Do I owe a user fee when visiting a GP or specialist if I have a TELK decision for over 71% disability? Is this visible at the registry when entering the EGN? If this information is missing, should the TELK decision be mandatory?
Nikolay Mihailov, city of Varna
A certain category of people specified in Article 37, paragraph 4 of the Law on Health Insurance, including patients with diseases specified in a list to the National Framework Agreement for Medical Activities 2020-2022, is exempted from paying a user fee.
The document is published on the website of the National Health Insurance Fund, menu NRD 2020-2022 – link “Appendix No. 11 “List of diseases for which health insured persons are exempt from paying a fee under Article 37, paragraph 1 Health Insurance Fund”.
In the list, it is explicitly stated in item XVI. that all health-insured persons suffering from diseases with over 71% reduced working capacity are exempt from user fee.
The doctor is presented with a TELK decision with permanently reduced working capacity with the relevant diagnosis and ICD code appearing in the List of people exempted from the user fee.
