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:
- insurance against sickness and injury outside work, and
- occupational injury or occupational disease insurance.
Basic rights stemming from health insurance
the right to health care;
- the right to compensation
of salary during temporary disablement, and
- 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:
- in case of occupational injury or occupational disease;
- in case of medical emergency and in case of exercising
pertaining pecuniary benefits, and
- 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.