Table 8 Cost-sharing arrangements
Country | Co-payments/coinsurance/benefit ceiling | Groups exempted from cost-sharing |
|---|---|---|
Croatia | Co-payments for inpatient and outpatient hospital services (20 % of price), dental services (20 % of price), primary care, prescribed drugs | Children, pregnant women, people living below the poverty line are exempted from co-payments [28] |
Price cap for all co-payments [28] | ||
Czech Republic | Co-payments for dental care, medical aids, and some prescribed drugs | Children and adolescents up to the age of 18 years are exempted from user fees for doctor visits [24] |
User fees for doctor visits, hospitals stays, prescription drugs and the use of outpatient services outside the regular office hours (annual ceiling per insured individual) | ||
Children and adolescents up to the age of 18 and people older than 65: lower annual ceiling [24] | ||
Estonia | Co-payments for outpatient specialist care (if contracted by health insurance), inpatient care, prescription drugs, prescribed drugs, dental care (except tooth preservation) | n/a |
Co-insurance for specific inpatient care services set by the Estonian Health Insurance Fund [16, 40] | ||
Hungary | Co-payments and co-insurance for drugs, medical aids and prostheses, balneotherapy, dental prostheses, treatment in sanatoria, long-term chronic care, some ‘hotel’ aspects of inpatient services | n/a |
Co-payments for non-referral specialist services, except in emergency cases; co-payments for services beyond the doctor’s recommended treatment [17] | ||
Poland | Cost-sharing for drugs, certain dental procedures and material, certain health resort services | Veterans with disabilities and their spouses if they are dependant, veterans’ widows or widowers if they are entitled to a survivor’s pension are exempted from co-payment [18] |
Co-payments for orthopaedic devices [18] | ||
Slovakia | User fees for prescriptions (drugs, medical devices) and various health services beyond primary and secondary outpatient care and inpatient care. | People with disabilities and children under 6 years are exempted from co-payments [54] |
Co-payments for drugs, sanatoria treatment and transport to health service [22] | ||
Slovenia | Co-payments for visits to GP, specialists, hospitals and laboratories for the use of services covered by the Health Insurance Institute of Slovenia [23] | Children, unemployed individuals, those with income below a certain threshold and chronically ill people are exempted from co-payments [23] |