The
Public Health Insurance Act No. 48/1997 Coll. provides in Section 16:
“The
competent health insurance fund shall reimburse, pursuant to Section 19(1)(a),
in exceptional cases healthcare services otherwise not covered by health
insurance, provided that the provision of such healthcare services constitutes
the only option in view of the insured person’s health condition.”
That
such requests are not rare is evidenced, for example, by statistics published
by the General Health Insurance Company of the Czech Republic.
In cases of non-reimbursed treatment, its use pursuant to Section 16—which allows reimbursement in justified cases—is not uncommon in practice. The complexity of such assessments is also reflected...
