Decree for copayment, maximum copayment (unofficial translation)

THE GENERAL HEALTH SYSTEM LAWS OF 2001 TO 2017

                                                   Decree pursuant to Article 64 (5) 
 
89(I) of 2001
134(I) of 2002
101(I) of 2004
62(I) of 2005
74(I) of 2017.
The Minister of Health, exercising the powers granted to him under article 64(5) of the General Healthcare System Law, upon the recommendation of the Health Insurance Organisation and with its agreement, issues the following decree:
 
PART I
INTRODUCTORY PROVISIONS
 
 
Short title.
 
1. This Decree shall be referred to as the General Healthcare System (Co-payment, Maximum Co-payment, Contribution I and Contribution II) Decree (No.1) of 2019 and shall be read together with the General Healthcare System (Co-payment, Maximum Co-payment, Contribution I and Contribution II) Regulations of 2019 (hereinafter referred to as the "basic Regulations") and the basic Regulations and this Decree shall be referred to together as the General Healthcare System (Co-payment,  Maximum Co-payment, Contribution I and Contribution II) Regulations of 2019 to Decree (No.1) of 2019.
Amendment to Annex I of the basic Regulations.
 
Amendment to Annex II of the basic Regulations.
 
Date of Entry into force.
2. Annex I of the basic Regulations is amended by replacing it with Annex I of this Decree.
 
3. Annex II of the basic Regulations is amended by replacing it with Annex II of this Decree.
 
4. This Decree shall enter into force on the date of its publication in the Government Gazette of the Republic.
 
 
 
 
ANNEX I
(Order 2)
ANNEX I
(Regulation 4)
 

First Table

Health care services for which the beneficiary pays a copayment, and copayment amount.

Healthcare services *(Note 1)
 
Amount of
co-payment
By pharmaceutical product.
1,00
 
By medical device or medical hygiene supplies.
1,00
 
By laboratory test or group of laboratory tests *(Note 2).
1,00
 
Per visit to a nurse or midwife.
6,00
 
Per visit to an outpatient specialist doctor, excluding outpatient doctors specialised in diagnostic radiology, cytology and pathological anatomy.
 
6,00
 
Per healthcare service performed by an outpatient specialist doctor specialising in diagnostic radiology.
 
10,00
 
Per visit to an allied health professional.
 
10,00
 
Per visit to a hospital to receive healthcare services in cases of accidents and emergencies.
 
10,00
 
 
Note 1:
In cases where healthcare services are provided as part of inpatient health care, no copayment is paid.
 
Note 2:
The total maximum possible charge per category of laboratory tests is ten euros (10€). The laboratory test group and/or category shall be determined by regulations.
 
 

Second Table

 
Healthcare services for which a beneficiary pays additional co-payment, and additional co-payment amount.
 
Healthcare services
Amount of additional co-payment
Per visit to a personal doctor within the time specified in Annex II.
0-25.00 *(Note 1)
Per visit to an outpatient specialist doctor, excluding outpatient doctors specialised in diagnostic radiology, cytology and pathological anatomy, within the time specified in Annex II.
0-25.00 *(Note 1)
Per visit to a personal doctor, provided that the beneficiary has exceeded the number of visits to a personal doctor per calendar year, as specified in the Third Table of this Annex, with the exception of:
(a) chronic patients,
(b) recipients of a guaranteed minimum income,
(c) low-income pensioners, and
(d) children under the age of 21 of persons referred to in categories (a), (b) and (c) above.
*(Note 2)
0-15.00 *(Note 1)
 

 


 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 
 

 


Note 1:
The amount of the additional copayment is determined by the doctor.
 
Note 2:
The number of visits to a personal doctor per calendar year set out in the Third Table of this Annex shall not take into account visits for which the beneficiary may pay additional copayment.
 
 

Third Table

 
Number of visits to a personal doctor per calendar year beyond which an additional co-payment of fifteen euros (€15) per visit shall be paid.
 
Personal doctor
Age of beneficiary
No. Visits
Personal doctor for children
Since birth till the age of 1
10
Personal doctor for children
From the age of 1 to the age of 3
8
Personal doctor for children
From the age of 3 to the age of 6
7
Personal doctor for children
From the age of 6 to the age of 11
4
Personal doctor for children
From the age of 11 to the age of 18
3
Personal doctor for adults
From the age of 15 to the age of 18
3
Personal doctor for adults
From the age of 18 to the age of 41
4
Personal doctor for adults
From the age of 41 to the age of 51
6
Personal doctor for adults
From the age of 51 to the age of 65
8
Personal doctor for adults
From the age of 65 onwards >
10
 
 
 
 
ANNEX II
(Order 3)
ANNEX II
(Regulation 4)
 
Time within which an additional co-payment of up to twenty-five euros (€0-25) is paid
 
Α. Weekdays from 08:00 p.m. until 07:00 a.m.
B. Saturdays and Sundays
C. Public holidays;
  1.  January 1st.
  2.  January 6th.
  3. Green Monday.
  4.  March 25th.
  5.  April 1st.
  6. Good Friday.
  7. Easter Sunday.
  8. Easter Monday.
  9.  May 1st.
  10. Monday of the Holy Spirit.
  11.  August 15th.
  12.  October 1st.
  13.  October 28th.
  14.  December 25th.
  15.  December 26th.