Table 1 Overview of OOPP settings and protection measures
From: The out-of-pocket burden of chronic diseases: the cases of Belgian, Czech and German older adults
Country | Type of Care | Co-payment | Co-insurance | Supplementary payments | Uninsured services | Protection measures |
|---|---|---|---|---|---|---|
Belgium | Outpatient | NA | GP and specialist consultations, GP home visits, physiotherapy, speech therapy, podology, etc. | Non-convention healthcare providers | Individual health services | Household level annual maximum for co-payments and co-insurance from 450 to 1800 EUR according to income. A maximum for the chronically ill reduced by 100 EUR. Lower co-payments and co-insurance for low-income households. |
Drugs | NA | Various % according to drug category | NA | Non-essential drugs (e.g. diarrhoea, stomach pain) | ||
Inpatient | Flat rate charge per day for inpatient stay, drugs; per stay for tests, radiology | A | A (e.g. one-person rooms) | Individual health services | ||
Czech Republic | Outpatient | Emergency visit fee 3.5 EUR; flat rate charge for therapeutic aids | NA | NA | Individual health services | Exemptions from emergency visit fee for defined vulnerable groups |
Drugs | Flat rate charge per package | NA | NA | Non-essential drugs (e.g. diarrhoea, cold, pain); contraception | Individual annual maximum for drug co-payments: basic (200 EUR); lowered for younger 18 and older 65 (100 EUR) | |
Inpatient | NA | NA | Above standard services (one-person rooms) | Individual health services | NA | |
Germany | Outpatient | Physiotherapy 10 EUR per day | 10% (min. 5 EUR and max. 10 EUR) for transport services, therapeutic aids | NA | Individual health services | Individual annual maximum for co-payments: 2% of household gross income; 1% for chronically ill |
Drugs | NA | 10% for prescription drugs (min. 5 EUR and max. 10 EUR); 10% for herbal remedies | NA | Non-essential drugs (e.g. diarrhoea, stomach pain) | ||
Inpatient | Flat rate charge 10 EUR per day for a maximum of 28 day per year | NA | Above standard services (one-person rooms) | Individual health services |