General Health Insurance
What are the main features of the GHS?
The General Healthcare System (GHS) is modern, patient-centric healthcare system with the aim of delivering quality healthcare services to beneficiaries.
The main features of the system are:
- Universal coverage of the population
- Equal and equitable treatment of all beneficiaries
- Provision of a comprehensive package of healthcare services
- Freedom of choice of provider by the beneficiaries
- Social reciprocity
For the implementation of the GHS, a special fund was established for purposes of gathering the relevant contributions, and from which all payments to providers of healthcare services will be made. The GHS fund will be administered by the Health Insurance Organisation (HIO).
The General Healthcare System (GHS) is a people-centred healthcare system providing quality healthcare services to its beneficiaries.
implemented?
According to the provisions of The General Healthcare System (Amending) Law of 2017, that the GHS shall be implemented in two stages.
The first stage of GHS implementation, beginning June 1st 2019, provides for the introduction of outpatient healthcare, i.e. the provision of healthcare services by personal doctors and outpatient specialists, pharmacists and laboratories on June 1st, 2019.
The second and final stage of GHS implementation, beginning June 1st, 2020, includes introduction of all the remaining healthcare services, i.e. inpatient healthcare and services, services offered by allied health professionals (clinical dieticians, occupational therapists, speech pathologists, physiotherapists, and clinical psychologists), nurses and midwifes, the accident and emergency departments, ambulance services, dentists, palliative healthcare services and medical rehabilitation services.
Due to the dramatic social and economic effects effected by the COVID-19 epidemic during 2020, from June 1st 2020, Inpatient Services will be introduced by GHS and will be provided to all beneficiaries by all contracted hospitals. The rest of the Phase 2 services mentioned above, will be introduced at a later stage and the exact date will be announced by the HIO.
The collection of the contributions for the first stage will start on March 1st, 2019. For the complete implementation of the GHS, contributions started on March 1st, 2020, however, due to goverment measures for supporintg the economy during COVID-19, the contributions start may be deferred by 3 months (up to July 1st) under certain conditions.
How is the GHS financed?
The GHS Fund revenues will come from contributions, co-payments, personal contributions 1, donations and legacies, income from assets of the HIO and any other income accrued from the activities of the HIO
- Contributions
The main GHS source of financing is contributions. The payment of the contributions for the first phase will start on 1 March 2019 and for the full implementation on 1 March 2020.
The Contributors’ Categories are:
- Employees
- Employers
- State
- Self-employed
- Pensioners
- Income-earners
- Goverment Officials
- Persons responsible for the payment of remuneration to Goverment Officials
The contribution rates for each category of contributors as they have been set by the General Healthcare System (Amending) Law of 2017 are the following:
Table: Contribution rates
|
Contributors Categories |
First Phase (As of 1/3/2019-28/2/2019) |
Full Implementation (As of 1/3/2020) |
Explanation |
|
Employees (Public and Private Sector) |
1,70% |
2,65% |
On their salaries |
|
Employers (Including the State as an Employer) |
1,85% |
2,90% |
On the salaries of every person employed by them |
|
State |
1,65% |
4,70% |
On the salaries of the employees, the remuneration of the self-employed and officials and on pensions |
|
Self-employed |
2,55% |
4,00% |
On their remuneration |
|
Pensioners |
1,70% |
2,65% |
On their pension |
|
Income earners (e.g. rent, interest, dividends) |
1,70% |
2,65% |
On their income |
|
Government Officials |
1,70% |
2,65% |
On their remuneration |
|
Persons responsible for the payment of remuneration to Government Officials |
1,85% |
2,90% |
On the remuneration of the Government Official |
For every natural person, the total maximum annual amount on which contributions will be paid is € 180,000.
In case that the natural person is not a tax resident of Cyprus, he/she will pay contributions only for the income, earnings and pensions that derive from the Republic of Cyprus, excluding dividends and interest.
- 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.
B. Personal Contribution I and II
In case a Beneficiary visits directly an Outpatient Specialist, without a referral from their Personal Doctor, the Personal Contribution I will be paid as set out below:
| Healthcare Services |
Personal Contribution I Amount € (euros) |
| Outpatient visit without referral from Personal Doctor | 25.00 |
| A female beneficiary who has attained the age of 15 and visits an Outpatient Specialist in Gynaecology/Obstetrics, | No charge |
| A beneficiary who is serving his compulsory military service in the National Guard of the Republic and holds a referral by a military doctor referring him to an outpatient specialist | No charge |
In cases where Personal Contribution I is paid, no Co-payment will be paid for the same visit. Personal Contribution I is paid directly by the beneficiary to the healthcare providers and constitutes part of the healthcare providers’ fee.
In cases where beneficiaries choose a more expensive pharmaceutical product than the one covered by the GHS they will pay a Personal Contribution II which is equal to the difference between the price of the pharmaceutical product covered by the GHS and the price of the pharmaceutical product that the beneficiary chose. Personal Contribution II is paid in addition to the Co-payment or the Personal Contribution I.
- What is the Global Budget?
The Global Budget is the annual expenditure for healthcare services covered by the GHS. The Health Insurance Organisation (HIO) will set an individual global budget for each segment of healthcare providers following consultations with the respective representatives of the healthcare providers.
In any given financial year, the actual expenditure for any segment of healthcare providers within the framework of the GHS cannot exceed the predetermined global budget, irrespectively of the volume of services provided. This practice is a requirement for the sustainability of the System.
The annual global budget of each healthcare provider segment will be allocated to the 12 months of the year and will be made fully available to the healthcare providers.
The information contained in this Site has been written in general terms and therefore cannot be relied on to cover specific situations; application of the principles set out will depend upon the particular circumstances involved and we recommend that you obtain professional advice before acting or refraining from acting on any of the contents of this newsletter. PanAudit Konnaris Limited would be pleased to advise readers on how to apply the principles set out in this newsletter to their specific circumstances. PanAudit Konnaris Limited accepts no duty of care or liability for any loss occasioned to any person acting or refraining from action as a result of any material in this newsletter.
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