Health Systems and Policy Monitor (HSPM)

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Updates

Expanding the breadth and scope of statutory coverage

01 July 2024 | Country Update

In 2023, the low share of the population covered by statutory health insurance (around 87% in 2019) led to the decision to extend the benefits package of primary healthcare services to the uninsured population. Uninsured patients still had to pay out of pocket for the lab tests and imaging investigations then, as well as for the outpatient medicines prescribed by a family doctor.

From 1 July 2024, the benefits package was further adjusted to include services for uninsured populations that will ensure early detection and early treatment for several serious diseases such as cancers, hepatitis B and C, and HIV/AIDS in pregnant women.

In particular, the new services covered for uninsured people include: lab tests and specialist visits for uninsured patients suspected to have any type of cancer; testing for hepatitis B and C; and testing for HIV/AIDS for uninsured pregnant women. These services will be reimbursed to laboratories, ambulatory services and hospitals (day hospitalization) for these patients once the diagnostic is confirmed. These services will also be provided by and reimbursed to mobile healthcare units, to increase access for populations in remote, isolated areas. 

Improving early detection and (earlier) initiation of treatment of these diseases are expected to result in better health outcomes and the improvement of amenable mortality across the population.
Authors
  • Silvia Gabriela Scîntee
  • Cristian Vlãdescu
Country

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