A A A   

HEALTH CARE ABROAD

Contributors can use health care abroad in cases of their temporary stay or permanent residence, in accordance with the international agreements of social insurance or the Law.

In cases of posting a contributor to work abroad, or sending a contributor to advanced training or education abroad, namely the country which has an international agreement on social insurance concluded with the Republic of Serbia, the contributor uses health care abroad in the content, scope, manner and in accordance with the procedure stipulated by the Law or the international agreement. His family members are also entitled to the same scope and contents of rights.

In cases of posting a contributor to work or sending a contributor to a country with which no international agreement on social insurance has been concluded, he is entitled to using health care if:

1. employed in a domestic or mixed-ownership enterprise, institution or another organisation or employed with an entrepreneur (detached workers);
2. employed in a household of a domestic subject posted in that country and employed with international and foreign organisations or employers;
3. sent to that country to study, to attend advanced training or specialisation, and
4. sent on a business trip.

The above listed persons, during their stay abroad, are entitled to using health care only in cases of urgent medical care, and the same scope of rights is provided to their family members.

Health care abroad is provided to contributors on the basis of the Certificate on the Use of Health Care Abroad.

Pursuant to the Law, the Certificate on the Use of Health Care Abroad is valid until the expiration of the time period it was issued for, not longer than the period of 12 months since its issuance (in cases of posted workers), or not longer than for the period of 90 days since its issuance (in cases of private stay abroad).

A member of a contributor’s nuclear family staying abroad with the contributor uses health care under the same conditions as the contributor.

Article 53. of the Law defines the terms urgent medical care and necessary health care.

Urgent medical care is direct – instant medical care provided so as to avoid bringing the contributor to a life-threatening danger, namely to avoid inflicting incorrigible or impairing consequences to his health or to avoid his death. In other words, urgent medical care is the one provided within 12 hours from the moment of admitting the contributor in order to avoid expected advent of urgent medical condition.

Necessary health care comprises health care that is adequate, that is, required for diagnostics or treating diseases or injuries of the contributor, which is in accordance with the standards of good medical practice in the country and which is not provided, at the request of the contributor or a health-care worker, in the aim of putting the contributor into a more favourable position in comparison to other contributors, that is, is not provided in the aim of acquiring special benefits for the health care institution, private practice or health care worker.

In accordance with the regulations on health insurance, urgent and necessary medical care is to be ascertained by professional medical bodies in the procedure of exercising the right (commission of physicians).

During a temporary (usually a tourist) stay abroad, contributors are provided with health care in accordance with the international agreements on social insurance on the condition that there is an agreement on social insurance concluded with that country.

The procedure laid down by the Law stipulates previous checking of the contributor’s health condition. On the basis of the excerpt from the contributor’s health record kept at the chosen MD and dentist, the authorised commission of physicians of the Republic Fund for Health Insurance gives a report, opinion and estimation on the basis of which the contributor is issued a certificate on using health care abroad.

A contributor failing to comply with the prescribed procedure cannot exercise the right to covering of expenses incurred by using urgent medical care during his stay abroad unless the international agreement stipulates subsequent issuing of the certificate on using health care abroad. In such a case, a subsequent procedure estimates the condition of his health prior to his going abroad and incurred expenses of health care are covered, with the participation of the contributor in the amount of 5% of the total expenses.

Within the right to health care, contributors are provided with the opportunity of sending abroad for medical treatment. Contributors can be sent to be treated abroad in cases when their health condition demands treating of diseases, conditions or injuries that cannot be successfully treated in the Republic of Serbia, and there is an opportunity of successful treatment in the country they are being sent to.

Conditions, manner and procedure of sending contributors abroad for medical treatment are regulated by the Regulations on conditions and manner of sending contributors abroad for medical treatment.