Public announcement

Dear all,

Due to the increasingly frequent misuse of the Health Insurance Fund by citizens collecting donations for treatment abroad, we are compelled to respond publicly.
Recently there has been a surge of requests circulating on social networks asking citizens to show solidarity and help by making payments to donation telephone numbers or directly to a bank account.

These concern the collection of donations for cases where no conciliary opinion had been submitted at all, that is, treatment at the expense of the Fund had not been requested.
It often happens that the HIF is misused because the requests circulate under the pretext that “the Fund does not approve”, although the patient has not submitted any documents to the HIF at all and therefore has not requested treatment abroad through the Fund.

In this way, not only is the institution, the Health Insurance Fund, being misused, but citizens are also being manipulated. The Fund is aware of several cases that are collecting financial resources from citizens in this manner.
One of many is the case where 16 500 euros are being requested for urgent surgery for a 13-year-old girl at the Institute of Orthopaedics in Banjica. Under the photograph of the girl shared on social networks, where “URGENT” is written in large green letters, it states that the operation in Banjica is “not supported by the Fund”.

We inform the public that, for the specific case, NO request for treatment abroad has been submitted to the HIFRNM.

The parent was contacted and explained that he does not need treatment through the HIF, but decided to collect donations for an operation in Banjica and explained why he decided to take such a step, a procedure from which it is evident that he is not familiar with the details of the procedure.
We explain the procedure for referral for treatment abroad, which is initiated at the request of the insured person.

Together with the request, the insured person submits:
- a proposal for referral for treatment abroad from the relevant university clinic in Skopje;
- the necessary medical and other documentation on the course of treatment in health institutions in the Republic of Macedonia.

Pursuant to Article 4 paragraph 1 of the Rulebook on the manner of using health services by insured persons abroad, the proposal for referral for treatment abroad is issued by a clinical council of at least three subspecialist/specialist doctors and the director of the relevant university clinic in Skopje and is valid for six months from the date of issue.

Thereafter, the case with the complete documentation is reviewed by the medical commissions, whereupon, after an assessment and opinion have been adopted, an appropriate administrative act is issued by the Fund.

We point out that disinformation should not be written in requests shared on social networks and that the HIFRNM should not be misused in cases where treatment through the Fund had not been requested at all, because in this way the reputation of the institution is undermined, a wrong perception is created among the public, and citizens are also manipulated.

Respectfully, HIFRNM