Ukrainians want to be compensated for treatment abroad: new rules registered in the Rada

Ukraine proposes to introduce a new system for receiving medical care abroad. Bill No. 15542 provides for the possibility of compensation for treatment costs, prior approval of expensive procedures, use of foreign prescriptions in Ukraine, and continuation of therapy after returning home.

The document has been registered in the Verkhovna Rada and is intended to bring Ukrainian legislation closer to the rules of the European Union in the field of cross-border healthcare. In particular, the authors are guided by EU Directive 2011/24/EU and European rules for the coordination of social security systems.

The state will be able to compensate for treatment abroad

One of the key proposals is to create a separate mechanism for reimbursing Ukrainians for medical care received in another country.

Compensation will be possible within the framework of the Medical Guarantees Program. It is proposed to determine its size taking into account two indicators: the patient’s actual costs and the cost of a similar medical service in Ukraine.

At the same time, this does not mean that the state will pay for any treatment in any foreign clinic.

The Cabinet of Ministers should determine the cases when costs can be fully compensated, as well as the rules for reimbursement of related costs.

Expensive treatment may require permission

It is proposed to introduce prior approval for some medical services.

It may be required in the case of hospitalization, expensive or highly specialized treatment and medical care with increased risk.

When making a decision, the patient’s condition, medical indications, urgency of care and the possibility of receiving similar treatment in Ukraine should be taken into account.

Where to turn to Ukrainians

One of the main roles in the new system is planned to be given to the National Health Service of Ukraine.

The National Health Service of Ukraine should become the national contact point for cross-border medical care. The service will consider applications for prior approval of treatment, applications for reimbursement of costs and will work with relevant institutions of other states.

Before the trip, the patient will be able to receive information about the conditions of treatment, the procedure for compensation and the possibility of appealing decisions.

Foreign prescriptions want to be allowed to be used in Ukraine

Another important change concerns people who started therapy abroad, but then returned home.

The draft law provides for the possibility of receiving registered medicines and authorized medical products in Ukraine according to prescriptions or other medical documents issued by a doctor in another country.

At the same time, foreign prescriptions must meet the established requirements for information about the patient, drug, dosage and doctor. The detailed procedure must be determined by the Ministry of Health.

After returning from abroad, treatment must continue

It is separately proposed to guarantee the continuity of medical care.

If a Ukrainian, for example, has undergone surgery abroad, after returning he must be able to continue treatment, undergo rehabilitation, dressings or necessary examinations in Ukraine.

The fact of conducting the main treatment in another country should not be a reason for refusing further medical care.

European Health Insurance Card may come into effect in Ukraine

The draft law also mentions the European Health Insurance Card and forms S1 and S2.

Their use must be in accordance with European rules and international treaties of Ukraine. It is also planned to establish electronic exchange of information between Ukrainian and foreign institutions.

Medical guarantees for children want to be extended to 18 years

Another proposed change concerns the age limit for children within the Medical Guarantees Program.

Instead of the wording “children under 16 years of age”, it is proposed to establish “children under 18 years of age”.

When will the new rules come into effect

At the moment, this is only a draft law, so the new mechanism is not yet in effect.

If the document is adopted, the Cabinet of Ministers will have to separately determine the procedure for cross-border medical care, the deadlines for considering applications, the list of services for which prior approval is required, the rules for compensation and the procedure for appealing decisions.

Thus, bill No. 15542 proposes to move from separate mechanisms for sending Ukrainians for treatment abroad to a comprehensive system that will determine where a patient should go, when permission is required, and under what conditions the state can compensate for treatment costs.