05-03-2007

Higher benefits health insurance

As from January the first, 2007, the situation of almost 100.000 care needing Flemish people will improve financially. The renumeration from the Health Care will be raised with 120€/a year, as a result of which they will receive in total 1260€ annualy.  This raise means a considerate difference to the care needed.

In 2008 and 2009, 120€ will be added annualy so that the renumeration will be at the same level as the persons residing into a rest or nursing home, namely 1500€/a year.The Flemish government will give this signal for the care needed to stay at their familiar environment as long as possible.

The health Insurance is created to offer financial support for non-medical costs.  The renumeration is been used at this very instance to supply warm meals, adaptations to the habitat, purchasing means of help, cleaning help… The Flemish Patient Platform “vzw” has pleaded together with the Working Group House Take Care in 2002 already for an equalization of the prime whatever the situation of residency is.

Remark: The ALS League has offered her collaboration to the extension of the Health Insurance.

Info: persons with ALS who are holders of a PAB cannot make a claim on the benefits of the health Insurance. Both are not to be combined.

Increase of fees

As from January the 1st 2007, the fees will be elevated with 1.65 % for all the medicines (except plastic surgeons and radiotherapeutists).  The elevation of the global medical file to 25€/year will start on Oktober the 1st  2007 and not in January as previously said.

The fees of doctors acceded to the convention (doctors who agree with the wage agreement of the Health Insurance) are the following:

– global medical file: 22.36€

– consultations of general practitioners: 18.10€

– consultations at night: 41.57€

– consultations weekend: 31.18€

– house visits: 31.18€

Decreased fee at a referral by a general practitioner

As from February the 1st 2007, patients pay less fees at the consultation of a specialist after referral of their general practitioner.  The decrease of the personal part amounts to 2€ for holders of preferential treatment and 5€ for the normal holders.

CONDITIONS

The decrease of the fees is only valuable under certain conditions:

– The decrease is only valuable for a consultation of a specialist in the internal medicine (gynaecology, ophtalmology, urology, stomatology, geriatry, endocrinology,ORLogy), neurologist, psychiatrist, neuro-psychiatrist, cardiologist, pediatrist, gastroenterologist, pneumologist, reumatologist, dermavenerologist (specialist skin – and gender diseases) or internal medecine;

– you have to possess a global medical file by the general practitioner with a referral;

– the referring doctor has to make up a reference document wherein he mentions that he refers the patient to a specialist;

– you have to put a certificate of aid provided with the reference document to the Health Care to receive reduced fees;

– the reduction of the fee is only foreseen once a year;

– the decrease is only valid if the third party payers regulation is adapted.

Translation: Anja

Source: Vlaams Patiënten Platform (Flemish Patient Platform)