Gesy beneficiaries are entitled to four visits to a clinical dietician a year for health issues covered by the general health system, the Health Insurance Organisation (HIO) said on Wednesday.
Services from clinical dieticians have been available from December 1 when they joined Gesy, offering services to beneficiaries with healthy problems who need to regulate their nutrition, it said.
The aim is to cover cases of individuals who have been diagnosed with eating disorders, diabetes, problems with their circulatory system, endocrinological and other metabolic problems, thyroid problems etc. Individuals wishing to lose weight for aesthetic reasons are not covered under Gesy’s payment system, it clarified.
Patients are entitled to four annual visits for cases where their health condition falls within those Gesy covers for clinical dieticians’ services. In cases where the clinical dietician and doctor decide that more treatments are needed, then a request can be submitted which will be evaluated by the HIO. Treatments within Gesy are calculated from the start of each calendar year.
For referrals, beneficiaries must contact their personal or specialist doctor. Should a beneficiary arrange an appointment directly with the clinical dietician without first obtaining a referral, then the fee must be covered by the patient. The same applies in cases where the patient has used up the maximum number of visits they are entitled to, as determined by the HIO.
Referrals for clinical dieticians are of two types – short and medium term. A short-term referral is issued for three treatments and must be executed over six months. A medium term one is for six treatments, again over six months. In cases where a referral includes two diagnoses, it is clarified that the clinical dietician can evaluate only one.
Home visits are not covered in the package of services agreed with clinical dieticians, however if the condition of a beneficiary does require home care, they have the discretionary power to opt to offer such a service.
Moreover, a clinical dietician registered with Gesy can offer services to a patient being treated at a non-HIO hospital, but these services are not covered by Gesy and the beneficiary will have to pay.
In cases where the service is provided to a beneficiary during treatment at a Gesy hospital, then the service will be paid according to the DRG system, the announcement concluded.