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Chairman: Amends procedure for issuing health insurance referrals to citizens

14 December 2023 11:48 (UTC+04:00)
Chairman: Amends procedure for issuing health insurance referrals to citizens
Abbas Ganbay
Abbas Ganbay
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Chairman of the Board of the State Agency for Compulsory Medical Insurance, Zaur Aliyev, stated to local media outlets that changes have been made to the procedure of issuing referrals to citizens for medical insurance, Azernews reports.

The head of the agency said that the main change is that citizens can use the service in a public or private medical institution within the administrative district of residence or on the territory of the medical territorial unit (MTA) without losing time and financial resources.

According to the chairman reporting the change, for example, under the previous rule, if it was not possible to provide a service to a person residing in Gakh in that district or a public health facility within a TAB (e.g. Shaki), it could be ensured that a service located in another TAB (e.g. Mingachevir) would be referred to a public health facility.

Under the current rule, when it is not possible to provide services to a person residing in Gakh in the area or in a public health facility within a TABIB (e.g. Shaki), a health facility located within that TABIB (at the patient's choice, e.g. Shaki) that has a contract with the agency for delivery is provided to receive the service in a private one.

That is, the main difference and advantage from the previous rule is that if it is impossible to provide a service to a citizen in a public hospital within the TABIB, the citizen is given the right to choose. So, either the citizen chooses a public health facility located outside TABIB or he chooses a contracted private health facility within the TABIB to which he belongs.

Another innovation is that if the citizen is unable to use the service of a public health facility in another TABIB of his/her choice (e.g. in Mingachevir) (medical equipment is not in working condition, the attending physician is not at work, insurmountable circumstances, etc.), the attending physician will be referred to that TABIB by the attending physician and referred to a contracted private health facility located in the territory of the agency.

It should be noted that there are a total of 14 TABs. TAB is a grouping of TABIB public health facilities by administrative-territorial units. Public health facilities in several cities and districts are included in one TAB. The distribution of TABs by administrative-territorial units was formed taking into account population size, geographical area, transport infrastructure, network and capacity of medical institutions, and number of doctors and nursing staff.

Chairman of the Board of the State Agency for Compulsory Medical Insurance Zaur Aliyev, presenting the annual report of the institution, stated that a list of medicines subject to compulsory medical insurance in Azerbaijan will be prepared soon

According to the Сhairman, work is underway to improve the service package of compulsory health insurance:

"It is planned to cover some prescription drugs in outpatient treatment in stages.

The first year is for diseases of the cardiovascular system", the second year for diseases of the digestive organs, and the next year for diseases of the respiratory organs. We are endeavouring to include medicines in the policy. It is planned to conclude contracts with pharmacies to provide citizens with medicines. A positive list of medicines will also be prepared. The positive list is a set of medicines covered by insurance in outpatient conditions.

Of course, all this is prepared in the form of a draft, opinions and proposals will be submitted to the relevant institutions to study them".

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