Azerbaijani State Agency for Compulsory Medical Insurance talks co-financing mechanism

  17 January 2020    Read: 789
Azerbaijani State Agency for Compulsory Medical Insurance talks co-financing mechanism

Azerbaijani State Agency for Compulsory Medical Insurance has disclosed the information related to Azerbaijan’s districts where the co-financing mechanism will be launched, Trend reported on Jan. 17 referring to the Agency.

The introduction of the co-financing mechanism will be launched on April 1, 2020. However, this will be implemented in the districts that have been already covered by the compulsory medical insurance system as a pilot project. In other words, the number of districts and cities in which the co-financing mechanism will be applied will also increase as far as the territory covered by compulsory medical insurance is expanded.

Residents of districts in which compulsory medical insurance is not applied will be able to use the services of medical institutions in nearby cities and districts without paying the amount of co-financing before the compulsory medical insurance is applied in those districts.

At the preliminary stage, compulsory medical insurance is applied in 23 Azerbaijani districts, namely, Guba, Gusar, Khachmaz, Shabran, Siyazan, Khizi, Shamakhi, Ismayilli, Agsu, Gobustan, Balakan, Zagatala, Gakh, Sheki, Oguz, Gabala, Goychay, Ujar, Zardab, Kurdamir, Mingachevir, Agdash and Yevlakh.

At the same time, compulsory medical insurance is used in Azerbaijan’s Nakhchivan Autonomous Republic. Insurance is implemented by the State Agency for Compulsory Medical Insurance under the Cabinet of Ministers of Nakhchivan Autonomous Republic.

Twenty-one more districts will be connected to the system from April 1, namely, Ganja, Goygol, Goranboy, Dashkesan, Samukh, Naftalan, Shamkir, Gazakh, Agstafa, Gadabay, Tovuz, Barda, Tartar, Aghdam, Aghjabadi, Fizuli, Beylagan, Khojavand, Khojaly, Lachin, Kalbajar in the second stage.

At the third stage, compulsory medical insurance will be applied in 15 more districts - Lankaran, Masalli, Lerik, Yardimli, Astara, Jalilabad, Salyan, Neftchala, Bilasuvar, Imishli, Saatli, Hajigabul, Shirvan, Sabirabad and Jabrayil.

At the last, fourth stage, from Oct. 1, Baku, Sumgayit, Absheron, Khankendi, Gubadli, Zangilan and Shusha will be connected to the system.

The amount of co-financing is a part of the cost of the medical service that must be paid by the insured in case of his or her non-compliance with the conditions specified in the Services Package. It is paid directly to the medical facility.

Thus, if a citizen without a family doctor’s referral appeals to a medical institution at the place of registration for outpatient services, for each insured event he or she will have to pay the cost of co-financing in the amount of 5 manat ($2.9). If a citizen appeals to a medical institution located in another administrative territory for outpatient services, for each insured event he or she will have to pay the cost of co-financing in the amount of 5 manat.

If a citizen, without a family doctor’s referral, appeals to a medical institution located outside the medical territorial department where he or she is registered for outpatient services, for each insured event he or she must pay the cost of co-financing in the amount of 15 manat ($8.8).

If a citizen, without a referral from a medical institution at the place of registration or residence, appeals for in-patient services to a medical institution located in another administrative territory, but inside a medical territorial department, for each insurance case the cost of which exceeds 100 manat ($58.8), he or she will have to pay the cost of the joint financing in the amount of 30 manat ($17.6).

If a citizen without a referral from a medical institution located in the administrative territory at the place of registration appeals for in-patient services to a medical institution located outside the medical territorial department where he or she is registered, for each insurance case the cost of which exceeds 100 manat, the citizen will have to pay the cost of co-financing in the amount of 90 manat ($52.9).

If the conditions specified in the Services Package are met (appeal to a family doctor, appeal to a specialized doctor based on the referral from a family doctor, etc.) while providing emergency medical care, outpatient (excluding CT - computerized tomography and MRI - magnetic resonance imaging) and inpatient care, no payment of the cost of co-financing is required.

 


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