Maximum co payment

[Sadie]

Good morning
Does anyone know if/when you reach the maximum 150€ co payment in Gesy what happens after that? Do you pay full price for treatment or nothing?
TIA

[trevnhil]

Good morning Sadie..
I saw this in another place and although it is not an official 'link' I believe it is correct..

" The maximum annual amount of co-payments is € 150.
When you reach this maximum amount you will continue receive healthcare services within GHS without paying any additional co-payments. "

[Mrblobby]

Does co payment just apply to medication , not treatment ?

[trevnhil]

It certainly includes the 6 euros to see a consultant. For instance I had a heart Echo scan this week and that was 6 euros

[galexinda]

GESY website:

Co-Payments and Personal Contribution I and II
Wherever applicable, the beneficiaries, upon receiving healthcare services, will pay directly to the providers for the services they receive:

A. Co-Payment
This is an international best practice aiming at creating a responsible behaviour on behalf of the patients and healthcare providers and preventing abuse of the services offered. For the healthcare services that a co-payment is applied, the beneficiary will pay directly to the healthcare providers the set amount, which will constitute part of the providers’ fee.

The healthcare service for which a co-payment will be paid and the amount of the said co-payment are set out in the table below:

Healthcare Services (Note 1)
Amount of Co-Payment
€ (euros)
Per pharmaceutical product 1.00
Per medical device or medical supplies 1.00
Per lab test or group of lab tests * (note 2) 1.00
Per visit to a nurse or midwife 6.00
Per healthcare service performed by a specialist doctor in radiology/diagnostic radiology 10.00
Per visit to allied health professionals 10.00
Per visit to a hospital to receive healthcare services in cases of accidents and emergencies 10.00
Note 1: No co-payment is paid in cases where the healthcare services are provided within the context of inpatient healthcare.
Note 2: The total maximum charge per category of lab tests is ten euro (€ 10)

A maximum annual amount of co-payments will be set for each beneficiary in order to protect vulnerable groups (e.g. low income persons and/or persons with increased needs in medical care) and safeguard unhindered access of the population to the necessary healthcare services.
The maximum annual amount of co-payments will be € 75 for the recipients of the Guaranteed Minimum Income, the low- income pensioners and children up to the age of 21, and € 150 for the rest of the population''.

[Lucky Lady]

I have reached my 150 euro max co- payment and now do not need to pay any contributions for medication. Not certain about blood tests, but still need to pay consultant fees.

[mike strand2]

I have reached my 150 euro max co- payment.................but still need to pay consultant fees.

That's not what it say in the post above.

[trevnhil]

I have reached my 150 euro max co- payment.................but still need to pay consultant fees.

That's not what it say in the post above.

You should not have to pay any more, and the consultant or secretary should be able to see that ..

[daveg]

Don't think I would worry about a €6 fee to see a consultant........

[mike strand2]

Don't think I would worry about a €6 fee to see a consultant........

If someone has racked up €150 co payments already, then I would certainly not want to rack up another €100 or so by the end of December!

[trevnhil]

I did wonder when the 12 month ran from and to.. Because the system as far as I know opened in June

[galexinda]

I did wonder when the 12 month ran from and to.. Because the system as far as I know opened in June

From 01 January to 31 December.

[Lucky Lady]

I haven't "racked up" 150 euros, I happen to have several chronic conditions that require daily medication and regular blood tests. Gesy has been a godsend to me, I used to spend over 50euros a month on medication and about 200euros every six months for blood tests. Unfortunately these were never covered by private insurance, I never paid anything for prescriptions or blood tests in the UK but always knew I would have to pay here, and have been happy to do so.

[mike strand2]

I unfortunately have reached the €150 mark for this year, and since that day in early September have not had to pay for anything; consultants, diagnostics, prescriptions, etc.. So I need to get fully fit by 31 Dec 2020.