As of 01.01.2012 and according to the Law 3918/02.03.2011)“Structural Changes to the health system and other provisions” a reform has been brought about regarding healthcare benefits in kind for the insured persons in Greece, due to the establishment and functioning of EOPYY, the National Organization for Healthcare Services Provision.
EOPYY is the Hellenic Organization which has already merged the largest Greek insurance institutions regarding healthcare benefits in kind such as: IKA ETAM (Social Insurance Institute, Unified Insurance Fund for Employees), OPAD & TYDKY (Civil Servants’ Insurance Funds), OAEE (Insurance Organization for Freelancers), OGA (Agricultural Insurance Organization), OIKOS NAFTOU (Seaman’s Home), TAYTEKO (Insurance Fund for Banks & Public Benefit Companies Employees), ETAA (Unified Insurance Fund of Independently Employed), & ETAP MME (Institution for insured persons who work for the media) while other Institutions will join EOPYY gradually.
Implementing the ‘Integrated Regulation for Health Services’ – EKPY, EOPYY aims to ensure equal access of all its insured persons, to a single system for the provision of health services, prevention, maintenance, promotion, improvement, rehabilitation and protection of health.
More specifically such healthcare benefits concern:
- prevention and promotion of health
- primary health care – medical care – diagnostic medical acts
- paraclinical examinations
- physical therapy – occupational therapy – speech therapy – psychotherapy
- pharmaceutical care
- dental – stomatological care
- special treatment
- secondary healthcare -hospital care
- obstetric care – childbirth allowance
- hospitalization abroad
- health rehabilitation
- provision of treatment aids and prostheses – additional care
- other allowances etc.
For the aforementioned provisions, EOPYY has been contracted with a large number of doctors/physicians of various specializations as well as private clinics and diagnostic centers to ensure the entitlement in benefits in kind to all its beneficiaries. A list of the contracted health providers can be found to the following link: http://www.eopyy.gov.gr/MedSupplier.
Furthermore, on 05.08.2013, EOPYY was also designated as the Hellenic Liaison Body for the reimbursement of healthcare benefits in kind according to EC Regulations and Competent Institution of the place of stay or residence for sickness benefits in kind (A.C. 351/13/05.08.2013) for the insured persons from EU member-states, EEA countries and Switzerland, who are on a temporary stay in Greece and they are European Health Insurance Card (EHIC) or Provisional Replacement Certificate (PRC) and IKA-ETAM healthcare booklet holders. Healthcare benefits in kind are also entitled to portable documents’ holders (such as S1 and S2) as indicated in the respective forms.
On 9.12.2013 EOPYY was also designated as the Hellenic National Contact Point implementing the Directive 2011/24/EU of the European Parliament and of the council of 9 March 2011 on the application of patients’ rights in cross-border healthcare as it was aligned with the Greek Law (Law 4213/09.12.2013) which concerns information regarding medical treatment in another EU member-state and the right to have some or all of the costs in the home country.
Moreover, Law 4238/17.02.2014 brought about a crucial reform regarding the role of EOPYY from ‘provider’ to ‘purchaser’ of Healthcare Services.
That means that in order to purchase hospital, medical and pharmaceutical care services, as well as other kinds and means of healthcare, EOPYY is able to make contracts/agreements with health providers, specifying the terms and conditions governing the obligations of the contracting parties.
Last but not least EOPYY is eager to initiate bilateral agreements not only as an international instrument to coordinate national social security systems -so as to solve problems which patients may face- but also as a ratification process based on the general principle of reciprocity and especially with States, which although they are not EU members, are variously related with Greece and its social security orientation.
More information: www.eopyy.gov.gr.