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Amerikanska -- View topic - Högkostnadskort: huh?

 
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Amerikanska Forum Index -> Life in Sweden

Högkostnadskort: huh?

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Tess
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Joined: Apr 28, 2003
Posts: 839
Location: Stockholm
Högkostnadskort: huh?

Can someone please explain, using very small words, how the högkostnadskort (high-cost health card) works? I have one that hardly anyone ever seems to stamp because they're not eligible (not connected to the state system or something?). Now I am about to submit to Payroll some receipts for doctor's visits-- some of which were covered by the högkostnadskort and some of which weren't, but all of which I paid for. I realized that I also have a "frikort" which I'm afraid I was supposed to be using all this time, but I'm not sure if it is still valid. If I was supposed to be using it, does that mean I'm SOL in terms of getting these costs reimbursed?

(Of course I wouldn't have incurred all these costs if they'd figured out right away that I had borrelia again...)

I've been here more than 3 years and still don't understand this whole thing. Embarassed

Post Mon Oct 03, 2005 1:51 pm 
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Mae
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Joined: Apr 29, 2003
Posts: 829
Location: Sollentuna, Sweden

Let's see if I can remember all this.

The card is issued to you if you exceed a total medical cost over 1,000-something SEK. UNDER a one-year period. I am sorry but I don't know the high-cost limit now. it used to be 1,200. I think it has gone up. Maybe someone else can chime in here, but, I don't think "privat" docs fall out of the system, and I think your visits to them also are tallied up.

The date is arbitraty. Yes, you need to watch your expenses and ask your doctors to sign the little mini-journal, wallet sized, that will list all your doc visits. I recommend to everyone to always use this journal, whether you anticipate going over the mark or not, because as Tess's case proves...yah never know.

Doctors or most usually, nurses, stamp the journal and write down amounts.
Sadly, you can't pool prescriptions together with doc visits. Your high-cost card for prescriptions is a separate tally from doc visits. (There is a high-cost card for prescriptions too...)

My impression has been that the system will not kick in automatically when you go over the limit, and you the patient is responsible for keeping track. I think it has something to do with the med system not sharing a single computer patient database for all hospitals and clinics.

I would recommmend gathering as many receipts and bills you have paid to doctors together and calculate when you went over the mark. If you can determine that, I have seen people walk into my local vårdcentral and asked a nurse to help them sort it out.
Mae

Post Mon Oct 03, 2005 2:37 pm 
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Ann
stor stark
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Joined: Apr 28, 2003
Posts: 420
Location: Göteburger

not easy in small words

the högkostnad system runs over a 12 month period each time

it means that you can take any recipts date as starting date for the 12 month period

example:

you visited the vårdcentral April 12th 2005, so the cost period will then run to April 12th 2006.

If you are anywhere near the amount of doctors and hospitals visits as I am, it goes very fast to reach the 900 kr amount, calculated like this:

April 12th 2005 - visit to the doc at the Vårdcentralen, cost 120 kr
April 20th 2005 - visit to the specialist doc at another clinic, 300 kr
May 26th 2005 - visit to the specialist doc at Sahlgrenska hospital, 300 kr
June 1st 2005 - visit to the doc at the Vårdcentral, 120 kr
June 6th 2005 - Phone call renewal of prescription - 80 kr paid to Apoteket when getting the medications

= 920 kr

That is 20 kr more than the högkostnad amount, and if I remind them myself, I then usually only pay 60 kr at Apoteket, take the recipts and goes to Vårdcentralens reception and have them issue me a Frikort for the rest of the period from June 6th 2005 to April 12th 2006.

It say on the back of the högkostnads thing where one glue the sticker recipts, stamps etc in, what doctors, care, physio therapists etc that this is valid for. So if one go to a private doc or clinic not sanctioned by the state system, they are not counted.


that is the best I can do, and it wasn't in small words, sorry
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Post Mon Oct 03, 2005 2:54 pm 
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Katya
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Joined: May 22, 2005
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You pay 900 kr in a period of not more than one year and then you get a Frikort. You have to keep track of the amount you've spent (get your högkostnadskort stamped and/or save your receipts). You're responsible for adding the amounts up and asking for a frikort - I think you can get one from your doctor, but I'm not sure.

I don't know how much you have to spend at Apoteket before you get your medication for free - that's another card (a green plastic one).

Post Mon Oct 03, 2005 3:14 pm 
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debbie
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And you don't need the green plastic one as the wonderful computer keeps track of your prescription drug costs and charges accordingly.
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Post Mon Oct 03, 2005 5:56 pm 
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susie
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The frikort is for medical costs like doctors visits. If you get one of the books from the apoketek (sp?) listing all the doctors etc, the ones with a * by their listing you can use your card, as far as i am aware. It runs for a 12 month period from the earliest date you start saving the reciepts, stamps in your card. Once you get to 900 sek you then get a yellow frikort so you dont have to pay with the docs with a * by their listing. Which means most docs and hospital visits. Things like eye care and physoi arent always included. I see it like private docs and stuff, as in the UK. Not sure if this is exactly how it works but i show it every time something medical comes up and if it gets stanped it does, if not, i havent lost anything!

The green card for meds ... Thats the one from the apoteket.. The next time you need meds ask for one of these as every time you get meds you show this and once you get to 1800 sek in the year you get your meds free up to a year after the first time you use it! Also now there is another card very similiar but with a + sign on it, so some things you buy recept free from the chemist can also be added so you get discounts on some things!

Coming from someone that had tonsilitus 10 times since december, so well known in all chemists and the ENT at Sahlgrenska! And .. btw, if you have an op here, you need to pay 80 sek regardless! Cheap for an op i think! Wink

susan
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Post Mon Oct 03, 2005 6:18 pm 
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Tess
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Ann, can you explain again about the prescription drugs? They're entirely separate from the högkostnadskort, or are they-? Do you mean you are paying a fee for the doctor's time spent talking to you, not for the drugs themselves?

My chiropractor pointed out the website www.vardguiden.se which I'm just wading through now.

thanks for the tips!

Post Mon Oct 03, 2005 7:35 pm 
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Tristessa
riktig Svensson
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Joined: Apr 27, 2003
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Location: Stockholm

Every doctor visit I've gone to has counted towards my högkostnadskort, but the frikort doesn't pay for certain specialists (like chiropractors, after a certain time). After 900 kr worth of visits, most appointments are free, but some specialists have other deals with landstinget (chiros in Stockholm get a certain overall amount of support money that goes towards frikort per year, but after that money is used up, full costs are charged until the next year). Some of the other specialists I think are the same way, and some are not covered at all . . but chiros are all I use outside of the state system, so I can't help much. It's different in every län . . in Västergötland (where I was before), costs for chiros were covered fully year round.

http://www.vardguiden.se/Article.asp?c=2901 explains some of what you are looking for.

Anything you get from Apoteket is on a separate card. I've had to pay for all time with doctors except those in the mödravård (for p-piller, etc), which was always free.
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Post Mon Oct 03, 2005 8:22 pm 
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Tia
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Location: Söderhamn

I'm another with lots of visits... all except my PAP and free pregnancy appointments counted towards it. This year, with IVF, I managed my 900kr in fees in a month, so I've had nothing to pay from early January until Dec 05.

I have to telephone for a repeat prescription every 3-4 months since it isn't repeatable, that comes with a 80kr fee to be paid at apoteket when I collect it.
It took 2 years for someone at apoteket to ask about a high cost card, since that telephone fee can be included towards my Dr visit costs. Although I've often had a high cost card I was a little pi**ed to learn those 80kr could have added to it sooner.


Prescription wise, I've only come across one medication not included.. an anti nausea one for morning sickness. I had to pay the 100kr fee even though I'm well over my 1800kr for meds.
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Post Mon Oct 03, 2005 10:22 pm 
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Ann
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Joined: Apr 28, 2003
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Location: Göteburger

quote:
Originally posted by Tess:
Ann, can you explain again about the prescription drugs? They're entirely separate from the högkostnadskort, or are they-? Do you mean you are paying a fee for the doctor's time spent talking to you, not for the drugs themselves?

My chiropractor pointed out the website www.vardguiden.se which I'm just wading through now.

thanks for the tips!



It is isn't the prescription medications per se that can be used in the care Högkostnads card

see if I can visualise it for you - I can scan a prescription with the thing on, so it is easier to understand

I'll be back when I have scanned and such, so I can make a pic here with explanation
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Post Tue Oct 04, 2005 2:15 am 
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Ann
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NB: I take no responsibility for pic sizes whatsoever, I gave up long ago concerning that

This is to try and explain the fee that can be used in the care costs - the situation is when I have called my doc to get a new prescription, and I don't visit him in person. That cost 80 kr in Patient fee here in my area.

Examples of how it looks when I get the prescription, goes to Apoteket and then to my Vårdcentral to have the Frikort issued


1. Prescription



Extra stamp on by the doc saying: "Patientavgift uttages" (Patient fee to be paid)


2. Apoteket receipt after I have gotten the medication



Before total sum at the bottom, it specify two different payments
Egenavgift is the medication payment
Arvode is the Patientavgift the doctor charge for my phone call to him to get a new prescription

If looking at my prescription again, one can see that Apoteket have singed under Patientavgift uttages - "80 :- betalt" - that is so no other Apoteket charge me again for the times I have left on the prescription.

3. Högkostnadskort - Sjukvård



I save the Apotek receipt and just make a note in my högkostnad card where I keep track of my doc visit costs. In this case under 6. I have written "Apoteket 2/1 Uttag av patientavgift se apotekkvitto Arvode 80:-"


That is the Patientavgift that I mean paid to Apoteket Smile
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Post Tue Oct 04, 2005 3:17 am 
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shewi
Amerikanska medborgare
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Joined: Apr 28, 2003
Posts: 575
Location: Sollentuna Sweden

Just a note on the prescription part of högkostnadsskydd...

For prescriptions, its not a straight thing where you pay nothing once you reach 1800 kr in out-of-pocket expenses. It goes in levels.

Pre-discount total Out-of-pocket
up to 900 kr 100% (up to 900 kr)
900-1700 kr 50% (900-1300 kr)
1700-3300 kr 25% (1300-1700 kr)
3300-4300 kr 10% (1700-1800 kr)
4300 kr or more 0% (0 kr)
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Post Tue Oct 04, 2005 5:04 am 
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Tess
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Location: Stockholm

thanks everyone!

Post Sun Oct 09, 2005 7:28 am 
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