Greek (Greece)

The General Healthcare System (GHS) is modern, patient-centric healthcare system with the aim of delivering quality healthcare services to beneficiaries.

The main features of the system are:
• Universal coverage of the population
• Equal and equitable treatment of all beneficiaries
• Provision of a comprehensive package of healthcare services
• Freedom of choice of provider by the beneficiaries
• Social reciprocity


For the implementation of the GHS, a special fund was established for purposes of gathering the relevant contributions, and from which all payments to providers of healthcare services will be made. The GHS fund will be administered by the Health Insurance Organisation (HIO).

The General Healthcare System (GHS) is a people-centred healthcare system providing quality healthcare services to its beneficiaries.

The General Healthcare System Law of 2001 (N.89(I)/2001), as it has been since amended or replaced, is the legislative framework that governs the operation of the Health Insurance Organisation (HIO) and the implementation of the General Healthcare System

FINANCING
How is the GHS financed?

The GHS Fund revenues will come from contributions, co-payments, personal contributions 1, donations and legacies, income from assets of the HIO and any other income accrued from the activities of the HIO
1. Contributions
The main GHS source of financing is contributions. The payment of the contributions for the first phase will start on 1 March 2019 and for the full implementation on 1 March 2020.
The Contributors’ Categories are:
• Employees
• Employers
• State
• Self-employed
• Pensioners
• Income-earners
• Goverment Officials
• Persons responsible for the payment of remuneration to Goverment Officials

The contribution rates for each category of contributors as they have been set by the General Healthcare System (Amending) Law of 2017 are the following:

Table: Contribution rates

Contributors Categories  First Phase
(As of 1/3/2019-28/2/2019) 
Full Implementation
(As of 1/3/2020) 
 Explanation
 Employees (Public and
 Private Sector)
 1,70%  2,65%  On their salaries
 Employers (Including the State as an  Employer)  1,85%  2,90%  On the salaries of every person employed by them
 State  1,65%  4,70%  On the salaries of the employees, the remuneration of the self-employed and officials and on pensions
 Self-employed  2,55%  4,00%  On their remuneration
 Retired  1,70%  2,65%  On their pension
 Income earners (e.g. rent, interest, dividends)  1,70%  2,65%  On their income
 Government Officials  1,70%  2,65%  On their remuneration
Persons responsible for the payment of remuneration to Goverment Officials  1,85%  2,90%

 On the remuneration of the Government Official

For every natural person, the total maximum annual amount on which contributions will be paid is € 180,000.
In case that the natural person is not a tax resident of Cyprus, he/she will pay contributions only for the income, earnings and pensions that derive from the Republic of Cyprus, excluding dividends and interest.


2. Co-Payments and Contributions
Wherever applicable, the beneficiaries, upon receiving healthcare services, will pay directly to the providers for the services they receive:


A. Co-Payment
This is an international best practice aiming at creating a responsible behaviour on behalf of the patients and healthcare providers and preventing abuse of the services offered. For the healthcare services that a co-payment is applied, the beneficiary will pay directly to the healthcare providers the set amount, which will constitute part of the providers’ fee.

The healthcare service for which a co-payment will be paid and the amount of the said co-payment are set out in the table below:

Healthcare Services (Note 1)  Amount of Co-Payment
€ (euros) 
 Per pharmaceutical product  1.00
 Per medical device or medical supplies  1.00
 Per lab test or group of lab tests * (note 2)  1.00
 Per visit to a nurse or midwife  6.00

 Per healthcare service performed by a specialist doctor

in radiology/diagnostic radiology

 10.00
 Per visit to allied health professionals  10.00

 Per visit to a hospital to receive healthcare services

in cases of accidents and emergencies

10.00

Note 1: No co-payment is paid in cases where the healthcare services are provided within the context of inpatient healthcare.
Note 2: The total maximum charge per category of lab tests is ten euro (€ 10)

A maximum annual amount of co-payments will be set for each beneficiary in order to protect vulnerable groups (e.g. low income persons and/or persons with increased needs in medical care) and safeguard unhindered access of the population to the necessary healthcare services.
The maximum annual amount of co-payments will be € 75 for the recipients of the Guaranteed Minimum Income, the low- income pensioners and children up to the age of 21, and € 150 for the rest of the population.


B. Personal Contribution 1 and 2
In case a Beneficiary visits directly an Outpatient Specialist, without a referral from their Personal Doctor, the Personal Contribution 1 will be paid as set out below:

Healthcare Services Personal Contribution 1
Amount
€ (euros)
Outpatient visit without referral from Personal Doctor 25.00

A female beneficiary who has attained the age of 15 and visits an

Outpatient Specialist in Gynaecology/Obstetrics,

No charge

A beneficiary who is serving his compulsory military service in the National Guard of the

Republic and holds a referral by a military doctor referring him to an outpatient specialist

No charge

In cases where Personal Contribution 1 is paid, no Co-payment will be paid for the same visit. PC1 is paid directly by the beneficiary to the healthcare providers and constitutes part of the healthcare providers’ fee.

In cases where beneficiaries choose a more expensive pharmaceutical product than the one covered by the GHS they will pay a Personal Contribution 2 which is equal to the difference between the price of the pharmaceutical product covered by the GHS and the price of the pharmaceutical product that the beneficiary chose. PC2 is paid in addition to the Co-payment or the PC1.


When will the GHS be implemented?
According to the provisions of The General Healthcare System (Amending) Law of 2017, that the GHS shall be implemented in two stages.
The first stage of GHS implementation, beginning June 1st 2019, provides for the introduction of outpatient healthcare, i.e. the provision of healthcare services by personal doctors and outpatient specialists, pharmacists and laboratories on June 1st, 2019.


The second and final stage of GHS implementation, beginning June 1st, 2020, includes introduction of all the remaining healthcare services, i.e. inpatient healthcare and services, services offered by allied health professionals (clinical dieticians, occupational therapists, speech pathologists, physiotherapists, and clinical psychologists), nurses and midwifes, the accident and emergency departments, ambulance services, dentists, palliative healthcare services and medical rehabilitation services.


The collection of the contributions for the first stage will start on March 1st, 2019 and for the complete implementation of the GHS on March 1st, 2020. The two stages will be implemented within a one year time-span, starting with the first stage on 1st June 2019 and ending with the second stage on 1st June 2020.


BENEFICIARY CATEGORIES
Citizens Of The Republic Of Cyprus (RC)
This category includes persons who are:
• Citizens of the Republic of Cyprus and
• Permanent residents of
o The areas controlled by the Republic of Cyprus or
o The sovereign territories of the United Kingdom, Great Britain and Northern Ireland bases in Cyprus,
• Dependants of Cypriots.
European Union (EU) Citizens
This category includes persons who are:
• EU citizens and
• Permanent residents of the areas controlled by the Republic of Cyprus and
o Are working in the areas controlled by the Republic of Cyprus, or
o Have a permanent residence permit in the areas controlled by the Republic of Cyprus, in accordance with the provisions of The Right of EU Citizens and their Family Members to Move and Reside Freely within the Territory of the Republic of Cyprus Law.
• Dependants of EU citizens.


Non-EU Citizens
This category includes persons who are:
• Citizens of a third country and
• Permanent residents of the areas controlled by the Republic of Cyprus and
• Have a permanent residence permit in the areas controlled by the Republic of Cyprus or the right of equal treatment in the social insurance sectors, in accordance with the Aliens and Immigration Law,
• Dependants of Non-EU Citizens.


Refugees and persons with a status of supplementry prodection:

This category includes persons who are:
• Permanent residents of the areas controlled by the Republic of Cyprus and
• Have been granted refugee or supplementary protection status, in accordance with The Refugees Law
• Dependants of Refugees and Persons with a Supplementary Protection status.


Beneficiaries' Dependants
This category includes persons who are:
• Citizens of the Republic of Cyprus or EU citizens or Non-EU Citizens and
• Permanent residents of the areas controlled by the Republic of Cyprus and
• Members of a beneficiary’s family, and
• In case of family members of a beneficiary from a third country who is a holder of a permanent residence permit, the members must also have a permanent residence permit in the areas controlled by the Republic of Cyprus in accordance with the Aliens and Immigration Law


Other Categories
• Persons, who are specified by the HIO Board as special cases can also be included in accordance with the Regulations.
• The HIO may, at its discretion, include, on a voluntary basis and under terms and conditions set by internal regulations, persons who are excluded from the GHS.

Source: Health Insurance Organisation - https://www.gesy.org.cy

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