25 December 2020 15:58

Starting next year, all insured persons will use Benefit Package of the Mandatory Health Insurance

In accordance with the sequence of the application of mandatory health insurance in the administrative-territorial units of the country, starting in 2021, all insured persons will use the Benefit Package of mandatory health insurance.

The Benefit Package is a set of medical services provided under mandatory health insurance to the insured persons in the appropriate type, scope, and conditions.

The Benefit Package will help to increase the frequency of visits to medical facilities, and ensure provision of the necessary medical care in a timely manner in order to improve the health and healthcare indicators of the population, as well as access to and the quality of medical services, and ensuring the early detection of diseases by improving primary healthcare (home visits, raised awareness of healthy lifestyle, collection and regular monitoring of health indicators, etc.).

The “Mandatory Health Insurance Benefit Package” approved by Resolution No. 5 of the Cabinet of Ministers of the Republic of Azerbaijan, dated January 10, 2020, includes 2,550 different medical services, including:

• primary healthcare

• emergency and urgent medical care

• specialized outpatient care

• laboratory service

• physiotherapy service

• invasive radiology service

• inpatient care

It should be noted that the State Agency on Mandatory Health Insurance has developed  a project to amend the Benefit Package. The project envisages increasing the number of medical services included in the Benefit Package to 3,000.

Inpatient treatment of diseases with a high risk of disability and death, which are widespread in the country, will be provided under mandatory health insurance. These services include inpatient therapeutic services that cover more than 3,500 diagnoses and the treatment of myocardial infarction, stroke, ischemic heart disease, heart failure, and other cardiovascular diseases, cerebrovascular diseases, gastrointestinal diseases, urological diseases, infectious and parasitic diseases, treatment of the insured in case of burns, and poisonings which will be carried out within mandatory health insurance. In addition, examination and treatment during the pregnancy, childbirth, and post-childbirth periods are covered by mandatory health insurance.

More than 1,100 surgeries are included in the Benefit Package. Among the operations covered by insurance, life-critical and costly operations are of great importance for ensuring the health and material well-being of the population. These include cochlear implant surgery, joint endoprosthesis placement, aorto-coronary bypass surgery, heart valve replacement and recovery, aneurysm surgery, the surgical treatment of congenital heart defects, and minimally invasive cardiac surgery (coronary artery bypass grafting). Costly surgeries also include a wide range of ophthalmological, traumatological, urological, and neurosurgical operations.

According to the medical indication, medical services covered by the Benefit Package are provided to citizens in medical facilities controlled by the Administration of the Regional Medical Divisions (TABIB), and in medical facilities operating under contract if it is not possible to provide services in the medical facilities controlled by TABIB. The referral letter for medical services is issued by the medical facility controlled by TABIB. Medicines used during inpatient treatment and emergency medical care are included in the Benefit Package. Prescription drugs for outpatient treatment are not provided by the Benefit Package.

It should be noted that, starting January 1, 2020, mandatory health insurance will be provided in the Nakhchivan Autonomous Republic, Mingachevir, Gusar, Khachmaz, Guba, Shabran, Siyazan, Khizi, Gobustan, Ismayilli, Agsu, Shamakhi, Balakan, Zagatala, Gakh, Sheki, Oguz, Gabala, Goychay, Ujar, Zardab, Kurdamir, Yevlakh, and Agdash districts. On January 1, 2021, 36 more cities and regions will join the mandatory health insurance system. Starting on April 1, 2021, the populations of Baku, Sumgayit, Absheron, Khankendi, Gubadli, Zangilan, and Shusha will be covered by mandatory health insurance.

In this way, mandatory health insurance will be provided throughout the country in 2021.