2024-04-16 14:30:41
Residents who will accumulate a basket of drug premiums this year reaching 48.33 euros, like last year, will no longer have to pay patient premiums for reimbursed drugs with the lowest premium until the end of the year. Most likely, the compensatory drug basket is accumulated by those suffering from serious or chronic diseases that require more drugs to treat. Such residents will save dozens of euros in premiums, which they will no longer have to pay out of their own pockets.
From the beginning of each year, the accumulated basket of compensatory drug premiums is calculated for all residents covered by compulsory health insurance. The best way to check how many premiums have already been accumulated in the basket is to look in your personal E.sveikatos account. The data on the patient’s accumulated premium basket is updated the next day after the purchase of reimbursed drugs.
Residents who do not use electronic means can find out information about the accumulated premium basket at pharmacies and territorial sick offices.
“Specialists of the residents’ service departments in the territorial health funds not only help to find out the amount accumulated in the residents’ premium baskets, but also examine cases of unreasonably paid premiums. If it turns out that the resident had to pay a patient premium for compensatory drugs, even though the premium basket was already accumulated, the unjustified patient premium is returned,” says Inga Kvedarienė, head of the Resident Service Department of the Šiauliai Territorial Hospital Fund.
Health insurance companies point out that the basket of premiums is calculated only for reimbursed drugs with the lowest premium. Such drugs include drugs with the lowest patient premium specified in the applicable reimbursement drug price list, as well as drugs with a low therapeutic index (for example, drugs prescribed to treat epilepsy, immunosuppressants given after transplantation), biologics (for example, insulin), single-provider group drugs, and drugs , for which a decision was made by a council of doctors for the appointment of a specific name of the drug according to their therapeutic indications for a specific patient, that is, drugs that are irreplaceable or can be changed only on the doctor’s order.
Premiums paid for compensable medical assistance measures are not accumulated in the drug premium basket.
In addition, all residents aged 75 and over, as well as the disabled and pensioners, if their income for the previous month was less than 100 percent of the amount of the minimum consumption needs of the current year, which this year amounts to 446 euros per month, do not have to pay premiums for compensatory medicines at the pharmacy and medical aids. For these residents, patient premiums are also paid from the state budget.
According to Regina Vitkauskienė, the chief specialist of the Resident Services Department of the Šiauliai Territorial Hospital Fund, it should be noted that when buying medicines, a person’s income received for the previous month is calculated.
For example, if a person buys medicine in March, the electronic system compares his income in January to see if it was less than 446 euros. If there were individual cases where these groups of the population had to pay a premium at the pharmacy for compensatory drugs and medical aid, it would be possible to apply for a refund of this premium to the territorial health fund of your place of residence.
Last year, the state budget allocations for covering the premiums of the most vulnerable population groups, as well as the basket of premiums, amounted to 25.8 million. euros. in 2022 the amount of covered premiums amounted to 15.7 million euros.
Šiauliai territorial sick fund information
2024-04-16 14:30:41