Ebtv. Commentary

2023. October 3.

 

The Commentary of the Health Insurance Act, written by Dr. Éva Lukács Gellérné has been published by Wolters Kluwer Publishing.

Act LXXXIII of 1997 on Compulsory Health Insurance Benefits (Ebtv.) is one of the lex specialis laws governing Hungarian social insurance. It covers health insurance benefits in cash and in kind for Hungarian citizens living and working in Hungary and for foreigners working and settled in Hungary. The importance of the Act is demonstrated by the fact that it covers not only sickness and maternity benefits (e.g. sick pay, accident benefits, child care fee child care allowance) but also the whole spectrum of sickness care, from primary care to specialised outpatient care and inpatient care, and also covers the issues of drug subsidies and medical treatment abroad. This complex and complicated system may be the reason why no comprehensive commentary on the law has been produced so far, hence the first major Commentary on the Ebtv.

The Commentary explains the principles of the Ebtv, the conditions for access to services and benefits, and details the different entitlements. The Ebtv. contains the basic rules of compulsory health insurance, which is supplemented by a number of other laws and related lower-level legislation, professional guidelines and methodological guidelines. It is not an exaggeration to say that health insurance is one of the most diverse and therefore most difficult to grasp areas of regulation in the Hungarian legal system. Therefore, the Commentary necessarily also refers to related legislation that makes the framework of the Ebtv. more comprehensible and understable, especially when the Ebtv. rather defines certain entitlements by references to other legislative instruments.

The Commentary is divided into two thematic parts: the first part deals with the principles and health services in kind, while the second part deals with cash benefits. In the first part, important topics such as the progressivity levels of the health care system, the rules governing the different contracts of publicly funded providers, the territorial coverage obligation, the rules governing waiting lists, the inclusion of medicines and medical devices into the price reimbursement system and the extraterritorial scope of Hungarian health insurance law are covered. The second part describes the types of cash benefits and their beneficiaries, highlighting the overlaps between benefits.

 

 

 

 

 

 

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