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The activities of National Health Insurance Fund

The National Health Insurance Fund provides the financing of the Hungarian healthcare system from the Health Insurance Fund.
It is a basic interest, besides the rights of patients, to respect the equality of the insured, to improve the quality of healthcare and the professionalism of the working physicians and to practice appropriate, professional and economically efficient healthcare in a reasonably structured specialist care.
By the implementation of the 2011/24/EU Directive on patients’ rights in cross-border healthcare adopted by the European Parliament and Council (hereafter ‘the Directive’), the National Health Insurance Fund received new tasks.
 
The role of the National Health Insurance Fund in the implementation of Directive 2011/24/EU on the application of patients’ rights in cross-border healthcare
 
The National Health Insurance Fund (hereinafter: NHIF) is responsible for carrying out the following tasks in cross-border healthcare since the entry into force of the laws on 25 October 2013 transposing Directive 2011/24/EU on the application of patients’ rights in cross-border healthcare:
 
I. Prior-authorization of cross-border healthcare
 
The NHIF is competent to authorize cross-border healthcare, if the treatment in question is subject to prior authorization. Patients shall submit their application to the NHIF, which examines assisted by a medical expert, whether the treatment in question is available in Hungary within a medically justifiable time limit at a healthcare service provider contracted to the NHIF and decides on the merits of the case. The NHIF refuses the application and designates the Hungarian contracted healthcare service provider, if the treatment can be provided within a medically justifiable time limit in Hungary. If the treatment cannot be provided within a medically justifiable time limit in Hungary at a contracted service provider, the authorization will be granted.
 
II. Reimbursement of domestic cost of cross-border healthcare
 
Domestic cost of cross-border medical treatment, medicines and medical devices is reimbursed by the NHIF. The application, the referral, the original invoice, the official translation of the invoice and the certification of payment shall be submitted to the NHIF, which determines and decides on the reimbursement of domestic cost.
 
III. Registration of reports of cross-border healthcare
 
The healthcare service providers contracted to the NHIF are subject to report the cross-border healthcare treatments provided by them to the NHIF, which registers the reports. If the treatment is available within a medically justifiable time limit in Hungary, and is provided for the patient, the NHIF finances the cost of the treatment in question directly to the service provider.
 
For faster and more accurate provision of information the National Health Fund operates a central website. The web page www.oep.hu provides up to date information about the health services funded by health insurance and about the benefits available in and outside the European Union for patients, relatives, visitors.
 
The National Health Insurance Fund and the NCPD work closely with a wide range of information on cross-border healthcare benefits.


© 2013 OBDK
weboldal tervezés: IRQ