In the face of disease
The ageing of the body is associated with various molecular and cellular changes that in turn result in gradual deterioration of our physical and mental abilities and an increasing risk of developing various diseases. Although biological changes occur in all people, both their manifestation and effects vary from person to person.
There are, however, diseases that are more prevalent at older ages, such as hearing loss, vision problems, various back or neck pains, osteoarthritis, depression, dementia, etc.
Factors such as physical condition, heredity and how well you take care of yourself affect the extent to which these changes aggravate your health. Old age is also often associated with other changes in our lives, such as retirement, relocation, the loss of friends, partners, etc. All of these factors equally affect our well-being.
Visiting a doctor and following the treatments suggested are necessary for staying healthy, regardless of age. As we get older, however, medical attention is needed and sought after more often.
Affordable and people-centred programmes for the provision of health services are therefore particularly important. Increased use of healthcare services unfortunately also entails increased costs. When the need arises to pay our contribution for health care as insured persons, the amount can be higher than our income can cope with, especially when the conditions are severe or there is a need for ongoing care. Such a case could lead to financial disaster.
For all the above reasons it’s important to be informed about the insurance coverage options offered, as they can prove to be lifesaving in future emergencies.
Benefits & shortcomings in public and private insurance
In Greece, insurance coverage is provided through the public health system and/or private insurance companies, with the Constitution ensuring everyone's right to protect their health and genetic identity. It is the state's obligation to take care of the health of its citizens and take special measures to protect the elderly.
Public Health Insurance: National Health System (ESY)
Services covered by ESY:
- Free or low participation in hospital care for operations, tests and hospital stay.
- Primary healthcare services with visits to doctors and tests in public health centers and hospitals.
- Access to pharmaceutical products with participation in the purchase cost, usually from 0% to 25%, depending on the condition and the drug.
- Diagnostic tests with no or low participation for laboratory and imaging tests.
- Coverage of expenses for prenatal tests, childbirth and medical care of mother and child.
- Physiotherapy and rehabilitation after serious health problems.
- Coverage for specific cases of home hospitalization.
Services not covered by ESY:
- Dental services for emergencies or for children.
- In relation to optical products, insured persons receive a specific amount of compensation amounting to approximately €100 for eyeglasses every four years, unless their condition worsens.
- Pharmaceutical products not related to serious conditions such as painkillers, vitamins or dietary supplements, ointments and eye drops.
- Cosmetic procedures or treatments for aesthetic improvement that are not medically necessary.
- Alternative therapies such as homeopathy, acupuncture and others, unless approved by the National Organization for the Provision of Healthcare Services (EOPYY) as part of medical care.
- Regarding physiotherapy and rehabilitation, only basic physiotherapy and rehabilitation for specific conditions are covered, such as rehabilitation after surgery or accidents. Additional or more specialized physiotherapy may not be partially or fully covered.
- Patients bear the extra cost incurred by changing rooms or moving from a ward.
- Tests outside partnered centres are also covered by the patient.
- ESY covers specific cases of treatment abroad, when these cannot be carried out in Greece. However, it does not cover treatment or surgery in private hospitals abroad, unless there is special permission and coverage by EOPYY.
- While home care is provided in special cases, for more general needs – such as help with everyday life and home nursing care – full coverage is not provided.
Private health insurance
By choosing a private health insurance plan, you are entering into an agreement with an insurance company. The term and benefits of each plan vary. It’s important to carefully examine the benefits and obligations arising from each insurance policy with the help of an authorized insurance agent.
The option of insurance is also available to older people, as some insurance companies offer programs regardless of the age of entry of the insuree.
Private health insurance is often chosen to complement the public system’s coverage, to avoid delays in medical tests, or to enable access to better services.
Services that may be covered by private insurance:
- Selection of doctors and hospitals.
- Hospital coverage in private hospitals, full or partial, for hospitalization, tests, surgery.
- Total or partial coverage of pharmaceutical products not covered by EOPYY.
- Diagnostic tests in private centers without the waiting lists of public hospitals.
- Preventive tests and check-ups.
- Many private insurance plans include coverage for medical services outside Greece, which can be useful in cases of serious illness or specialized treatments.
- Dental coverage.
Prevention is your ally
The public health system covers basic medical needs and services. Private insurance, which can be drawn up alongside public insurance, provides more flexibility, speed and access to a wider range of medical services, always depending on individual needs and our financial capacity. Because health care can become very expensive and burden our budget, private health insurance helps reduce this financial burden and fill the gaps in the public system.
What we should keep in mind is that health insurance is not only useful to us during periods of our lives when we are sick. Prevention and medical attention help us stay healthy throughout our lives, prevent diseases before they become dangerous, and save money.
Older people deserve to enjoy quality of life, which enables them to stand by younger generations, which is extremely beneficial for everyone. As long as they receive care from a supportive environment, which includes access to high-quality medical services.
Source: αθηΝΕΑ, Financially Empowered newsletter