The Health Care Insurance Act of the Republic of Serbia was originally published in the “Official Gazette of the Republic of Serbia” Nos. 107/05 and 109/05 in the year 2005. The Act provides access to healthcare services and financial support during times of medical need, establishing key principles and mechanisms to ensure both equity and efficiency in healthcare delivery.
The law defines two types of insurance. Compulsory health insurance is mandatory for employed citizens and specific population groups, offering essential benefits such as healthcare services and financial compensation for periods of incapacity. On the other hand, voluntary health insurance is an optional form of coverage for those not included in the compulsory system or those seeking enhanced entitlements.
The principles governing compulsory health insurance include reciprocity and solidarity, where contributions are pooled based on financial ability and benefits are distributed according to healthcare needs. This ensures fairness across different demographics such as age, gender, and socioeconomic status. The transparency principle emphasizes that insured individuals have access to full information about their rights and entitlements. Additionally, the protection of rights and public interest principle highlights measures to ensure insured individuals can exercise their rights without compromising the management of public resources.
The scope of coverage includes a range of healthcare services, such as treatment for diseases and injuries, preventive care, early disease detection, family planning, pregnancy care, and care for work-related injuries. Financial mechanisms are also in place to cover the costs of medical services, medications, and technical aids.
Significant amendments to the Act, published in Official Gazette No. 119/12, revised several articles (e.g., Articles 17, 22, 24, and 43) to address changes in healthcare policy and improve the system’s efficiency. Article 96, which introduced key legal provisions, came into effect on January 1, 2014.
The amendments aimed to adapt to evolving healthcare needs by expanding coverage for underserved populations and enhancing regulatory oversight of healthcare services. These updates improved the administrative management of the Republican Health Care Insurance Fund, setting clearer guidelines for entitlements and service provision.
The Act emphasizes financial and legal responsibility, requiring contributions from employers, employees, and other insured parties. It strikes a balance between ensuring universal access to healthcare and maintaining cost-effective service delivery. This includes measures to prevent resource misuse through reviews of medical necessity and prioritization of services.
Finally, the Act upholds social equity by ensuring that economically disadvantaged groups, including those with disabilities and chronic illnesses, can access healthcare without facing excessive financial hardship. Special protections are also provided to vulnerable populations, such as children, pregnant women, and the elderly, giving them priority access to healthcare services. These principles and provisions contribute to a healthcare system designed to serve the entire population fairly and sustainably.
