As a society, we all want to be healthy, or in the event of illness, we want to recover as soon as possible. Because of this, the government established compulsory health insurance. This system ensures protection of public health and medical services when necessary for all policyholders whether in their home country or abroad. In the last few years, many flaws in the efficiency of the system could be noticed. More specifically, the long waiting lists which can often worsen the medical service seeker’s condition. As aforementioned, patients seek for additional help with domestic medical private providers and even foreign medical providers. Until recently, foreign treatment was restricted to unexpected situations or was a solution when individuals domestic treatment was completed. This was rectified as the European Institutions recognized the need for more closer regulation of cross-border medical treatments. Regulation of cross-border medical treatments gave policyholders a wider list of possibilities specifically stating its country and provider.
The first part of my master’s thesis is an introduction to the Slovenian health insurance system, as it is the basis of rights and cost reimbursement regarding cross-border medical treatment. Furthermore, the thesis includes analysis of available possibilities of medical treatment services respective to countries under European Law and outside it. The extent of rights and types of cost reimbursements vary for each country; therefore, it is important for policyholders to understand their options. Domestic legislation that arranges cross-border medical treatment is also examined. In my master’s thesis I was interested in (un)justified differentiation between policyholders that find medical service in the foreign country and policyholders that decide to use domestic providers. A similar problem present unequal status of domestic and foreign medical health service providers. Finally, social court case-laws concerning the question of possible policyholder discrimination are introduced, as well as case-laws regarding court’s decision on the eligibility of the cross-border medical treatment, cost reimbursements and other questions arising in the decision-making process.
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