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IKA. Documents for sickness booklet (family, individual)

 

IKA. Documents for sickness booklet (family, individual)

IKA. Documents for sickness booklet

The personal health booklet is the insurance ID for the benefits and benefits of the directly insured. The family booklet is issued to members of his family

Supply SSN ( A algorithm M register R oinonikis A safeguard)

 

Individual:

The issuance of the individual health booklet requires from 01/03/09 to have at least 60 days insurance at IKA-ETAM within the previous year or within the last 15 months. These conditions will be increased by ten (10) per year and up to 100 working days in 2013. When calculating the 15 months, the last three months are not counted. The same conditions are required for the extension of the validity of the individual health booklet.
Directly insured, IKA-ETAM retirees, old-age, invalidity and death pensioners and other insurance funds covered by IKA-ETAM are eligible for individual benefits.

Family :
For those directly insured, they are extended for one year each time, from 1/3 to 28/2 of the following year.
For old-age, invalidity pensioners and their spouses over 65 years old, health books are considered for an indefinite period, while for other members as well as spouses under 65, the visa is valid each year.
For fixed-term disability pensioners, the visa is valid for a fixed period of time, while their family members receive a visa each year.
For pensioners up to (65) years of age the visa is issued annually, for those over 65 for an indefinite period.
For insured soldiers and family members, it is valid throughout the conscription and up to six months after their discharge from the Armed Forces.

Documents for the publication of a sickness booklet

Directly insured

Supply SSN ( A algorithm M register R oinonikis A safeguard)

Personal Insurance Account Statement or Employer Certificate validated by IKA-ETAM Branch Controller based or registered at IKA-ETAM Employer Branch, showing at least sixty (60) days of insurance (or as 10 days) year up to 100 days in 2013) the previous year or 15 months. This form can be obtained by the employer from his employer.
An ID photo
Police ID or other equivalent document (Passport etc).
Document proving the security address of the security officer (PPC Account, OTE, Tax Clearance etc.).
Certificate of cancellation by another institution or Responsible Statement of Law 1599/86 that he is not insured in another Fund.

 

Indirectly insured (Protected members)

Supply SSN ( A algorithm M register R oinonikis A safeguard)

Certificate of Marital Status by Municipal Authority or Marriage Act for Spouse or Identity and Marriage Act for Children.
Photo (recent).
For children over 18 years of age who are unemployed, MD, with coverage up to 24 years.
For children over 24 years of age who are unemployed and studying, attestation of the relevant school, with coverage up to the age of 26 years.
For children who are unemployed and have completed their studies, the degree is eligible for coverage for two years after graduation and not beyond the age of 26.
To prove the conditions of co-habitation and maintenance, tax statements of the directly insured and family member or any other evidence of such conditions.

Note: In order to have a protected health insurance card in view, the insured must have the capacity to provide care to the person directly insured.

EFKA. Conditions for issuing insurance cover (health booklets)

EFKA. Conditions for issuing insurance cover (health booklets)

Renewal of insurance capacity by EFKA to insured and unemployed persons and their family members for the period from 1/3/2018 to 28/2/2019

 

Law 4529/2018  –  GG Issue A 56 / 23.03.2018
Incorporation into Greek law of Directive 2014/104 / EU of the European Parliament and of the Council of 26 November 2014 on certain rules governing actions for damages under national law on infringements the provisions of competition law of the Member States and of the European Union and other provisions .

Article 23
Granting of health insurance capacity
1.a. The directly insured and his / her family members are entitled to insurance in kind and health care benefits in kind provided that:

(aa ) The employee has completed at least seventy-five (75) working days in the preceding calendar year or in the last twelve months prior to the date of occurrence or occurrence of the insurance risk;

bb ) the self-employed person has completed at least three (3) months of insurance in the previous calendar year or in the last twelve months before the date of occurrence or occurrence of the insurance risk and has paid the required insurance contributions in accordance with Law 4387/2016 ( A 85).

In order to meet the conditions of the case, account shall also be taken of sickness or accident subsidy days, regular unemployment subsidy days, and work-related subsidy days.

b . Insurance shall be renewable from the first of March of each year until the last day of February of the following calendar year subject to the same conditions as above. Especially for self-employed persons, the insurance capacity shall be renewed if, in addition to the conditions of subparagraph bb of this paragraph, the required contributions have been paid in accordance with law 4387/2016 until December 31 of the preceding renewal of the insurance capacity. calendar year. If there is a debt, the insurance capacity is renewed on a monthly basis as long as the debt has been settled or settled and the installments paid.

c . For construction workers within the seventy-five (75) days insurance cover includes a 20% surcharge and leave days.

d . Land Workers Covered by Former OGA Insurance – Employee-Paid Employees are provided with health insurance coverage if they have completed one hundred and fifty (150) days of insurance in the preceding calendar year or last calendar year or previous calendar year of insurance risk.

e . Returning land workers – third-country nationals and returning foreign fishermen referred to in Article 40 (5) of Law 4387/2016 acquire health insurance coverage from their first working day and this is for as long as they are employed in accordance with the contract. their work.

f . Apprentices or trainees or trainees and employees of OAED programs are entitled to health care in kind from the first day of commencement of courses, education or training or program.

2 . General, special or statutory provisions providing for the granting of insurance from the date of oath or the date of insurance or employment or employment or employment continue to apply.

3. State, OTAA officials first and second degree, of the laws and NPIDs. during the unpaid leave they receive, in accordance with the provisions of the Code of Conduct for Public Officials and Civil Servants. (Law 3528/2007, A 26) and the Code of Conduct for Civil and Community Employees (Law 3584/2007, A 143) for more than one (1) month, may continue their health care insurance at the institution that prior to being granted unpaid leave upon request. In this case, they pay the corresponding insurance contributions per month for the health insurance of the insured and the employer calculated on the last month’s earnings before receiving unpaid leave. If the employee is not insured, the insurance capacity is terminated from the first of the following month of the unpaid leave decision. The above shall also apply to other officials or officials of the State or the Law who, under their constitutional or legislative provision, are governed by provisions specific to them.

4 . Employees and self-employed persons who have met the requirements for the provision of insurance capacity to the EFKA immediately prior to their recruitment shall be entitled, themselves and their family members, to health care during their term of office for a period of six (6) months. after their dismissal. Self-employed persons who fulfill their compulsory military service shall be exempted from paying health care contributions to EFKA for the duration of their term of office.

5 . (a ) Employees who apply for retirement and who meet the minimum requirements for the establishment of a pension entitlement, as long as a pension decision is pending, are still insured for sickness benefits in the EFKA, even if they do not have the required time for renewal capacity as insured.

bSelf-employed persons who discontinue their occupation, under which they are subject to compulsory Pension Insurance, are entitled to health benefits up to one (1) year from the termination of insurance, provided they have no debts or have regulated them and the payment is respected. of doses. If they apply for a pension within the year of termination of their occupation, they shall continue to receive health care insurance from EFKA until the end of the month of retirement and if they have the minimum requirements for retirement and have no debts exceeding the amount specified by the EFSA. current legislation. Insured persons who apply for retirement one year after the termination of their occupation are entitled to healthcare by EFKA from the date of application until the issuance of a pension decision,

(c ) If a pension decision is pending on the basis of successive insurance provisions, they shall continue to be covered by the EFKA insurance until the issuance of the pension decision, provided that they meet the minimum requirements for retirement by the EFKA affiliated entity, where the insurance risk has occurred. and have no debts exceeding the amount specified by applicable law.

6 . Fixed-term disability pensioners and their family members referred to in the preceding article shall be entitled to healthcare by the EFKA for as long as they are entitled to a pension and for six (6) months after expiry.

 

7 . a . Specifically for the period from 1.3.2018 to 28.2.2019 for the acquisition of insurance capacity and the provision of in-kind healthcare benefits to the directly insured and his family members:

(aa ) The employee must have completed at least fifty (50) working days in the preceding calendar year or in the last fifteen months prior to the date of occurrence of the insurance risk, excluding the days worked in the last calendar quarter of the fifteenth. For employees in construction work within fifty (50) days of insurance include a 20% surcharge and leave days.

bb ) The self-employed person has completed at least two (2) months of insurance in the previous calendar year or in the last twelve months before the date of occurrence or occurrence of the insurance risk and has paid the required insurance contributions in accordance with Law 4387 / 2016.

b . The insurance capacity shall be renewed from 1.3.2018 to 28.2.2019 in accordance with the time requirements of indent a) of this paragraph and in accordance with the other conditions of indent 1 (b).

c . General, special or statutory provisions providing for insurance coverage from the date of oath or the date of insurance or employment or employment or employment, and the provision of insurance coverage in the event of an accident at work or occupational illness and an accident outside work.

d . Employees obtain insurance for health care benefits, from 1.3.2018 to 28.2.2019, without the condition of completing the insurance days referred to in paragraph 1, employees of the company under the name “ROLLING MATERIAL COMPANY GREECE SA” of Naupi , the Perama Shipyard and Elefsina Shipbuilders, horse riders, apprentice riders and horse trainers and persons covered by EFKA insurance as employees, on a case-by-case basis par. 3 of Article 38 of Law 4387/2016, as well as members of their families.

e . Insured persons in cases A, B and C of subparagraph A.3. of par. A of article 1 of Law 4254/2014 (A΄ 85), par. 7 of article 30 of Law 4320/2015 (A) 29), and for their protected members, the right is extended. sickness benefits in kind until 28.2.2019 under the same conditions as those provisions.
f. Extends coverage until 28 February 2019 for sickness benefits in kind:

aa ) Unemployed persons over the age of twenty-nine (29) and up to fifty-five (55) years who have made use of the provisions of Article 5 (4) of Law 2768/1999 (A 273), and

(bb ) insured persons coming from the former UAE, over thirty (30) years old and up to sixty-five (65) years old, who have ceased pursuing their profession, have made use of its provisions; 8 of article 3845/2010 (A 65), remain unemployed and uninsured and have no debts owed by the former UAE. or have settled their debts and are in compliance,

g . Former OGA insured persons who owe EFKA are entitled to acquire insurance, provided that a decision has been made by the financial weakness committees of article 14, paragraph 6 of Law 2458/1997 (A 15) until 28.2.2019 the time span of the decision.

EFKA. Who are covered by health insurance

8 . The provisions of paragraphs 1 (a), (b) and (c) of paragraph 1 and paragraph 2 shall apply with effect from 1.3.2019. The indents of paragraphs d, e and f of paragraph 1 and paragraphs 3 to 6 shall apply from 1.3.2018.

How do I see if my Health Record is valid (if I have insurance)

 

On the issue of the renewal of the insurance capacity of the insured and unemployed, as well as their family members for the period 1/3/2018 to 28/2/2019, EFKA with a document to its services (No. P.F. 40021 / ec.11259 / 571 / 28-2-2018 (IDA: 7CP465C1-7B4) states the following:

TOPIC : Provision of insurance coverage to EFKA employees and self-employed persons and the unemployed

We know that for the renewal of insurance capacity by EFKA to the insured and unemployed, as well as to their family members for the period from 1/3/2018 to 28/2/2019, a law provision has already been drafted and promoted

Until the completion of the relevant legislative process, please inform your competent departments immediately to renew the insurance capacity of EFKA insured persons. and their family members for the period 1/3/2018 to 28/2/2019 with the above conditions.

Access for the Insured to the Public Health System

24/06/2016

Image courtesy of taesmileland at FreeDigitalPhotos.net

With Law 4368/2016 and JMD A3 (c) / DG/ik.25132/ 4-4-2016, the right of free access to all public health structures for the provision of nursing and medical care to uninsured and for the first time is established. to vulnerable social groups. The most fundamental change introduced by the above institutional framework is the equation of the right of insured, uninsured and formerly holders of the Individual Booklet of the Economically Weak or Uninsured to access the public health system. The health coverage guaranteed by the new framework is complete and includes their nursing, diagnostic and pharmaceutical coverage.

What am I entitled to without insurance?

  • Exactly what the insured are entitled to by public health care structures.
  • Free and Free Access to Primary and Secondary Public Health Structures , Mental Health Units, Detention Structures and University Hospitals.
  • All nursing and diagnostic services free of charge
  • Scheduled surgeries free of charge
  • Prevention and promotion of health (eg vaccinations) free of charge
  • Free dental care
  • Free maternity and childbirth planning benefits from Public Hospitals
  • Private and public pharmacy treatment . An important part of the uninsured population is entitled to zero participation in medication.
  • Abolition of 1 € per prescription for uninsured persons entitled to zero drug treatment.
  • Physiotherapy, speech therapy, ergotherapy, psychotherapy and special treatment.
  • Administration of medical aids and consumables

Who are the beneficiaries of benefits and how?

  • If you are a Greek citizen or reside legally in Greece, you apply to all public structures with your AMKA .
  • If you do not legally reside in Greece but belong to a vulnerable group that needs immediate health coverage (pregnant, children, elderly, invalids, mentally ill, etc.) you are entitled to the Aliens Health Care Card (CIP) with which you will have access to the Public Health Structures. Until the issuance of the CFSP, it is entitled to all hospital and diagnostic benefits from public hospitals.
  • All people , regardless of legal status, still have access to Emergency Departments
  • No person is examined by any hospital committee to approve his access to the Public Health System.

Where to go?

  • If you have AMKA in all public health structures that are supposed to provide you with full access to their services immediately
  • If you do not have an AMKA or legalization of residence, but you belong to a vulnerable population group (a.33 of 4368/2016), the Rights Protection Offices or the Hospital Administration Services will tell you how to get your Health Card.

Who is the regulation?

  • 2.5 million uninsured citizens
  • People who have lost their insurance because of a crisis, even if they have debts to their insurers
  • Those who reside legally in the country
  • Those who do not have legal residence documents but need immediate health care as members of vulnerable social groups (eg minors, pregnant women, people with disabilities, drug addicts, homeless, etc.)

What do I have to pay?

  • You do not have to pay anything for all the nursing and diagnostic services provided for in the regulation and carried out in public structures.
  • You do not have to pay anything if you are exempt from membership due to more specific provisions
  • You have nothing to pay for outpatient treatments, vaccinations and prevention
  • You are liable for the same contributions as insured persons in the pharmaceutical expense, unless you are subject to the JSA’s income, clinical and social exemptions, so you have zero participation again.

In particular, the following categories are eligible for zero participation:

A) BENEFICIARIES OF FREE PHARMACEUTICAL TREATMENT OF PAR. 2 A of A. 6 of JMD A3 (c) / DG/51/254/4-2016

FAMILY COMPOSITION

INCOME LIMIT

REAL ESTATE VALUE LIMIT

DEPOSIT LIMIT

Individual person

2,400 €

150,000 €

7,200 €

Family without dependent members or single parent family with one dependent member

3,600 €

165,000 €

10,800 €

Family with one dependent member or single parent family with two dependent members

4,200 €

180,000 €

12,600 €

Family with two dependent members or single parent family with three dependent members

4,800 €

195,000 €

14,400 €

Family with three dependent members or single parent family with four dependent members

5,400 €

210,000 €

16,200 €

Family with four dependent members or single parent family with five dependent members

6,000 €

225,000 €

18,000 €

Family with five dependent members or single parent family with six dependent members

6,600 €

€ 240,000

19,800 €

B) Individuals who at the time of publication of JMD A3 (c) / DG/kk 255132/4-4-2016 had a legally held Individual Booklet of Economically Impaired or Uninsured , upon expiry of the Booklet and without any formality, provided that their actual income does not exceed € 6,000 per person per year, plus € 1,200 for the spouse and for each dependent family member (minor or protected child)

C) BENEFICIARIES FOR FREE PHARMACEUTICAL TREATMENT OF PAR.8 OF A.6 OF JD A3 (c) / CAP

  • Minors up to 18 years
  • Persons who are hosted in all therapeutic structures of approved treatment organizations of Law 4139/2013
  • Prisoners and Visitors to Juvenile Institutions and Minors’ Sheltering Homes
  • Beneficiaries of international protection (recognized refugees and beneficiaries of subsidiary protection) and stateless persons and their family members.
  • Those residing in Greece on humanitarian or exceptional grounds and members of their families
  • Victims of trafficking crimes
  • People with a disability of 67% or more.

Where will I get my drugs as uninsured?

  • From private pharmacies affiliated with EOPYY
  • The psychiatric and neurological drugs for t s zero participation beneficiaries medication costs (former booklet holders financially weak or uninsured, uninsured who meet the income criteria, members of vulnerable groups), provided outside of pharmacies of hospitals and from private pharmacies Other beneficiaries purchase these medicines from private pharmacies.
  • The Medicines Abroad , which do not circulate but imported in case Greece, will be granted on the same terms and conditions as apply to the insured.
  • High Cost Medicines will be provided by both hospitals and pharmacies and EOPYY distribution points (you can find the relevant files at the bottom of the page)

What can I do as an uninsured person to ensure that I am entitled to zero drug participation?

  • Visit the website of HIDIKA SA, where, by entering the username and password for taxisnet, as well as the AMKA, I will find the participation rate in medication, in accordance with paragraphs 2 and 8 of Article 6 of JMD A3 (c) ) / GPS/doc 255132/4-4-2016.
  • If the system does not find my AMKA I will need to contact the KEPs to update the AMKA interface with my ID
  • Vulnerable categories of citizens – beneficiaries of Paragraph 2B and 8 of the CYC, including former holders of the Individual Booklet of the Economically Impaired or Uninsured – are informed that the provision of free medical care requires prior filing of a request to the Service. of their residence
  • Should I be required to participate in prescription, I have the right to appeal to the Provincial Welfare Office within 15 days of the date of the prescription provided that I meet the income and property criteria set by the JMC.
  • I need to ask the prescribing physician to inform me of any possible costs of changing my medication, as well as the possibility of prescribing therapeutically equivalent medicines, without any additional charges.

Where can I find more information?

You can contact the Administrative Services of Hospitals and Nursing Units, Municipal Welfare Services, the Ministry of Health, the Ministry of Labor and Social Solidarity and HIDIKA SA

Ministry of Health contact e-mail:

damy@moh.gov.gr

minister@moh.gov.gr

depminister@moh.gov.gr

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