THE Health Insurance Organisation (HIO), tasked with implementing the national health scheme (Gesy), issued further guidelines and explanations for the public on Wednesday in a bid to clarify continued confusion ahead of the June 1 launch of outpatient care.
The first phase of Gesy will provide outpatient care, pharmacies and laboratory tests.
With the launching of the second phase on June 1, 2020, Gesy will also include inpatient care, A&E units, ambulance transportation, healthcare by nurses, midwives, clinical psychologists, clinical dietitians, physiotherapists, occupational therapists and speech therapists.
The second phase of the scheme will also offer preventative dental care, relief healthcare and medical rehabilitation and homecare.
To register to Gesy, the HIO stated that beneficiaries can either follow the step-by-step procedure on the Gesy website – www.gesy.org.cy – or visit their GP of choice. Registration is free.
Upon registering with a GP, if a confirmation is not received by the beneficiary within seven working days, the request is cancelled, and the beneficiary must register with another GP.
As of June 1, beneficiaries will have access to their GPs or paediatricians, who can refer patients to a special doctor and for laboratory tests, and also prescribe medication.
If referrals to specialist doctors do not include the name of a specific doctor but instead state the specialisation of the doctor (e.g. cardiologist), beneficiaries can visit the doctor of their choice.
A specialist doctor can then also refer patients to other specialist doctors.
Normal referrals from a GP to a specialist doctor are valid for three visits and for a period of three months, while long-term referrals are valid for 12 visits and 12 months.
Referrals for diagnostic tests by radiologists, cytologists and anatomic pathologists are valid for 30 days. The same applies for referrals from one specialist doctor to another and for referrals for diagnostic tests by specialist doctors.
Patients suffering from chronic illnesses will receive repeat prescriptions which are valid for six months. During this period, patients will visit their pharmacy on a monthly basis to receive their prescribed drugs, without the need to revisit their doctor.
Beneficiaries will be asked to pay small sums when receiving services from specialist doctors, labs, pharmacies, nurses, midwives and other medical professionals.
There is a €1 surcharge on each drug, medical device, or sanitary product bought from Gesy pharmacies.
Laboratory tests will also cost €1, while the total maximum charge per class of laboratory tests is €10.
Patients will pay €6 per visit to a specialist doctor, except for visits to doctors specialising in radiology/radio diagnostics, cytology and pathological anatomy, for which patients will pay €10 per visit.
Patients will also pay €6 per visit to a nurse or midwife, €10 per visit to an A&E unit, and €10 per visit to other medical professionals.
Patients who visit a specialist doctor directly and without a referral from a GP will be required to pay €25 for the visit.
However, women over the age of 15 directly visiting gynaecologist or midwives will be charged the regular fee of €6 for a visit to a specialist doctor or midwife.
In cases where patients visit their GP or specialist doctor after 8pm and at any time on weekends or on public holidays, doctors may charge as much as €25.
If a beneficiary’s GP is unable to provide services outside their working hours, the HIO noted that patient clinics staffed with GPs and paediatricians will operate from 7pm-11pm on weekdays, and from 9am-11pm on weekends and public holidays.
Furthermore, in cases where patients choose to purchase a drug which is more expensive than one whose cost is fully covered by Gesy, patients will be required to pay the price difference, in addition to the €1 surcharge for the purchase of drugs from a Gesy pharmacy.
Patients will not be charged for visits to their GP, though should patients exhaust the maximum number of free visits per year they are allowed, a €15 fee per extra visit will be charged. The HIO said that this fee was implemented in order to avoid over visitation to GPs, and noted that chronic patients, low-income pensioners, and GMI beneficiaries and their children are exempt from this fee.
For the remaining groups, the number of free visits per year is set according to age groups.
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An annual cap for payments by beneficiaries has been set to €150 for the general public, and €75 for low-income pensioners, GMI beneficiaries and -12s, while no additional sums will be paid by beneficiaries who have reached their cap for the remainder of the year.
Gesy will cover all vaccination services included in the national vaccination programme. In cases where doctors administer a vaccine not included in the programme, the doctor is free to determine the sum to be paid.
For more information on GPs, pharmacies and clinical laboratories participating in Gesy, beneficiaries can visit the Gesy website, the beneficiary’s portal, or call the Gesy service centre free of charge at 17000.