National health insurance card becomes compulsory this month

As of this month, Romanians can start using their national health insurance card. From now on, patients will be able to use it whenever they see their doctor, go to the hospital or pharmacy. The card can also be used by providers of medical services and equipment. From May, the card will be the sole validation instrument for people insured in the public health system.

Until April 30, the card can be used in parallel with the current system. After this date, it will become the only proof of entitlement to medical services in the public health insurance system, according to information from the National Health Insurance House (CNAS).

Citizens who wish to check whether they are still insured in the public health system can do so simply by applying to the CNAS: only a personal ID card code is required to check eligibility. The application gives the date when the person became insured but does not give any details regarding the name of the family doctor or medical background. The system will also return the Insured Identification Code, which is printed on the health card.

The national health insurance card serves to prove that the person is insured and also confirms their presence at the provider of medical services. The introduction of the cards is intended to reduce red tape and corruption in the medical sector.
Those in need of emergency medical services will not need to provide a national health insurance card. These services are part of the minimum package of medical services that are provided both to insured and non-insured individuals.
In the event of continuous hospitalization, the card will be used twice, upon admittance and discharge from hospital, so that the insurance beneficiary’s length of stay is clearly stipulated. During this time, no other services outside the hospital unit will be covered.

Anytime the health card is used, the system will record the time and place.

Children will not be provided with a health card and will receive medical services based on their parents’ card. Pregnant women, who do not pay social health contributions, will only be insured during their pregnancy.

People who decline, for religious or other reasons, to use the national health card must submit a statement to the health insurance house they belong to, together with the national card that was distributed to them. Such patients may prove their eligibility through an insurance certification with a three-month validity which will be released by their health insurance house at their request.

If the insured person loses the card or has to change the personal data on it, a new one will be provided. The user must go to the insurance house to submit a request, a copy of their ID card and the cost of the card and postal delivery services. The production cost of the card is EUR 2.2 plus VAT, and the cost of distribution is RON 2.74 plus VAT.

Within a month of submitting these documents, the beneficiary will receive a new card at home. During this time, the card will be inactive in the system and the holder can only access medical services based on a certificate that stipulates that the card is being replaced.

The Romanian Post and the CNAS have signed an agreement for the distribution of health cards across the country. The RON 37.5 million (EUR 8.5 million) contract runs for four years, according to Romanian Post officials.

The delivery of the health cards started on September 18. In total, approximately 13.6 million cards will be sent out over the four-year period.

National health insurance cards not delivered by post will be distributed by health insurance houses. The insured person needs to either go to the health insurance house they belong to or to pick up the card from their family doctor when they show up for an appointment.

The national health cards are printed solely with the personal identification data of the insured person. There is no medical information printed on the card, but this can be added by the family doctor, at the request of the patient.

The card chip contains the following information: name and surname of the insured person, the unique code for identification in the social insurance system, the card identification number, the birth date of the beneficiary and the validity period, which is five years.

The card can be activated by any provider of medical services, with the exception of pharmacists. The insured person does not need to go to the doctor to activate the card.

According to the president of the CNAS, activation takes about 30 seconds and consists of replacing the card’s default PIN with a four-digit PIN chosen by the insured.

The new PIN is introduced and confirmed personally by the patient. The insured person must change the PIN, or else the card remains inactive and cannot confirm eligibility for medical services in the system.

Once activated, the card must be used for every doctor’s appointment or visit to the pharmacy. The PIN will be introduced each time the insured person benefits from a medical service, for the validation and coverage of services from the public health insurance fund.

But even though things appear simple on paper, the situation on the ground is different. Some family doctors have complained about problems in the activation of patients’ health cards.

“We have not managed to use the health cards, because the application is not working. The system is blocked,” a family doctor in Bucharest told Mediafax newswire.

The president of the National Society for Family Medicine, Rodica Tanasescu, said that activation of the health cards burdened GPs.

“This is just another burden. We have activated several hundred cards, but there were days when the system simply did not work or there were problems with the card. For the problems that we could not solve, we sent the insured persons to the Health Insurance House,” she told Mediafax newswire.

According to GPs, the activation of the card takes longer than announced by the CNAS management. Tanasescu said that card activation takes between three and five minutes. “We need several minutes for the activation of the card. We also agreed to activate the card of the husband, wife and child where one family member comes to the consultation with the others’ cards,” she said.

According to the CNAS president, Vasile Ciurchea, in the cases where the card could not be activated, this was due to an incompatibility issue.

“The providers using a different application than the one placed at their disposal free of charge by the CNAS must make their personal system compatible with that of the CNAS. In all the rules on validating the contract for the provision of medical assistance, it is stipulated clearly that all reports must be submitted into a system that is compatible with the CNAS application. So they should either take the application free of charge from us or bring a specialist to make the two systems compatible,” said the president of the CNAS.

The health card is blocked when the PIN code is entered wrongly five consecutive times. In this situation, the doctor should call the helpdesk on 021 202 69 95 or send an e-mail to suport.ceas@casan.ro, and give the necessary information regarding the blocked card.

The phone number printed on the health card, 0800 800 950, is for insured people who have questions about their health card. Providers of medical services must call the helpdesk to receive the necessary support.

According to the CNAS management, a unified and centralized helpdesk solution will be implemented in order to optimize and simplify all procedures related to the CNAS IT system.

The national health insurance card does not work when the user is in another EU country. Romanians intending to travel elsewhere in the bloc are advised to obtain the European health insurance card based on which they will receive medical assistance, but only in certain state clinics and hospitals in the public system of the country in question. Not all treatment is covered by this card and the beneficiary of medical services may also have to cover some of their medical expenses.

Otilia Haraga

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