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09-11-2023

The basket of premiums for reimbursed medicines is already saving patients’ money

The health insurance funds receive positive feedback from residents who have already managed to accumulate a basket of premiums for reimbursed medicines. This year, the basket amounts to EUR 48.36, and residents, who have accumulated the basket by the end of the year, will no longer have to pay premiums for reimbursed medicines with the lowest premium. It is calculated that patients have already saved EUR 1 million.

According to the data of the National Health Insurance Fund under the Ministry of Health, in July-October, the basket of premiums helped to reduce the cost of medicines for 40,000 patients, while the basket of premiums for reimbursable medicines required EUR 1 million of state budget funds.

Patients with severe or chronic diseases, that require more medicines to treat them, were the fastest to accumulate a basket of reimbursable medicines. Such residents calculate that they have already saved dozens of euros of premiums, which they no longer have to pay out of their own pockets.

However, even though the procedure for reducing the premiums for the basket of reimbursable medicines came into force in July this year and it can be accumulated throughout the calendar year, health insurance funds receive questions from residents who do not understand how the basket works and do not know how much of patient’s premiums have been accumulated in their baskets.

From the beginning of each year, the basket of reimbursable medicines is calculated for all residents covered by compulsory health insurance. The best way to check how many premiums are already in your basket is to look in your personal electronic health account. It is important to know that data about patient’s accumulated basket of premiums will be renewed the next day after the purchase of reimbursed medicines. 

Residents, who do not use electronic means, may find information about their accumulated basket of premiums in pharmacies and territorial health insurance funds. “Specialists from the Population Service Divisions of the territorial health insurance funds not only help to find out the amount of money accumulated in residents’ baskets, but also deal with cases of unjustified premiums paid. If it turns out that a resident had to pay a premium for reimbursable medicines when the basket of premiums had already been accumulated, the unjustified premium will be refunded,” Inga Kvedarienė, the head of the Population Service Division of Šiauliai territorial health insurance fund says.

The size of the basket of premiums is calculated by adding three average annual premiums for reimbursable medicines with the lowest premium, based on the data from the previous calendar year, so the size of the basket of reimbursable medicines for the following year may be different from this year. At the end of the calendar year, the basket is cancelled and the counting starts again until the next year’s amount is collected again.

Health insurance funds note that medical aids are not subject to the procedure for accumulation of the basket of premiums. The basket of premiums is calculated only for reimbursable medicines with the lowest premium. Such medicines include not only those with the lowest patient’s premium in the current Pricelist of Reimbursed Medicines, but also medicines with a low therapeutic index (epilepsy medicines, immunosuppressants, prescribed after transplantation), biologics, such as insulin, single supplier medicines, and medicines for which the prescribing of a specific brand name in accordance with the therapeutic indication has been decided by the consilium of doctors for a particular patient, i.e. medications which cannot be changed or can only be changed on doctor’s instructions.

As a reminder, the patient’s premium for reimbursable medicines and medical aids is also covered by the state budget for insured persons aged 75 and over, as well as for people with disabilities and pensioners with low insurable incomes.

Information of Šiauliai Territorial Health Insurance Fund

(Freepic photo)

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