LAW OF THE AZERBAIJAN REPUBLIC

of October 28, 1999 No. 725-IQ

About medical insurance

This Law establishes organizational, legal and economic basis of medical insurance of the population, governs the relations between subjects of medical insurance.

Chapter I. General provisions

Article 1. Basic concepts

1.1. For the purposes of this Law the following basic concepts are used:

1.1.1. service package - set of international non-proprietary names of medicines (names of active ingredients) and medicines for provision insured medical services of the corresponding type, amount and conditions, and also use of medicines in out-patient or stationary conditions at the expense of financial resources of compulsory medical insurance;

1.1.2. it is cancelled;

1.1.3. it is cancelled;

1.1.4. insurance premium - amount of money which the insurer shall pay to the insurer according to the procedure, established by this Law, in exchange for acceptance or distribution of risks;

1.1.5. the insurer - the local legal entity having the corresponding license for implementation of insurance activity according to the Law of the Azerbaijan Republic "About insurance activity", being the agreement party of insurance incurring the obligation on issue of insurance payment in case of the loss occurrence provided by the insurance contract, according to the procedure, the established laws on compulsory medical insurance or the agreement and the body (structure) established by relevant organ of the executive authority in relation to compulsory medical insurance;

1.1.6. the insurer - person paying on its own behalf or on behalf of insured insurance premium in the cases provided by this Law;

1.1.7. insured - physical persons which health is insured in obligatory or voluntary procedure;

1.1.8. insurance payment - the financial resources paid to medical institution or the pharmaceutical organization according to the procedure, provided by this law, according to envelope of services and rates concerning compulsory medical insurance in case of loss occurrence, and also in the amount of conditional compensation, and concerning voluntary medical insurance - according to the agreement of voluntary medical insurance;

1.1.9. insurance limit - the extreme number of the medical services rendered insured within calendar year in the cases provided by service package within compulsory medical insurance;

1.1.10. insured event - the event or the arisen case which are the basis for implementation of insurance payment based on this Law (including preventive measures);

1.1.11. it is cancelled;

1.1.12. it is cancelled;

1.1.13. the agreement on rendering medical services - the contract between the medical institution and body (structure) established by relevant organ of the executive authority for the purpose of rendering medical services within compulsory medical insurance;

1.1.13-1. The contract for leave of medicines in out-patient conditions - the agreement signed between the pharmaceutical organization and body (organization) determined by relevant organ of the executive authority for the purpose of leave of the medicines applied in out-patient conditions, to insured persons within compulsory medical insurance;

1.1.13-2. the positive list of medicines (further - the positive list) - set of the medicines applied in out-patient and polyclinic conditions under international non-proprietary names (names of active ingredients) of the medicines provided in service package;

1.1.14. territorial medical subdivision - group the body (structure) established by relevant organ of the executive authority, the medical institutions placed under its authority entering the state health care system on administrative territorial units;

1.1.15. the joint financing amount - the part of the losses which resulted from insured event or damage suffered which is not covered by ensuring compulsory medical insurance and paid insured;

1.1.16. medical institution - the legal entity entering the state or non-state health care system and performing medical activities;

1.1.17. The conditional amount of compensation - the size determined according to the procedure, provided by this Law, for implementation of insurance payments for the medicines included in the positive list.

1.2. Other concepts used in this Law have the values established by regulatory legal acts of the Azerbaijan Republic.

Article 1-1. Medical insurance and its forms

1-1.1. Medical insurance as form of social protection of the population in the sphere of health protection guarantees obtaining insured medical care, providing with medicines and medical means in case of loss occurrence.

1-1.2. Medical insurance is performed in obligatory and voluntary form.

1-1.3. Compulsory medical insurance, being component of the national social insurance, use by them provides the compulsory health insurance insured during the moment loss occurrence of medical care at the expense of financial resources and within service package, and also of medicines and medicines.

1-1.4. Voluntary medical insurance provides insured additional medical service and the medicinal help.

1-1.5. The health insurance certificates provided by articles 5 and 15-13 of this Law and also the data specified in the direction provided by articles 15-28 of this Law can be provided (are received) by means of information system of the electronic government. Submission of the data specified in these documents by means of information system of the electronic government is equated to submission of these documents.

Article 2. Legislation of the Azerbaijan Republic on medical insurance

2.1. The legislation of the Azerbaijan Republic on medical insurance consists of the Constitution of the Azerbaijan Republic, this Law, the Civil code of the Azerbaijan Republic, the Law of the Azerbaijan Republic "About the Central bank of the Azerbaijan Republic", the Law of the Azerbaijan Republic "About insurance activity", other regulatory legal acts and interstate agreements supported by the Azerbaijan Republic.

2.2. The relations in the sphere of medical insurance in the Alyatsky free economic zone are governed according to requirements of the Law of the Azerbaijan Republic "About the Alyatsky free economic zone".

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