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The law on social insurance and pensions promulgated by law no. 148 of 2019 allowed many sectors affected by the provisions of the law to benefit from health insurance, and from these groups (contract workers, entrepreneurs and the like, irregular workers, pensioners).
In order for the patient to be able to benefit from health insurance benefits, the law requires that he must subscribe for a period of three consecutive months or six intermittent months, so that the last two months are continuous..
And it has determined that the provisions of this insurance will cease to be effective during subsequent periods:
The duration of the insured person’s work for an agency that is not subject to this insurance
Duration of the recruitment, detention and mandatory summoning of the armed forces.
– The periods of special holidays, secondments, study permits and scientific missions that the insured person spends outside the country.
The law establishes the right of the patient and the insured person during pregnancy and childbirth to medical treatment and treatment according to the provisions contained in the Law on the Integral Health System promulgated by Law no. (2) of 2018.
The law also provides for the right of the insured to obtain wage compensation in the event of illness between him and the performance of his work, and the competent authority must pay the wage compensation during the period of his illness. This allowance is estimated at 75% of his daily wage for which contributions have been paid for a period of ninety days, after which it is increased to 85% of the wage. Mentioned.
Notwithstanding the foregoing, a patient with a chronic illness is granted an allowance equivalent to the contributory salary for the duration of his illness until his recovery or stabilization of his condition in order to allow him to return to work or to be completely disabled..
The party obliged to pay compensation may decide to suspend payment for the period in which the insured violates the treatment instructions.
The units of the administrative apparatus of the State, the public authorities, the units of the public sector and the units of the public enterprise sector are obliged to implement this text without the need for a decision by the chairman of the board of directors of the Authority concerned. ‘health insurance..
The insured woman, in the event of pregnancy and childbirth, is entitled to compensation of wages equal to 75% of her daily wage for which contributions have been paid by the competent authority for the compensation of wages for the period of pregnancy and leave for childbirth under the law on childhood or labor law or civil worker regulations in the state, public sector or public affairs sector According to the circumstances, provided that the period of your participation in the insurance is not less than ten months.
The competent authority must pay compensation for the costs of transporting the patient by regular means of transport from the place of residence to the place of treatment if he is outside the city where he resides and by special means of transport whenever the attending physician decides. that the patient’s health conditions do not allow him to use normal means of transport, and the head of the authority issues the approval The Board of Directors decides the rules governing the transfer and its expenses.
General provisions in health insurance:
– The provisions of this insurance do not affect the rights that the injured or sick person may have under laws, regulations, special systems, joint contracts, agreements, etc., in relation to the compensation of wages and service levels, in in relation to the amount exceeding the rights established in this insurance.
The treatment and medical assistance of the injured or sick person in the areas of care designated for them by the health insurance authority must comply with the rules established by the relevant draft law.
– The competent health insurance authority is obliged to examine workers exposed to infection with one of the occupational diseases listed in table no. (1) attached to this Act, in exchange for its withdrawal in exchange for a benefit of fifty pounds for each insured person exposed to the aforementioned diseases and the employer bears it.
– The care authority is obliged to notify the injured person or patient of the end of treatment, the disability and the percentage of disability he may have left, and the patient can request a review of the report on the end of treatment or the delay of the disability .
– The treating authority is required to notify the above mentioned in the previous paragraph both to the employer and to the authority, indicating the days of delay in treatment, if any, and the decision of the care institution on the duration of the leave due to illness it is binding on the employer.
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