
THE RIGHTS AND OBLIGATIONS OF THE INSURED
Insured persons have the right, from the date of acquiring the quality of insured, to the package of services the base in the case of illness or of accident, from the first day of illness or from the date of the accident until recovery, under the conditions established by Law no. 95/2006 on health care reform.
A) THE RIGHTS OF THE INSURED:
a) to choose the provider of medical services, as well as the health insurance house to which he is insured, under the conditions of the law and of the framework contract;
b) sa or Submitted on list to a family doctor you request, if they meet all conditions legal in force, bearing the transport costs, if the option is for a doctor from another locality;
c) to change his chosen family doctor only after the expiration of at least 6 months from the date of registration on its lists;
d) sa benefits of services medical, drugs , materials health and medical devices in a non-discriminatory manner, under the conditions established by the framework contract and the methodological norms for its application;
e) sa out controls prophylactic, in conditions stable through the framework contract and the methodological norms for its application;
f) sa benefits of services of assistance medical preventive and health promotion, including for the early detection of diseases, in the conditions of the framework contract and of the methodological norms for its application;
g) sa benefits of services physician in the outpatient and in hospitals in a contractual relationship with houses of insurance health, under the conditions of the framework contract and of the methodological norms for its application;
h) sa benefits of services emergency medical conditions under the conditions of the framework contract and of the methodological norms for its application;
i) sa benefits of some services of assistance dental in the the conditions of the framework contract and of the methodological norms for its application;
j) sa benefits of treatment physiotherapy and of recovery in the the conditions of the framework contract and of the methodological norms for its application;
k) sa benefits of provision physician in the conditions FWC and of the methodological norms for its application;l) to benefit from home medical care services;
m) to guarantee their confidentiality regarding the data, especially regarding the diagnosis and treatment;
n) to be informed on the risks and benefits in case of medical treatments;
I will benefits of leave and allowances of insurance sociable of health under the conditions of the Government Emergency Ordinance no. 158/2005 and G. no. 400/2014 for the approval of the service packages and of the Framework Contract that regulates the conditions for providing medical assistance within the social health insurance system for the years 2014 - 2015.
B) THE OBLIGATIONS OF THE INSURED to be able to benefit from these rights are the following:
a) to register on the list of a family doctor;
b) to notify the family doctor whenever there are changes in their health;
c) to appear at the prophylactic and periodic controls established by the framework contract;
d) to notify within 15 days the family doctor and the health insurance company on the changes of the identity data or the changes regarding their classification in a certain category of insured persons;
e) to strictly observe the treatment and the indications of the doctor;
f) to have a civilized conduct towards the medical-sanitary personnel;
g) to pay the contribution due to the fund and the amount representing the co-payment under the conditions established by the framework contract and the methodological norms for its application;
h) to present to the medical service providers the justifying documents attesting the quality of the insured;
i) to accept the control of the health insurance house regarding the manner of granting the social health insurance holidays and indemnities;
j) to respect the scheduling for the provision of medical services from the basic package, based on the waiting lists, as the case may be;
k) to present to the doctor from the specialized outpatient clinic or to the hospital only after consulting the family doctor, except for emergencies and diseases that allow presentation directly to the specialist doctor, established by the framework contract and the methodological norms of its application .
