquainted with the Provisions of the Law on the Exercise of the Right to Health Care by Children, Pregnant Women and New Mothers

Taken from the web site of the Provincial Ombudsperson of the Autonomous Province of Vojvodina

A number of women from the territory of the Autonomous Province of Vojvodina addressed the Provincial Ombudsperson because some health institutions had refused to provide health care services to them for lack of health booklets, despite their right to the services as per the Law on the Exercise of the Right to Health Care by Children, Pregnant Women and New Mothers which came into effect on 27 November 2013.

In order to inform the public, we point to the fact that the Republic Fund for Health Insurance referred instructions to all its branches regarding the implementation of the Law which state that children up to 18 years of age, pregnant women and new mothers in the period of 12 months following childbirth  have the right to complete healthcare protection, including the right to medications in accordance with the Law on Health Insurance and general acts of the Republic Fund for Health Insurance, as well as to the travel cost reimbursement related to use of healthcare services, regardless of the basis of health insurance and of whether their health insurance documents are verified, while the costs shall be borne by the Republic Fund.

On the basis of this instruction, the branch offices of the Republic Fund for Health Insurance should have immediately informed all healthcare institutions on their respective territories that, despite not having verified health booklets, they were obliged to provide healthcare services to children up to 18 years of age on the basis of the health booklet and child’s date of birth, to pregnant women on the basis of the health booklet and a report from a gynaecologist on pregnancy, and to new mothers in the period of 12 months following childbirth on the basis of the health booklet and discharge papers from the hospital following labour.

The second instruction of the Republic Fund for Health Insurance explains that the health insurance document implies a health booklet, a certificate on use of healthcare services or a health insurance card. Children, pregnant women and new mothers shall have the right to complete healthcare protection even if they are issued a certificate on use of healthcare services. It means that, for example, a pregnant woman who possesses a health booklet which is not verified shall have the right to complete healthcare protection and not only to protection relating to pregnancy.

Pregnant women and new mothers (employed, entrepreneurs) with unverified health booklet do not have the right to salary allowance during temporary inability to work.

When using healthcare services in a health institution, a child, pregnant woman and a new mother prove their status of the insured person by their date of birth, report of a gynaecologist, and discharge papers following childbirth. Exceptionally, health institutions may accept as evidence that a woman is a new mother a birth certificate of the child with the date of birth visible.

Insured child up to 18 years of age, pregnant woman or a new mother may exercise the right to health protection if they possess a health booklet which is not verified. In case they do not possess it because their status of an insured person has not been determined, their status of an insured person should be determined as per the provisions of the Law on Health Insurance and a health booklet should be immediately issued. Thus, the stated persons will be issued a health booklet even when the conditions for verifying it have not been met.

Branch offices of the Republic Fund for Health Insurance are obliged to enable issuance of necessary evaluation of a medical committee to the stated insured persons for the purpose of exercising certain rights to heath protection and travel costs reimbursement.

Provincial Ombudsperson invites all citizens who have been denied healthcare services by a health institution, to which they are entitled as per the Law on the Exercise of the Right to Health Care by Children, Pregnant Women and New Mothers, to address the Provincial Ombudsperson for the protection of their human rights.

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