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RIGHTS STEMMING FROM HEALTH INSURANCE

The Law on Health Insurance (in further text: the Law) regulates the rights stemming from the compulsory health insurance, the circle of persons covered by the insurance, the manner and procedure of exercising rights, the contents and scope of rights, organisation and financing, as well as other issues of importance to the system of health insurance. The Law defines the circle of persons who are according to its provisions entitled to exercising the rights stemming from the compulsory health insurance, as well as to entering into compulsory health insurance. The Law also defines the opportunity of a voluntary health insurance providing a wider scope and contents of rights stemming from health insurance, as well as the exemption from participation in using health care.

The Law stipulates determining priority basis for a person to enter into compulsory insurance (employment, self-employment, performing work in agriculture – namely – contributories). The lower limit of property size is introduced for the first time, enabling the persons having the property the size of which is below that limit and belonging to socially most deprived categories of population, easier exercising of their rights stemming from health insurance.

Compulsory health insurance comprises:

  1. insurance against sickness and injury outside work, and
  2. occupational injury or occupational disease insurance.

Basic rights stemming from health insurance are:

  1. the right to health care;
  2. the right to compensation of salary during temporary disablement, and
  3. the right to compensation of transportation expenses related to using health care.

Citizens, namely contributors of countries concluding international agreements on social insurance with Serbia, exercise the rights stemming from compulsory health insurance in accordance with the Law, if international agreement on social insurance does not stipulate otherwise.

In the aim of exercising the rights, contributors must meet the requirement of preceding insurance. Putting it in other words, they must, in the capacity of contributors, complete the length of the minimum of three months of uninterrupted insurance coverage, or the length of the minimum of six months with interruptions in the period of 18 months prior to commencing their exercising of rights stemming from health insurance.

Preceding length of insurance coverage is calculated from the day a contributor acquired the capacity of a contributor and for the period of which contributions have been paid in.

Exceptionally, a contributor exercises the rights stemming from health insurance in cases of failing to meet the requirements related to preceding length of insurance coverage, in the following cases:

  1. in case of occupational injury or occupational disease;
  2. in case of medical emergency and in case of exercising pertaining pecuniary benefits, and
  3. for exercising of rights to compensation of salary in the amount of minimal salary determined in accordance with labour regulations for the month the compensation is paid for.

Members of contributor’s family exercise their rights stemming from compulsory health insurance under the condition that the contributor they exercise their rights through meets the requirements in terms of preceding insurance.

 
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