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Public health systems: Cost-sharing policies for basic health coverage, 2013
Patient charges for medical treatment
Patient charges for hospitalisation
Co-payments for pharmaceutical products
Netherlands
Health Insurance Act:
Compulsory deductible: all insured persons aged
18 years or older pay a maximum of EUR 350
per year. Care from a general practitioner, obstetric care, maternity care and dental care for children are exempted from the compulsory deductible.
Insured persons can opt for a voluntary deductible of EUR 100, EUR 200, EUR 300, EUR 400 or
EUR 500 to top up the compulsory deductible. In
return the insured person receives a discount on
the nominal health care premium.
General Exceptional Medical Expenses Act
(Algemene wet bijzondere ziektekosten, AWBZ):
For most types of care under the Act, insured
persons over 18 are required to make personal
contributions towards the costs.
Compulsory deductible: all insured persons
aged 18 years or older pay a maximum of
EUR 350 per year. Care from a general practitioner, obstetric care, maternity care and dental
care for children are exempted from the compulsory deductible.
Insured persons can opt for a voluntary deductible of EUR 100, EUR 200, EUR 300, EUR 400
or EUR 500 to top up the compulsory deductible. In return the insured person receives a
discount on the nominal health care premium.
The compulsory deductible of EUR 350 also applies to
pharmaceuticals included in the basic coverage. Besides
this, pharmaceuticals can be supplied and charged to the
private health insurance companies up to the average
price per standard drug dosage that belongs to a certain
classified medical package, with an additional payment to
be paid by the insured person.
Poland
No patient participation.
No patient charges.
Official list of medicines divides pharmaceuticals into 3
categories:
• Basic medicines: fixed price of PLN3.25 (EUR 0.75) or
PLN5.00 (EUR 1.15) determined by the Minister of Health
(Minister Zdrowia);
• special additional medicines: 30% to 50% of price paid
by the insured person;
• other medicines: 100% of the price paid by the insured
person.
Medicines free of charge in hospitals.
Portugal
The payment of the insured person's share borne
varies according to the medical visit:
• visit at home,
• normal or urgent visit,
• visit in a central or regional hospital,
• visit in a health centre.
It also depends on the diagnosis and therapy
auxiliary elements.
No participation in charges in public ward (or in
private room if recommended by the doctor).
If in private room freely chosen by beneficiaries,
charges are payable in full by the beneficiaries,
as well as private hospital and clinic charges.
Depending on type of illness, the State contributes 90%,
69%, 37%, or 15% of the cost of medicines on the official
list drawn up by the health services.
The State contribution is 95%, 84%, 52% or 30% for pensioners whose total annual income does not exceed the
equivalent of 14 times the guaranteed minimum retribution of the previous year or, if this is higher, the equivalent of 14 times the indexing reference of social support
IAS in force.
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