Social & Economic rights

Wednesday, 14 May 2014

New Mothers without Verified Health Booklets Pay for the Costs of Childbirth

In October 2013, E. K. gave birth in the Clinical Hospital Centre Zemun and had to pay for the costs of childbirth in the amount of 14,909.10 RSD, because she did not have her health booklet verified at that moment. Moreover, no one informed her that she had the right to the reimbursement of costs of childbirth.

Praxis’ lawyer provided legal assistance to E. K. in obtaining ID card and verifying her health booklet, as well as in submitting the request for reimbursement of childbirth and childbirth-related costs. The request for reimbursement of costs was sent to the Novi Beograd Branch of the National Health Insurance Fund, in accordance with the Article 70 of the Rulebook of the Method and Procedure of Exercise of Rights from the Mandatory Health Insurance, which ensures the right to reimbursement of costs to the insured persons – pregnant women, as well as in the accordance with the Article 162 of the Law on Health Protection and the Instruction of the National Fund 02/5 No. 54-684/10-1 as of 16 March 2010 which prescribe that the compensation for the provided medical assistance shall be covered from the budget of the Republic of Serbia, autonomous province, municipality/city, as well as that each childbirth shall be considered as an emergency case.

In addition, Article 68, paragraph 2 of the Constitution of the Republic of Serbia prescribes that children, pregnant women, mothers during maternity leave, single parents with children under seven years of age and elderly persons shall exercise health protection from public revenues, unless it is provided in some other manner, in accordance with the law. According to the Article 22 of the Law on Health Insurance (Official Gazette of the Republic of Serbia, No. 107/2005, 109/2005 - correction, 57/2011, 110/2012 – decision of the Constitutional Court and 119/2012), special category of insurers are women with respect to family planning, as well as during pregnancy, childbirth and maternity up to 12 months after childbirth. The Article 11 of the Law on Health Protection also provides for the special protection of this category of insurers.

Considering the request of E. K. for reimbursement of costs of delivery, the National Health Insurance Fund approved the request and referred E. K. to the Clinical Hospital Centre Zemun for the reimbursement of costs.

E. K. is surely not a sole case of an uneducated party, and thus the question is whether new mothers, who are in a similar situation, have information about the possibility to reimburse the costs of childbirth from the health institution and the ability to represent their own interests in the procedure before the competent body, or they do not ever exercise such right.

In addition, it should also be taken into consideration that 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, prescribes that children, pregnant women and new mothers shall have to right to health protection, regardless of whether their document on health insurance (health booklet, certificate on use of health care services or health insurance card) is verified or not. With regard to that, the National Health Insurance Fund forwarded instructions to its branch offices about the implementation of the Law, stating that the children up to 18 years of age, pregnant women and new mothers in the period of 12 months following childbirth shall 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.

In the upcoming period, the practice will show whether the afore-mentioned legal solution is consistently applied.

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Praxis means action