Azerbaijan approves medical territorial zones within compulsory medical insurance

Azerbaijan approves medical territorial zones within compulsory medical insurance

BAKU, Azerbaijan, Jan. 29

By Ilhama Isabalayeva – Trend:

The Azerbaijani State Agency for Compulsory Medical Insurance has approved "Medical Territorial Zones in accordance with the Azerbaijani Administrative Territorial Division", Trend reports on Jan. 29 referring to the Agency.

The medical territorial zone covers a group of medical institutions subordinated to the Administration of the Regional Medical Divisions (TABIB) of Azerbaijan in accordance with the administrative territorial division of the country.

These zones have been formed taking into account the size of the population, geographical location, transport infrastructure, medical facilities and their potential, as well as the number of doctors and paramedical personnel.

In total, the Agency has formed 13 medical territorial zones. Every zone includes state medical institutions in several cities and districts.

The interregional state medical institutions have been determined for all except for three medical territorial zones. This was carried out to ensure the efficient use of resources and personnel potential of medical institutions, optimize their activity, improve public access to the various types of medical care.

When paying the amount of co-financing, the administrative territory of the insured's registration, as well as the medical territorial zone in which the medical institution is located are taken into account.

A certain part of the cost of medical services that must be paid by the insured is called the amount of co-financing and it will be applied to the insured persons if they don’t comply with the conditions specified in the Services Package. The terms of payment of this amount are determined by the Services Package, and it must be paid directly to the medical institution. The introduction of the co-financing mechanism will be launched on April 1, 2020.

Thus, if a citizen without a family doctor’s referral appeals to a medical institution at the place of registration for outpatient services, for each insured event he or she will have to pay the cost of co-financing in the amount of 5 manat ($2.9). If a citizen appeals to a medical institution located in another administrative territory for outpatient services, for each insured event he or she will have to pay the cost of co-financing in the amount of 5 manat.

If a citizen, without a family doctor’s referral, appeals to a medical institution located outside the medical territorial department where he or she is registered for outpatient services, for each insured event he or she must pay the cost of co-financing in the amount of 15 manat ($8.8).

In case if a citizen, without a referral from a medical institution at the place of registration or residence, appeals for in-patient services to a medical institution located in another administrative territory, but inside a medical territorial department, for each insurance case the cost of which exceeds 100 manat ($58.8), he or she will have to pay the cost of the joint financing in the amount of 30 manat ($17.6).

If a citizen without a referral from a medical institution located in the administrative territory at the place of registration appeals for in-patient services to a medical institution located outside the medical territorial department where he or she is registered, for each insurance case the cost of which exceeds 100 manat, the citizen will have to pay the cost of co-financing in the amount of 90 manat ($52.9).

At the same time, for each magnetic resonance imaging and computed tomography service provided on the outpatient basis, a citizen must pay the co-financing in the amount of 20 manat ($11.7). All medical services to the insured are provided according to the relevant referral. All laboratory and diagnostic services, without undergoing appropriate examination of a doctor, are carried out at the expense of the citizen.

If the conditions specified in the Services Package are met (appeal to a family doctor, appeal to a specialized doctor based on the referral from a family doctor, etc.) while providing emergency medical care, outpatient (excluding CT - computerized tomography and MRI - magnetic resonance imaging) and inpatient care, no payment of the cost of co-financing is required.

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