Health insurance in Republika Srpska
Compulsory health insurance in Republika Srpska is implemented by Health Insurance Fund of Republika Srpska (HIF RS). It is based on the principles of solidarity, mutuality and equality of all persons included in the compulsory health insurance. It means solidarity of the young with the old, the health with the sick and the rich with the poor. All HIF RS insured persons have equal rights, regardless the sum they pay for the health insurance or the basis they are registered to health insurance.
Using the rights from the compulsory health insurance is conditioned by paying the contribution for health insurance. Persons belonging to the following categories are excepted from this rule: children under age of 15, pregnant women and new mothers, disabled war veterans, families of fallen soldiers, persons suffering from malignant diseases, diabetes, infectious diseases, mental illness, progressive muscle disorders, persons with transplanted organs and persons who are involved in receiving, donating and sharing of human tissues and cells and human organs. These categories of citizens, provided that they are registered on the health insurance, are enabled to use rights of compulsory health insurance even if the contributions for health insurance are not paid for them.
There are several bases for the application/registration for insurance. For example, employees are registered for the health insurance by their employers who also pay contributions for their employees, pensioners are registered by the competent Fund for pension and disability care, unemployed persons are registered by the Office for Employment, persons who are under protection of the Center for social work are registered by this Center, farmers are registered by themselves and they themselves pay the contributions, pensioners who have earned their pension abroad are registered for health insurance in accordance with the international agreements etc. Contribution bases and rates for the compulsory health insurance are regulated by the Law on Contributions RS.
Rights from compulsory health insurance are regulated by the Law on Health Insurance and general legal acts of HIF RS. The package of the compulsory health insurance rights consists of the right to health care and the right to compensation during temporary inability to work (sick leave). All rights from the compulsory health insurance are available to all insured persons under the same conditions and do not depend on the amount of contributions they pay for health insurance.
- preventive health care
- emergency medical care/treatment
- examinations and treatment at family doctors’, in hospitals and clinics in Republika Srpska and abroad
- consultative-specialist health care
- medical rehabilitation
- medical aids (orthopedic and other aids)
- diagnostic procedures, compulsory immunization, drugs/medications, medical transportation, treatment in the insured person’s home, palliative care etc.
Insured persons in Republika Srpska personally participate in expenses of health care. They pay a certain amount/percentage of co-payment in health institutions. Tthe amount depends on the service provided. For example, co-payment for all drugs on A-list is 10% of the reference price of the drug. However, a large number of insured persons is, on some basis, exempt from paying the co-payment (children under 15, pregnant women and new mothers, persons older than 65, disabled war veterans, persons suffering from malignant disease, diabetes and other serious illnesses).
There is a free choice of family doctors in Republika Srpska which means that citizens can choose and register within any family medicine team working in the institution which has signed the contract with FZO RS, regardless the place of citizen’s residence. Moreover, citizens/insured persons can also choose the hospital in RS where they want to be treated. This was enabled by the new model of payment for hospital services (DRG model) which was introduced in 2011. Its essence is that hospitals are paid according to the number of services they provide. Furthermore, parents of children who are under age of 6 can choose a pediatrician for their children and women older than 15 can choose their gynecologist and they can visit these specialist directly, without family doctor’s referral.
Insured persons with a certified health card can be treated in private health institutions which have signed contracts with FZO RS, under the same conditions as in public institutions. FZO RS has signed contracts with more than 80 private health institutions providing consultative-specialists services, diagnostic services (MR, CT etc.), family medicine services etc. Doctors employed in contracted private health institutions have the same authorizations as doctors from public health institutions. Therefore, private sector is almost completely integrated into Republika Srpska health system. List of contracted private health institutions can be found on FZO RS web site.
For more details related to health insurance and health system of Republika Srpska, feel free to contact us on the following e-mail address: email@example.com