Presenting identity card at the front desk of the healthcare facility is required to receive medical services covered by mandatory health insurance.
The identity card and the referral letter must be presented to the front desk of referral healthcare facility. The referral letter is valid for 10 days.
Since April 1, 2021 mandatory health insurance has been applying throughout the country.
Mandatory health insurance is a form of social protection of population. It is as a system of juridical, economic and institutional measures established by the government mainly focused on provision of primary health care, first aid and emergency medical assistance to population (insured) at the expense of resources of mandatory health insurance in case of insurance claim and in provision of the medical services to insured within the specified conditions of benefit package.
The purpose of mandatory health Insurance is accordingly to a new economic basis to improve the existing financing mechanisms of health sector and therefore increase the quality of medical services and the population’s access to these services.
The mandatory health insurance does not apply to military servicemen on fixed-term military service, arrested persons, persons deprived of their liberty for certain terms and persons serving life imprisonment (except persons in detention facilities), as well as except people mentioned in the articles 15-2.1, 15-2.2.1, 15- 2.2.2, 15-2.2.3 of the “Law on Medical Insurance”, foreigners or stateless persons temporarily visiting, temporarily or permanently living in the Republic of Azerbaijan in accordance with the Migration Code of the Republic of Azerbaijan (except foreigners or stateless persons who were granted refugee status in the Republic of Azerbaijan, as well as foreigners and stateless persons who are under protection of the Office of the United Nations High Commissioner for Refugees in the Republic of Azerbaijan).
A benefit package is a set of health services provided to insured person accordingly to the type, volume and conditions of health services provision and paid for from the mandatory health insurance fund.
Medicines used during inpatient treatment and emergency medical assistance are covered by the Benefit Package.
Insurance limit is applied to physiotherapy services in the Benefit Package. During the year, physiotherapy services are provided according to doctor's referral no more than 10 procedures per each part of the body. In addition, insurance limit is applied to the number of cochlear implantation and intra-articular endoprosthesis replacement surgeries. The annual limit for each of these services is 300 surgeries.
- Medical certificate about routine examination of children under 18 years of age
- Medical certificate about medical examination of conscripts to military service
- A certificate of fitness to drive – 40 AZN
- A certificate of fitness for work – 40 AZN
The Benefit Package does not include medical services provided as part of state programs, as well as cosmetic procedures, plastic surgeries, dental services, artificial insemination, and other medical services. The medical services not included in the Benefit Package must be paid at the expense of beneficiary.
The emergency medical service delivered by public healthcare facilities is available and free of charge for everyone. Calls for emergency medical assistance should be made only in emergency and urgent cases.
Emergency medical service is not sent in the following cases:
- Administration of a scheduled treatment by an emergency medical service or conducting a scheduled medical screening (electrocardiogram)
- Scheduled treatment and procedures (injections, intravenous infusions, applying bandages) or issuance of a medical certificate by a field doctor / family physician
- Providing dental care
- Transfer and transportation of the patients at their own request from one healthcare facility to another by ambulance
- Transportation of the patients to home and other locations after medical service is rendered at healthcare facility
- Transportation of deceased person
- Providing medical assistance to pets
Family physicians attached to the insured and in urgent cases an ambulance crew provide home health care services.
Family physician is a specialist who specializes in diagnosis, prevention and treatment of adults’ and children’s diseases. If an insured has any medical issue, he first and foremost should see the family physician. Family physicians may provide treatment or based on medical prescriptions send the patient for instrumental or laboratory testing, and if necessary, to refer him to health-specialists for treatment.
To register with a Family Doctor you must visit a public medical facility (Polyclinic/Family Health Center/ village physician station) providing primary healthcare services at the place of residence. Presenting an identity card and registration document according to the place of residence is required at the front desk of the medical facility. A Family Doctor is chosen based on submitted application. The application form for persons under the age of 18 years must be filled by their legal representatives.
The insured person has a right to choose and change a family doctor (general practitioner, pediatrician) employed at public primary healthcare facility (Polyclinic/Family Health Center/ village physician station) without restriction.
The insured person may change his / her attached healthcare facility at his / her own request at least 1 calendar year after the date of registration. When change in place of residence occurs, the insured person must apply to the healthcare facility in the new area for registration without considering the time limit.
Inpatient medical examination and treatment are provided on the basis of medical conditions and prescriptions. The medicines and medical supplies used in these cases and daily meal is included in the benefit package.
Healthcare services are rendered to insured persons during the waiting period:
- No later than 14 days from the date of referral issue for specialized outpatient care
- No later than 14 days from the date of referral issue for instrumental diagnostic and laboratory examinations
- No later than 20 days from the date the referral issued to the insured person for scheduled inpatient care, except for the cochlear implantation and intra-articular endoprosthesis replacement.
In case of emergency, medical care is provided immediately according to the medical indications.
Everyone except physical persons working under a contract of employment, military servicemen (except military servicemen on fixed-term military service), persons appointed by Milli Majlis (Parliament) of the Republic of Azerbaijan or by the body (institution) determined by the relevant executive body, persons elected to paid office, physical persons registered as taxpayers, physical persons implementing works (services) under civil-law contracts are exempted from payment of mandatory health insurance premiums. Their insurance premiums will be paid from state budget.
The mandatory health insurance premiums will be deducted at the rate of 2% from a part of the monthly wages fund amounting up to 8000 manats and at the rate of 0.5% from a part of the monthly wages fund exceeding 8000 manats of the employers and employees working for public and oil sectors.
The mandatory health insurance premium are deducted at the rate of 2% from a part of the monthly wages fund amounting up to 8000 manats and at the rate of 0.5% from a part of the monthly wages fund exceeding 8000 manats of the employers and employees working for non-public and non-oil sectors.
The mandatory health insurance premium will be deducted at the rate of 2% from a part of the monthly income amounting up to 8000 manats (including 8000 manats) and at the rate of 1% from a part of the monthly income exceeding 8000 manats of the physical persons implementing works (services) under civil-law contracts.
Physical persons registered as taxpayers are required to pay 4% of monthly minimum wage (currently the monthly minimum wage in the country is 300 manats, therefore the monthly premium for mandatory health insurance makes up 12 manats). This amount is calculated on a monthly basis and fully paid no later than the 15th of the month, following the reporting month. Pursuant to the Tax Code of the Republic of Azerbaijan physical persons (individual entrepreneurs) registered as taxpayers temporarily suspending entrepreneurial or other taxable operations are not required to pay premiums for mandatory health insurance.
Mandatory health insurance premiums are deducted from the income of foreigners based on whether the income is derived from an Azerbaijani source. Foreigners receiving official income from the Republic of Azerbaijan are subject to mandatory health Insurance premiums.
According to article 15-1 of the Law “On the Medical Insurance”, one of the main principles of mandatory health insurance is the mandatory payment of insurance premiums by the insured. Legal entities and individuals found guilty of violating the law are held accountable in the cases referred to the Civil, Administrative Offenses and Criminal Codes of the Republic of Azerbaijan.
According to the “Law on Medical insurance” of the Republic of Azerbaijan, the insured persons have the right to choose a healthcare facility and a doctor (given the 15-3.1 and 15-28 paragraphs of articles of the Law). A citizen is free to choose a family doctor and physician employed at public healthcare facility subordinated to the Administration of the Regional Medical Divisions (TABIB).
The salary of healthcare workers consists of fixed monthly official (base) salary, allowances for working conditions, incentive increments, and other payments provided by the Labor Code, depending on their position, seniority, and performance evaluation.
