30.06.2022
HOW TO GET AID FOR PEOPLE WITH DISABILITIES FROM JULY 1?
From July 1, 2022, the National Health Insurance Fund (NHIF) will negotiate, grant, pay and control aids, devices, equipment, medical devices (ADEMD) and repair activities, as the next step for the smooth passage of the process by the Agency for Social assistance (ASA) to the fund. Therefore, the NHIF issued explanations about the changes and useful information for consumers:
What are the advantages:
Save time:
You visit Medical Advisory Commission MAC/Territorial Expert Medical Commission TEMC/National Expert Medical Commission NEMC, where you will be issued an electronic protocol/decision for an aid, device, facility or medical device. On the spot you will have the opportunity to submit an application to the Regional health insurance fund (RHIF) and the NHIF, which will be sent electronically by MAC/TEMC/NEMC to the institution;
You receive a notification from the RHIF/NHIF for an approved approval for the provision of ADEMD by e-mail and/or by telephone, without visiting the RHIF offices.
You have the freedom to choose:
You can receive or repair your aid, device, equipment or medical device throughout the country from any retailer who has a contract with RHIF.
What to do if you are a person with a disability and need an aid, device, equipment or medical device (ADEMD):
To visit MAC/TEMC/NEMC, from where you will be issued an electronic protocol/decision for prescribing ADEMD;
To the protocol/decision to fill in on the spot an electronic application for consent with the prescribed ADEMD and the need to provide them. The application can also be submitted by a person authorized by you;
NHIF/RHIF expert commissions will review your electronic application and issue an approval or a motivated refusal;
Each approval will contain information about you or the person authorized by you, if the application is submitted by him. The approval will have a registration number and date of issue. It will include ADEMD with their NHIF codes;
You or the person authorized by you will be informed of the approval or the motivated refusal by a written message to the e-mail and/or by telephone specified by you. You do not need to visit an RHIF office;
You will receive your ADEMD from any retailer who has entered into a contract with RHIF, without territorial restriction – i.e., wherever it is convenient for you, in the country. For this purpose, you must identify yourself to the trader of your choice through an identifier – PIN or personal number of a foreigner, names, number and date of approval for granting ADEMD.
You should also know:
Applications for granting ADEMD of a total value of up to BGN 1,000 are considered by the RHIF.
Applications for granting ADEMD for a total value equal to or higher than BGN 1,000 are considered by the NHIF.
The prescribing of ADEMD is carried out according to the specification of the National Health Insurance Fund with a code, without specifying specific trade names or companies.
It is possible to submit applications for granting ADEMD on paper to the RHIF only when the application cannot be submitted electronically by MAC/TEMC/NEMC due to technical reasons.
If your aid, device, appliance or medical device needs repair:
You or a person authorized by you must submit an application for repair work (according to a sample) to the director of the RHIF. You can also send the application by letter with a notice of delivery (return receipt) through a licensed postal operator;
An expert commission in the RHIF reviews and approves the applications;
The director of the RHIF issues an approval for the provision of PPSMI or a motivated refusal. A motivated refusal is issued in case of non-compliance with the conditions specified in the list-specification with ADEMD, which is published on the NHIF website;
Retailers who have a contract with RHIF are obliged to provide repair work to ADEMD. For this purpose, you or a person authorized by you must identify yourself to the trader of your choice through an identifier – PIN or personal number of a foreigner, names, number and date of approval for granting ADEMD. According to set criteria, the trader notes in the specialized software product the provided repair activity.
Proceedings for the provision of ADEMD and repair works have started and are not completed until June 30, 2022.
Proceedings initiated and not completed by June 30, 2022 for the provision of ADEMD, including their payments, are carried out in the current order by the ASA;
If as of July 1, 2022 you have a document issued by MAC/TEMC/NEMC, which does not determine ADEMD according to the approved specification, you can receive your aid, device, equipment or medical device after their individual determination by MAC/TEMC/NEMC, as you need to submit an electronic application.
