Tasks of the National Health Insurance Fund of Hungary (Hungarian acronym: OEP)
Telefon: (+36-1) 350-2001
Fax: (+36-1) 298-2403
The OEP, as a central agency, performs the functions set out in legislation, carries out the tasks relating to the management of the National Health Insurance Fund, the maintenance of records, keeping financial accounts and fulfilling the reporting obligation.
The National Health Insurance Fund is supervised by the Government of Hungary, the central official organ of health insurance is managed by the Government through the Minister of Human Resources.
The core activity of the National Health Insurance Fund Administration includes:
functions relating to the management of the Health Insurance Fund, including funding and reimbursement accounting, the maintenance of records, keeping financial accounts and fulfilling reporting obligations, participates in drafting the Health Insurance Fund budget, the preparation of the final accounts and the tasks entrusted to it in relation to the determination of the detailed budgetary allocations of the Health Insurance Fund,
- performs the tasks entrusted to it in relation to healthcare services that are excluded from health insurance,
- carries out procedures relating to the social security assistance of pharmaceuticals and medical aids and the adoption of health technologies,
- maintains a unified record of the pharmaceuticals, medical aids and healthcare services receiving social security reimbursement,
- maintains health insurance records,
-conducts the procedures of legal remedy, individual authorisation and the leniency procedures provided for by legislation,
-manages and operates the supervisory, financial, professional and internal control system as defined in specific legislation,
-manages, operates and develops the information systems needed to perform health insurance functions, collects statistical data and publishes such data with the level of detail required,
-comments the mandatory health insurance bills, proposes amendments and initiates new legislation,
-takes part in the analysis and evaluation of health insurance related processes and in the elaboration of short-, medium- and long-term development concepts,
-within its scope of responsibility, the OEP contributes to the preparation and implementation of international treaties related to social security, maintains contact with the designated competent institutions and bodies, performs the coordination tasks stemming from EU membership and participates in the professional work of special EU committees and international organisations,
-provides information on health insurance and ensures the development of services allowing the enforcement of claims,
-ensures the education, training and examination of leaders and officers of the health insurance sector, including the officers of health insurance disbursement units,
-performs any tasks entrusted to it by legislation or the deed of foundation.
Healthcare services funded by the National Health Insurance Fund
Benefits in kind and cash benefits are provided by the OEP to the insured persons.
Benefits in kind includes cost-free healthcare services such as preventive examinations, primary healthcare, specialised inpatient care, specialised outpatient care, certain dental care, rehabilitation, the ambulance service, patient transport and accident-related benefits, drug reimbursement, reimbursement for medical aids, medical spa services, reimbursement of travel expenses and benefits granted on grounds of equity.
Cash benefits provided by the OEP include sickness benefit, prenatal allowance, child care fee and accident-related benefits.
The OEP has contractual relations with the healthcare providers. Investment and development costs of healthcare institutions are not covered by the Health Insurance Fund budget. The funding of these institutions is provided by their owners.