{"id":19223,"date":"2015-01-07T18:16:33","date_gmt":"2015-01-07T17:16:33","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=19223"},"modified":"2015-01-08T15:44:27","modified_gmt":"2015-01-08T14:44:27","slug":"zdravotni-pojistovny-vraceji-nemocnym-az-desitky-tisic-za-preplatky","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=19223","title":{"rendered":"Zdravotn\u00ed poji\u0161\u0165ovny vracej\u00ed nemocn\u00fdm a\u017e des\u00edtky tis\u00edc za p\u0159eplatky"},"content":{"rendered":"<p><strong>\u010cesk\u00e1 pr\u016fmyslov\u00e1 zdravotn\u00ed poji\u0161\u0165ovna (\u010cPZP) zve\u0159ejnila statistiky p\u0159eplatk\u016f za regula\u010dn\u00ed poplatky a doplatky, kter\u00e9 poji\u0161t\u011bnc\u016fm \u010dtvrtletn\u011b vypl\u00e1c\u00ed. Ve t\u0159et\u00edm \u010dtvrtlet\u00ed roku 2014 tato \u010d\u00e1stka p\u0159ekro\u010dila 7 milion\u016f korun a nejv\u011bt\u0161\u00ed \u010d\u00e1stka za tento kvart\u00e1l p\u0159\u00edslu\u0161ela mu\u017ei ze St\u0159edo\u010desk\u00e9ho kraje, kter\u00fd dostal zp\u011bt 12 tis\u00edc korun.<\/strong><!--more--><\/p>\n<p><em>ilustra\u010dn\u00ed foto: Photorack<\/em><\/p>\n<p>Ochrann\u00fd limit loni p\u0159ekro\u010dily tis\u00edce lid\u00ed, pacienti v\u0161ak \u010d\u00e1stky utracen\u00e9 za sv\u00e9 zdrav\u00ed sledovat nemus\u00ed, ud\u011bl\u00e1 to za n\u011b zdravotn\u00ed poji\u0161\u0165ovna.<\/p>\n<p>&#8222;B\u011bhem prvn\u00edch t\u0159\u00ed kvart\u00e1l\u016f lo\u0148sk\u00e9ho roku p\u0159ekro\u010dilo ochrann\u00fd limit 12 tis\u00edc poji\u0161t\u011bnc\u016f, za stejn\u00e9 obdob\u00ed p\u0159edminul\u00e9ho roku toto \u010d\u00edslo \u010dinilo pouze n\u011bco m\u00e1lo p\u0159es 9900. \u010cPZP z\u00e1rove\u0148 vr\u00e1tila poji\u0161t\u011bnc\u016fm o 2 miliony korun v\u00edce, p\u0159esn\u011b 10 234 522 K\u010d,&#8220; \u0159\u00edk\u00e1 tiskov\u00e1 mluv\u010d\u00ed \u010cPZP Elenka Mazurov\u00e1. Ochrann\u00fd limit je stanoven na 5000 K\u010d a je to maxim\u00e1ln\u00ed suma, kterou by m\u011bl za rok zaplatit pacient za zdravotn\u00ed p\u00e9\u010di. Pro d\u011bti a ml\u00e1de\u017e do 18 let a pro osoby nad 65 let je ochrann\u00fd limit 2500 K\u010d. Nad tuto \u010d\u00e1stku se lidem zaplacen\u00e9 poplatky a doplatky vracej\u00ed.<\/p>\n<p>&#8222;Existuj\u00ed poji\u0161t\u011bnci, kte\u0159\u00ed b\u011bhem jednoho \u010dtvrtlet\u00ed zaplat\u00ed na doplatc\u00edch hodn\u011b p\u0159es 10 tis\u00edc,&#8220; vysv\u011btluje Elenka Mazurov\u00e1 a dod\u00e1v\u00e1: &#8222;Nap\u0159\u00edklad za druh\u00e9 \u010dtvrtlet\u00ed uplynul\u00e9ho roku jsme jednomu pacientovi z Plzn\u011b vr\u00e1tili 16 427 K\u010d, ale v historii zn\u00e1me i p\u0159\u00edpady, kdy \u010d\u00e1stka za tak kr\u00e1tk\u00e9 obdob\u00ed p\u0159ekro\u010dila 24 tis\u00edc. V p\u0159\u00edpad\u011b vlekl\u00e9 nemoci se mohou ro\u010dn\u00ed doplatky vy\u0161plhat dokonce a\u017e na 50 tis\u00edc korun, jako u konkr\u00e9tn\u00ed pacientky v roce 2013.&#8220;<\/p>\n<p>Pr\u016fm\u011br vr\u00e1cen\u00fdch doplatk\u016f na jednoho poji\u0161t\u011bnce \u010cPZP za uveden\u00e9 obdob\u00ed roku 2014 \u010din\u00ed 852 K\u010d, \u010d\u00e1stka se tedy oproti stejn\u00e9mu obdob\u00ed p\u0159edlo\u0148sk\u00e9ho roku nijak v\u00fdrazn\u011b nezm\u011bnila (831 K\u010d za prvn\u00ed 3 \u010dtvrtlet\u00ed roku 2013). \u00dadaje za cel\u00fd rok 2014 bude m\u00edt poji\u0161\u0165ovna k dispozici zhruba v polovin\u011b \u00fanora 2015 a je\u0161t\u011b t\u00fd\u017e m\u011bs\u00edc hodl\u00e1 klient\u016fm rozes\u00edlat dopisy o vy\u00fa\u010dtov\u00e1n\u00ed p\u0159eplatk\u016f i vracet samotn\u00e9 p\u0159eplatky za posledn\u00ed \u010dtvrtlet\u00ed roku 2014.<\/p>\n<p>Regula\u010dn\u00ed poplatky ve zdravotnictv\u00ed byly zavedeny v roce 2008, aby se zamezilo pl\u00fdtv\u00e1n\u00ed a nadu\u017e\u00edv\u00e1n\u00ed zdravotnick\u00fdch slu\u017eeb. C\u00edlem ro\u010dn\u00edho ochrann\u00e9ho limitu je chr\u00e1nit p\u0159edev\u0161\u00edm chronicky nemocn\u00e9 pacienty p\u0159ed nadm\u011brn\u00fdmi v\u00fddaji za l\u00e9ky a n\u011bkter\u00fdmi regula\u010dn\u00edmi poplatky. Vybran\u00e9 poplatky mohou poskytovatel\u00e9 zdravotn\u00edch slu\u017eeb vyu\u017e\u00edt ke zlep\u0161en\u00ed sv\u00fdch slu\u017eeb.<\/p>\n<p>Do ochrann\u00e9ho limitu se zapo\u010d\u00edt\u00e1vaj\u00ed vedle 30korunov\u00e9ho poplatku za vy\u0161et\u0159en\u00ed u l\u00e9ka\u0159e a stejn\u011b vysok\u00e9ho poplatku za recept rovn\u011b\u017e doplatky za l\u00e9ky (z t\u011bch nejlevn\u011bj\u0161\u00edch variant). Nezapo\u010d\u00edt\u00e1v\u00e1 se tam poplatek za n\u00e1v\u0161t\u011bvu na pohotovosti, v l\u00e1zn\u00edch, l\u00e9\u010debn\u00e1ch a ozdravovn\u00e1ch, d\u00e1le zdravotnick\u00e9 prost\u0159edky vydan\u00e9 na poukaz, doplatky za p\u0159\u00edli\u0161 levn\u00e9 l\u00e9ky a v\u00fddaje za podp\u016frnou a dopl\u0148kovou l\u00e9\u010dbu.<\/p>\n<p>Od leto\u0161n\u00edho roku byly regula\u010dn\u00ed poplatky zru\u0161eny. Po sedmi letech tak pacienti p\u0159estali hradit 30 korun v ambulanc\u00edch a l\u00e9k\u00e1rn\u00e1ch, odpadla tak\u00e9 \u00fahrada 100 korun za denn\u00ed pobyt v nemocnic\u00edch, l\u00e9\u010debn\u00e1ch dlouhodob\u011b nemocn\u00fdch a l\u00e1zn\u00edch. Zachov\u00e1n z\u016fstal jen poplatek 90 korun p\u0159i n\u00e1v\u0161t\u011bv\u011b na pohotovosti, kter\u00fd se t\u00fdk\u00e1 d\u011bt\u00ed i dosp\u011bl\u00fdch. Poji\u0161\u0165ovna p\u0159edpokl\u00e1d\u00e1, \u017ee zbyl\u00e9 \u010d\u00e1stky regula\u010dn\u00edch poplatk\u016f roze\u0161le v pr\u016fb\u011bhu prvn\u00edho a druh\u00e9ho kvart\u00e1lu leto\u0161n\u00edho roku.<\/p>\n<p>Do ochrann\u00e9ho limitu budou nad\u00e1le zapo\u010d\u00edt\u00e1v\u00e1ny doplatky za l\u00e9ky, p\u0159eplatky nad limit bude \u010cPZP nad\u00e1le vypl\u00e1cet sv\u00fdm poji\u0161t\u011bnc\u016fm \u010dtvrtletn\u011b tak, jako dosud.<\/p>\n<p>\u010cPZP bude st\u00e1le sledovat u ka\u017ed\u00e9ho poji\u0161t\u011bnce ochrann\u00fd limit, do kter\u00e9ho se budou nad\u00e1le zapo\u010d\u00edt\u00e1vat zapo\u010ditateln\u00e9 doplatky za l\u00e9ky. \u010ctvrtletn\u011b budeme poji\u0161t\u011bnc\u016fm vracet p\u0159eplatky nad tento limit. V roce 2015 z\u016fst\u00e1v\u00e1 ochrann\u00fd limit ve stejn\u00e9 v\u00fd\u0161i jako dosud (ve v\u00fd\u0161i 5 000 K\u010d, u d\u011bt\u00ed mlad\u0161\u00edch 18 let, v\u010detn\u011b kalend\u00e1\u0159n\u00edho roku, ve kter\u00e9m dovr\u0161ily 18. rok v\u011bku, a u poji\u0161t\u011bnc\u016f star\u0161\u00edch 65 let, v\u010detn\u011b kalend\u00e1\u0159n\u00edho roku, ve kter\u00e9m dovr\u0161ili 65. rok v\u011bku, ve v\u00fd\u0161i 2 500 K\u010d).<\/p>\n<p>\u010cesk\u00e1 pr\u016fmyslov\u00e1 zdravotn\u00ed poji\u0161\u0165ovna &#8211; tiskov\u00e1 zpr\u00e1va<\/p>\n","protected":false},"excerpt":{"rendered":"<div class=\"mh-excerpt\"><p>\u010cesk\u00e1 pr\u016fmyslov\u00e1 zdravotn\u00ed poji\u0161\u0165ovna (\u010cPZP) zve\u0159ejnila statistiky p\u0159eplatk\u016f za regula\u010dn\u00ed poplatky a doplatky, kter\u00e9 poji\u0161t\u011bnc\u016fm \u010dtvrtletn\u011b vypl\u00e1c\u00ed. Ve t\u0159et\u00edm \u010dtvrtlet\u00ed roku 2014 tato \u010d\u00e1stka p\u0159ekro\u010dila <a class=\"mh-excerpt-more\" href=\"https:\/\/www.invarena.cz\/?p=19223\" title=\"Zdravotn\u00ed poji\u0161\u0165ovny vracej\u00ed nemocn\u00fdm a\u017e des\u00edtky tis\u00edc za p\u0159eplatky\">[&#8230;]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14319,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-19223","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/19223","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=19223"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/19223\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14319"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=19223"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=19223"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=19223"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}