The list of health care services contains all the medical services, procedures, the drugs necessary in the hospital and other items belonging to the health insurance package with their prices and the conditions of payment thereof. The Health Insurance Fund pays for the services on the list of health care services to the health care institution if it is provided to the person with health insurance on a medical indication.
The criteria for amending the list, and the conditions and procedures of their assessment, is established by the Government of the Republic. The list of health care services will be updated annually, according to need and the financial resources of the fund, so that a person can receive the best possible care, taking into account the evidence-based manner of the treatment, including medical efficacy and cost-effectiveness.
The Health Insurance Fund is able only to pay for those health care services, under these conditions and at the maximum price, which is set by the Government of the Republic in the Regulation of Health Care Services. The cost of the tools for the provision of the services, such as equipment, instruments, etc., are changing, and the methodologies and the treatment organization used in health care are evolving. Therefore, the costs are also changing, and financing must go along with it. Thus, the choice of health care services and their prices must be constantly updated. In order to make decisions on amendments, advance cooperation is performed with specialists and involved experts in their field, and then a broad-based analysis is performed. The list of health care services is updated in collaboration with family doctors, hospitals, and specialists in the field.