1. Tuzla, september 2007. godine FINANCING – HEALTHCARE SERVICE USERS Salihbašić Šehzada, dipl.ecc. Technical Training for Rehabilitation Center Managers Economy and Funding of Health Care Systems Health System Economies and Financing

2. Mandatory health insurance is part of the social insurance of citizens. It is used by citizens through their financial investments and on the basis of mutuality and solidarity, in which citizens implement their healthcare protection rights and other types of insurance based on legal and other provisions. MANDATORY HEALTH INSURANCE

3. WHAT IS INSURED? Mandatory health insurance allows users of healthcare services rights to: 1. Insurance policy holders: a) health care protection b) pay reimbursement c) reimbursement for traveling expanses related to the usage of healthcare protection. 2. Family members of the insurance policy holder : a) healthcare protection b) reimbursement of traveling expanses related to the usage of healthcare protection

4. HEALTHCARE PROTECTION Healthcare protection, insured by law, covers: urgent medical assistance, treatment of contagious diseases, treatment of acute and chronic diseases in cases when they are life threatening, healthcare of children to the age of 15; healthcare protection for regular pupils and students, treatment of endemic nephropathy, treatment of malignant diseases, reatment of insulin-dependent diabetes, healthcare protection during pregnancy and maternity leave healthcare protection of mentally challenged individuals who, due to their condition, can endanger their life and lives of others or can damage material goods; healthcare protection of individuals with progressive neuromuscular diseases, paraplegia, quadriplegia, cerebral paralysis, and multiple sclerosis; implementation of immunization against contagious diseases in children, treatment of work injuries and professional diseases; healthcare protection of citizens who are over the age of 65; if the income per person per household is not higher than the average income in the Federation of Bosnia and Herzegovina drug addiction treatment; service for blood transfusion.

5. HEALTHCARE PROTECTION INSURED BY LAW AND OTHER REGULATIONS: primary healthcare protection specialist-consulting healthcare protection hospital healthcare protection right to use drugs found on the Fund’s list right to dental-prosthetic assistance and dental-prosthetic implants right to use orthopedic and other devices right to use healthcare protection abroad right to be reimbursed during sick leave right to be reimbursed for the travel expenses which are related to the healthcare needs

6. SPECIAL REGULATIONS ADOPTED BY RESPECTIVE BODY DETERMINE: the scope of rights regulated by healthcare insurance – the so called Basic Package the scope of rights regarding the usage of orthopaedic and other devices the scope of rights regarding the usage of drugs which can be found on the Fund’s list and which can be prescribed and paid for by the Fund

7. HOW IS STATUS OF INSURED PERSON DETERMINED; WHO DETERMINES THE STATUS OF INSURED PERSON The right to mandatory healthcare insurance can only be used by individuals whose status of the insurance policy holder has already been established. After the submitting of request, the status of insurance policy holder is determined by the Fund.

8. Finances needed for implementation of rights, described by the mandatory healthcare insurance, are provided through revenues collected by the established funds for healthcare insurance, which are in accordance with the legal regulations and other regulations related to the law. Finances for expanded health insurance are provided by additional revenues in accordance with the regulations. The aforementioned finances can also be secured through the usage of other sources determined by law and other regulations (taxes, donations, bonuses, budget allocations and so forth) Finances for voluntary healthcare insurance are provided by individual citizens or companies and institutions that decide, on their own, to merge their finances in order to use insurance. FINANCING – INSURING FINANCES

9. PROTECTION OF RIGHTS The rights of healthcare protection users are protected through: -citizens organizations -non-government organizations -medical and pharmaceutical chambers of doctors

10. ENDING STATUS OF POLICY HOLDER By unsubscribing from health insurance, a citizen loses the status of an insurance policy holder.