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Ред за получаване на протоколи

by in Полезно за пациенти 28.01.2011

За да получите протоколи за назначена домашна терапия трябва да преминете през няколко стъпки:

  1. Да провери дали е здравно осигурен. Редовно проверявайте здравноосигурителния си статус. Това е изключително важно за да получавате лекарства и лечение. Може да направите проверка  в интернет на сайта на Националната агенция за приходите www.nap.bg както и в офисите на НАП. Лицата получаващи пенсия за инвалидност, за възраст както и децата до 18 години  са здравно осигурени за сметка на държавата.
  2. Да закупи рецептурна книжка на хронично болния. В случай, че пациента няма вече издадена рецептурна книжка трябва да закупи такава от аптека продаваща медицинска документация на здравната каса.  Личния ви лекар може да ви насочи къде се намират тези книжарници във вашия град.Книжката се попълва от личния лекар и се заверява в Районната здравноосигурителна каса.(РЗОК)
  3. Да получи протокол 1А от лечебно заведение. След набор от изследвания направени в лечебното заведение, посочено в изискванията за лечение публикувани на сайта на НЗОК на пациента ще бъде издаден Протокол за предписване на лекарства заплащани от НЗОК/РЗОК . Протокол се издава за всеки един от медикаментите, които се отпускат от НЗОК. Тук можете да намерите информация за необходимите ви изследвания, ограничаващите критерии за всеки медикамент. Обръщаме внимание, че след като стана възможно изписването на инхалаторен антибиотик Колистин, съществува изискване относно микробиологията, която предоставяте. При антибиограмата трябва да бъде тествана чувствителността на колистин. Протоколите са валидни в рамките на 6 месеца. Когато вземете последната рецепта и минат точно 6 месеца от датата на издаването им, можете да посетите своят наблюдаващ лекар, за да ви издаде следващите протоколи. Добре е да не се бавите, тъй като процедурата изисква време.
  4. Да подаде документите в РЗОК на територията на която е направил избор на личен лекар.
    Документите са:
    -Заявление до директора на РЗОК.
    -Попълнено и подписано Приложение 1А.
    -Пълния набор от изследвания включен в Изискванията. При наличие на  хоспитализация се прилага и епикриза с номер ИЗ.
    -Протокол за предписване на лекарства заплащани от НЗОК/РЗОК.
    -Декларация за информирано съгласие по образец.
    Уверете се, че всички необходими документи са приложени. Епикризата, експертните становища  и изследванията трябва да бъдат в оригинал или заверено от издалия документа копие.  Липсата на дори един документ може да доведе до отказ на НЗОК докато не бъдат представени всички необходими изследвания. Документите не се връщат, така че е добре да си направите копия. При подаването запазете входящия номер.
  5. В 5 дневен срок РЗОК изпраща документите в НЗОК. Там се свиква комисия, която взема решение. Ще бъде уведомени за решението с писмо. Биха могли да се свържат и по телефона. Здравната каса дава отговор от 2 до 4 седмици. В случай на забава се свържете по телефона или на място в офисите на РЗОК за да получите информация докъде са придвижени документите ви.
  6. Ако бъдете уведомен че отпускането на лекарството е одобрено, одете в РЗОК откъдето ще получите заверен Протокола за предписване на лекарства заплащание от НЗОК/РЗОК. С протокола и рецептурната книжка отидете при личния ви лекар, който ще ви издаде рецепта. Допълнително ще получите информация в кои аптеки имащи договор със Здравна каса ще може да получавате лекарствата. Консултирайте се с личния ви лекар кога ще ви издаде следващата рецепта.  Следете срока на протокола. Един месец преди изтичането му трябва да входирате нов комплект документи и актуални изследвания в РЗОК. Този път вместо приложение 1А ще подадете приложение 1Б.
  7. Получаване на лекарството от аптеката. В аптеката трябва да представите лична карта, заверена рецептурна книжка, оригинален протокол, рецепта от личния лекар. Рецептата трябва да бъде изпълнена в срок от 15 дни от издаването. Ако пропуснете този срок, няма да получите лекарства за месеца. Имайте предвид, че аптеките не обработват рецепти, заплащани от Здравна каса в почивни и празнични дни.
  8. Ако получите отказ за отпускане на лекарство. Уведомете лекуващия екип, издал протокола за причината за отказа. Той ще ви консултира как да получите документ за липсващото изследване.  Незабавно входирайте документа в РЗОК. Настоявайте това да стане към вече подадения входящ номер. Ако смятате, че РЗОК неправомерно е забавила или отказала лекарства може да подадете жалба в РЗОК и Министерството на здравеозването. Може да се обърнете и към пациентските организации, откъдето ще получите информация и съдействие.

Повече информация, относно новите процедури може да намерите на интернет страниците на пациентските организации на хора с редки болести

  • Национален алианс на хората с редки болести: www rare-bg.com
  • Асоциация на болните от акромегалия в България:www.ababbg.com
  • Организация на таласемиците в България: www.wilsonbg.org
  • Българска асоциация Болест на Уилсън:www.wilsonbg.org
    • Бълграска асоциация “Прадер-Уили синдром“: e-mail: stzonev02@abv.bg
  • Национална асоциация “Първична пулмонална хипертония”:www.apph-bg.org
  • Национална Гоше асоциация: www.gaucher-bg.org
  • Национална асоциация по сирингомиелия:e-mail: g.kolchakova@abv.bg

Критериите, качени в сайта на НЗОК за болните от муковисцидоза, бяха преработени благодарение експертното мнение на доц. Иванка Галева – ДК Александровска и доц. Каста Костов – ВМА.

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