November, 2015

The efforts of the association ROMA S.O.S. from Prilep in cooperation with associations [1] from 10 municipalities in Macedonia, in the period 2013 – 2015, resulted in introduced amendments to the Law on contributions for compulsory social insurance (LCCSI) in December 2014 and amendments to the Law on Health Insurance (LHI) in June 2015.

Legislative amendments contributed to simplify the procedure for exercising the right to health insurance for the unemployed and people with lower income (HIF insurance category), thereby providing continuity in the enjoyment of the right and constant health treatment for the most vulnerable insurers.

  1. Amendments to LCCSI in December 2014

In the period 2011-2014, all unemployed and people with lower income in order to continue their right were obliged to pre-register in the period from February to March in the HIF by submitting a Statement of income (form) by which they certified that they had no income higher than 96.600 denars in the previous years – a condition to exercise the right on the burden of the Budget of the Republic of Macedonia. [2]

By the introduced amendments, the procedure for pre-registration was abolished i.e. obligation of the insurers to submit a Statement of income, and the HIF in cooperation with the Public Revenue Office in 2015 checks the income for each insured ex-officio and delivers Decisions for extending the right at their home address, which automatically extends their right.

However, people who in 2014 had income higher than 105.600 denars [3], , after checking in the Public Revenue Office, HIF starting from the 1st September 2015 will deliver Decisions for abolishment of the right. These people will have to change the basis for insurance according to the determined income through submission of new documents.

Since the delivery of the Decisions is slow, and some insurers have different addresses in their ID and the actual place of residence, we appeal each insured person in this category to check the status of his/her health insurance on the website of the HIF “my insurance” and thus timely to intervene and prevent abolishment i.e. paying privately for using health services.

  1. Amending LHI in June 2015

Insurers who submitted a Statement of income in the process of re-registration in the period 2011-2014 have become potential criminals in the country since the HIF in the cases where it was found to have had higher income than the one that was presented, filed Criminal charges for submitted false Statement, and Basic courts brought Judgments for some of them by which they were declared guilty. [4]

By the amendments all criminal proceedings initiated by HIF, as well as in front of the basic courts stopped. Therefore, convicted persons are entitled to request deletion of the penalty from criminal records if they have already received a Judgment by the Basic Court. It is very important to know that the proceedings upon requests for compensation for the used health services have been stopped as well.

Since these procedures have been conducted without insurers knowing it, we appeal to them to refer to the HIF and check personally whether there have been charges filed against them or a Judgment has been brought, and after confirmation of that information to request deletion of the charges i.e. to address associations for further information and assistance.

We also appeal to the Ministry of Justice to adopt a Manuscript for procedure as soon as possible according to which actions for deletion of the charges from the criminal records will be undertaken, and for which the existing legal deadlines have been exceeded for several months.

In order to inform the citizens about the changes as well as the available assistance provided by associations, tribunes in the roma communities have been organized entitled as “Verification of the health insurance can provide continuous treatment” by the following order:

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Association Municipality Period Media
Bela Kula
Struska no. 31
Phone: 076 773 963
Kicevo 9-th November
 TV Uskana
SONCE
Ilirija no. 39/14
Phone: 044 352 390
Tetovo 16-th November
 TV Kiss
Bairska Svetlina
Jorgo Kostovski nn
Phone 047 241 694
Bitola 18-th November
 TV Orbis
KHAM
Marsal Tito nn
Phone: 033 413 695
Delcevo 19-th November
 TV Star
 TV Sitel
LIL
Nikola Ostrovski no. 2
(Local community Dame Gruev)
Phone 02 6134 076
Gorce Petrov 23-th November
 MTV2/Bijandipe
1. CDRIM
Vinicka no. 10
Phone: 02 2652 5912. H.E.R.A.
Debarca no. 56/4
Phone: 02 3290 395
Yougth Center
I want to know
Phone: 02 2651 955
Suto Orizari 24-th November
 TV 24 Vakti
 TV Sutel

Picture of the Flyer

Picture of the Leaflet

 


 [1] KHAM – Delcevo, LIL – Skopje, Bela Kula – Kicevo, H.E.R.A. – Skopje, CDRIM – Skopje, National Roma Centre – Kumanovo, Bairska Svetlina – Bitola, SONCE – Tetovo, ESE Skopje, RRC – Skopje and Association for Roma rights – Stip. The activities are conducted within the project Roma Health – basic human right, financially supported by the Foundation Open Society Macedonia, and technically by National Democratic Institute – Macedonia.

[2] Persons who used to miss the deadline for submitting the Statement of income were facing abolishment of the right to health insurance i.e. each year about 107. 502 insurers or 50% of the total number of insured persons who had such an obligation.

[3] Since the minimum salary in Macedonia increased in 2015, there was a change of the limit of the income for the insurers of the HIF who exercise their right on the burden on the Budget of the Republic of Macedonia.

[4] Criminal charges filed by the HIF were filed against 6 760 insurers, and for 1 804 of them Judgments were brought according to the responses of 20 Primary Public Prosecution Offices given upon our request for public information in February 2015 (which refer to the period 2011-2013).