{"id":245420,"date":"2022-01-24T11:54:50","date_gmt":"2022-01-24T10:54:50","guid":{"rendered":"http:\/\/zakrasnejsivimperk.cz\/?p=245420"},"modified":"2022-01-25T16:30:20","modified_gmt":"2022-01-25T15:30:20","slug":"vseobecna-zdravotni-pojistovna-zmeny-ve-zdravotni-peci-od-roku-2022","status":"publish","type":"post","link":"https:\/\/zakrasnejsivimperk.cz\/?p=245420","title":{"rendered":"V\u0160EOBECN\u00c1 ZDRAVOTN\u00cd POJI\u0160\u0164OVNA: Zm\u011bny ve zdravotn\u00ed p\u00e9\u010di od roku 2022"},"content":{"rendered":"

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OT\u00c1ZKA:<\/h6>\n
Na co m\u00e1m jako pacient n\u00e1rok od za\u010d\u00e1tku roku 2022? Do\u0161lo k\u00a0n\u011bjak\u00fdm zm\u011bn\u00e1m ve zdravotn\u00ed p\u00e9\u010di?<\/h6>\n
ODPOV\u011a\u010e:<\/h6>\n

Od 1. 1. 2022 je ve zdravotn\u00ed p\u00e9\u010di zm\u011bn cel\u00e1 \u0159ada<\/b>. T\u00fdkaj\u00ed se nap\u0159. o\u010dkov\u00e1n\u00ed hrazen\u00fdch z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed, stomatologie a ortodoncie, zdravotnick\u00fdch prost\u0159edk\u016f, indikace hrazen\u00e9 dom\u00e1c\u00ed p\u00e9\u010de, zaveden\u00ed pilotn\u00edho projektu roz\u0161\u00ed\u0159en\u00ed laboratorn\u00edho novorozeneck\u00e9ho screeningu o SMA a SCID, popula\u010dn\u00edho pilotn\u00edho programu \u010dasn\u00e9ho z\u00e1chytu karcinomu plic a dal\u0161\u00edch. P\u0159inesla je\u00a0novela z\u00e1kona \u010d. 48\/1997 Sb.<\/b>, o ve\u0159ejn\u00e9m zdravotn\u00edm poji\u0161t\u011bn\u00ed a souvisej\u00edc\u00edch pr\u00e1vn\u00edch p\u0159edpis\u016f. N\u00ed\u017ee jsou uvedeny nejz\u00e1sadn\u011bj\u0161\u00ed z\u00a0nich.<\/p>\n

Ve skupin\u011b stomatologick\u00fdch v\u00fdrobk\u016f jsou od 1. 1. 2022 nov\u011b pln\u011b hrazeny z\u00a0prost\u0159edk\u016f zdravotn\u00edho poji\u0161t\u011bn\u00ed korunky estetick\u00e9 pl\u00e1\u0161\u0165ov\u00e9 z\u00a0kompozitn\u00edho plastu na p\u0159edn\u00ed zuby<\/b>, kter\u00e9 byly doposud hrazeny se spolu\u00fa\u010dast\u00ed poji\u0161t\u011bnce. Celkov\u00e9 sn\u00edmateln\u00e9 n\u00e1hrady a \u010d\u00e1ste\u010dn\u00e9 sn\u00edmateln\u00e9 n\u00e1hrady jsou nad\u00e1le pln\u011b hrazeny v\u00a0z\u00e1kladn\u00edm proveden\u00ed, ale nov\u011b poji\u0161\u0165ovna \u010d\u00e1ste\u010dn\u011b p\u0159isp\u00edv\u00e1 i na ostatn\u00ed \u010d\u00e1ste\u010dn\u00e9 \u010di celkov\u00e9 sn\u00edmateln\u00e9 n\u00e1hrady<\/b>, kter\u00e9 doposud nebyly hrazeny. T\u00edmto poji\u0161t\u011bnci z\u00edsk\u00e1vaj\u00ed mo\u017enost \u00fahrady ze zdravotn\u00edho poji\u0161t\u011bn\u00ed na v\u00fdrobky z\u00a0nov\u00fdch materi\u00e1l\u016f \u010di za pou\u017eit\u00ed nov\u00fdch technologi\u00ed.<\/p>\n

V\u00a0oblasti ortodoncie\u00a0nov\u011b plat\u00ed, \u017ee ortodontick\u00e9 v\u00fdkony jsou pln\u011b hrazen\u00e9 ze zdravotn\u00edho poji\u0161t\u011bn\u00ed jen u pacient\u016f do dosa\u017een\u00ed 22 let v\u011bku<\/b>\u00a0a u\u00a0star\u0161\u00edch poji\u0161t\u011bnc\u016f jen za p\u0159edpokladu, \u017ee jde o poji\u0161t\u011bnce s<\/b>\u00a0t\u011b\u017ek\u00fdmi vadami chrupu<\/b>\u00a0\u2013\u00a0roz\u0161t\u011bpy rtu, \u010delisti a patra, s vrozen\u00fdmi celkov\u00fdmi vadami a syst\u00e9mov\u00fdm onemocn\u011bn\u00edm s ortodontick\u00fdmi projevy, mnoho\u010detnou hypodonci\u00ed (6 a v\u00edce chyb\u011bj\u00edc\u00edch zub\u016f v jedn\u00e9 \u010delisti, nezapo\u010d\u00edt\u00e1vaj\u00ed se t\u0159et\u00ed mol\u00e1ry). U t\u011bchto poji\u0161t\u011bnc\u016f jsou z\u00e1rove\u0148 nov\u011b hrazeny i n\u00e1klady na fixn\u00ed ortodontick\u00fd apar\u00e1t, kter\u00e9 doposud i u t\u00e9to skupiny poji\u0161t\u011bnc\u016f nebyly hrazeny.\u00a0Pro ortodontick\u00e9 v\u00fdrobky (sn\u00edmac\u00ed apar\u00e1ty) plat\u00ed, \u017ee pln\u011b hrazen\u00e9 bez omezen\u00ed v\u011bkem jsou pouze u poji\u0161t\u011bnc\u016f s\u00a0t\u011b\u017ek\u00fdmi vadami chrupu.<\/b>\u00a0Pro ostatn\u00ed skupiny poji\u0161t\u011bnc\u016f jsou ortodontick\u00e9 v\u00fdrobky hrazeny nad\u00e1le pouze \u010d\u00e1ste\u010dn\u011b, ale nov\u011b pro n\u011b plat\u00ed omezen\u00ed v\u011bkem 22 let.<\/p>\n

Ke zm\u011bn\u00e1m doch\u00e1z\u00ed od 1. 1. 2022<\/b>\u00a0tak\u00e9\u00a0v\u00a0p\u0159\u00edpad\u011b \u00fahrady zdravotn\u00edch slu\u017eeb v\u00a0oblasti asistovan\u00e9 reprodukce<\/b>.\u00a0Nav\u00fd\u0161ena je horn\u00ed v\u011bkov\u00e1 hranice<\/b>, kter\u00e1 ur\u010duje, do jak\u00e9ho v\u011bku jsou tyto slu\u017eby hrazeny z\u00a0prost\u0159edk\u016f ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed.\u00a0V\u011bkov\u00fdm limitem je tedy dosa\u017een\u00ed v\u011bku 39 let + 364 dn\u00ed<\/b>. Metody a postupy v\u00a0r\u00e1mci slu\u017eeb\u00a0asistovan\u00e9 reprodukce<\/b>\u00a0(IVF = in vitro fertilizace = mimot\u011bln\u00ed oplodn\u011bn\u00ed) jsou tedy od 1.\u00a01.\u00a02022\u00a0hrazeny z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed \u017een\u00e1m s\u00a0oboustrannou nepr\u016fchodnost\u00ed vejcovod\u016f ve v\u011bku od 18 let do dne dovr\u0161en\u00ed 40 let<\/b>\u00a0(39 let + 365 dn\u00ed), a d\u00e1le\u00a0\u017een\u00e1m ve v\u011bku od 22 let do dne dovr\u0161en\u00ed 40 let<\/b>\u00a0(39 let + 365 dn\u00ed). Ostatn\u00ed podm\u00ednky z\u016fst\u00e1vaj\u00ed stejn\u00e9, tedy metoda asistovan\u00e9 reprodukce je hrazena na z\u00e1klad\u011b doporu\u010den\u00ed registruj\u00edc\u00edho l\u00e9ka\u0159e v\u00a0oboru gynekologie a porodnictv\u00ed. \u00dahrada je i nad\u00e1le mo\u017en\u00e1 nejv\u00edce 3x za \u017eivot, nebo bylo-li v\u00a0prvn\u00edch dvou p\u0159\u00edpadech p\u0159eneseno do pohlavn\u00edch org\u00e1n\u016f \u017eeny nejv\u00fd\u0161e jedno lidsk\u00e9 embryo vznikl\u00e9 oplodn\u011bn\u00edm vaj\u00ed\u010dka spermi\u00ed mimo t\u011blo \u017eeny, 4x za \u017eivot.<\/p>\n

<\/a>Od 1. ledna 2022 je zah\u00e1jen\u00a0pilotn\u00ed projekt roz\u0161\u00ed\u0159en\u00ed laboratorn\u00edho novorozeneck\u00e9ho screeningu o<\/b>\u00a0spin\u00e1ln\u00ed muskul\u00e1rn\u00ed atrofii (SMA) a t\u011b\u017ekou kombinovanou imunodeficienci (SCID)<\/b>. Tento novorozeneck\u00fd screening se prov\u00e1d\u00ed laboratorn\u00edm vy\u0161et\u0159en\u00edm such\u00e9 kapky krve z\u00edskan\u00e9 odb\u011brem krve z pati\u010dky novorozence 48\u201372 hodin po narozen\u00ed. Odhalen\u00ed onemocn\u011bn\u00ed v\u00a0prvn\u00edch dnech \u017eivota novorozence je naprosto kl\u00ed\u010dov\u00e9 pro v\u010dasn\u00e9 zah\u00e1jen\u00ed adekv\u00e1tn\u00ed l\u00e9\u010dby. Pilotn\u00ed projekt je napl\u00e1nov\u00e1n na dva roky.<\/p>\n

K 1. lednu 2022 je tak\u00e9 spu\u0161t\u011bn\u00a0popula\u010dn\u00ed pilotn\u00ed program \u010dasn\u00e9ho z\u00e1chytu karcinomu plic, kter\u00fd je zam\u011b\u0159en na z\u00e1chyt \u010dasn\u00fdch st\u00e1di\u00ed karcinomu plic.<\/b>\u00a0Vy\u0161et\u0159it se mohou nechat ku\u0159\u00e1ci (sou\u010dasn\u00ed \u010di b\u00fdval\u00ed), jejich\u017e ku\u0159\u00e1ck\u00e1 minulost p\u0159edstavuje alespo\u0148 20 bal\u00ed\u010dkorok\u016f (tedy 20 cigaret denn\u011b po dobu 20 let) a jsou ve v\u011bku 55\u201374 let. Indikovat pacienta na CT vy\u0161et\u0159en\u00ed m\u016f\u017ee praktick\u00fd l\u00e9ka\u0159 \u010di pneumolog. Tento pilotn\u00ed program by m\u011bl trvat 5 let.<\/p>\n

Zm\u011bny se tak\u00e9 t\u00fdkaj\u00ed l\u00e1ze\u0148sk\u00e9 p\u00e9\u010de<\/b>. N\u00e1vrh na l\u00e1ze\u0148skou p\u00e9\u010di jako hrazenou z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed pod\u00e1v\u00e1 zdravotn\u00ed poji\u0161\u0165ovn\u011b l\u00e9ka\u0159 registruj\u00edc\u00edho poskytovatele, ambulantn\u00ed specialista, jen\u017e p\u00e9\u010di doporu\u010dil, nebo o\u0161et\u0159uj\u00edc\u00ed l\u00e9ka\u0159 p\u0159i hospitalizaci. V praxi to znamen\u00e1, \u017ee l\u00e1ze\u0148skou p\u00e9\u010di zpravidla doporu\u010duje odborn\u00edk-specialista pro jednotliv\u00e9 druhy onemocn\u011bn\u00ed tak, jak je uvedeno u jednotliv\u00fdch indikac\u00ed v indika\u010dn\u00edm seznamu, a\u00a0nov\u011b tento l\u00e9ka\u0159 m\u016f\u017ee z\u00e1rove\u0148 n\u00e1vrh i vystavit<\/b>. N\u00e1vrh schvaluje i nad\u00e1le zdravotn\u00ed poji\u0161\u0165ovna.\u00a0Zm\u011bna nastala<\/b>\u00a0v\u00a0p\u0159\u00edpad\u011b p\u0159\u00edm\u00e9ho p\u0159elo\u017een\u00ed pacienta z\u00a0akutn\u00ed l\u016f\u017ekov\u00e9 p\u00e9\u010de<\/b>\u00a0do l\u00e1ze\u0148sk\u00e9 p\u00e9\u010de, v\u00a0takov\u00e9m p\u0159\u00edpad\u011b<\/b>\u00a0se schv\u00e1len\u00ed zdravotn\u00ed poji\u0161\u0165ovnou nevy\u017eaduje<\/b>\u00a0(n\u00e1vrh je v\u0161ak pod\u00e1v\u00e1n zdravotn\u00ed poji\u0161\u0165ovn\u011b standardn\u00edm zp\u016fsobem).\u00a0Zm\u011bna nastala i u term\u00ednu n\u00e1stupu na l\u00e9\u010den\u00ed \u2013<\/b>\u00a0ten se nyn\u00ed po\u010d\u00edt\u00e1 ode dne schv\u00e1len\u00ed n\u00e1vrhu zdravotn\u00ed poji\u0161\u0165ovnou<\/b>.<\/p>\n

N\u011bkolik novinek se dotklo i oblasti zdravotn\u00ed p\u00e9\u010de ve vlastn\u00edm soci\u00e1ln\u00edm za\u0159\u00edzen\u00ed.\u00a0Od nov\u00e9ho roku mohou indikovat dom\u00e1c\u00ed p\u00e9\u010di po omezenou dobu<\/b>\u00a0(14 dn\u00ed, v p\u0159\u00edpad\u011b paliativn\u00ed p\u00e9\u010de a\u017e 3 m\u011bs\u00edce)\u00a0tak\u00e9 l\u00e9ka\u0159i z dal\u0161\u00edch odbornost\u00ed<\/b>, nap\u0159. ambulantn\u00ed specialist\u00e9, l\u00e9ka\u0159i poskytuj\u00edc\u00ed l\u00e9ka\u0159skou pohotovostn\u00ed slu\u017ebu, l\u00e9ka\u0159i poskytuj\u00edc\u00ed zdravotn\u00ed slu\u017eby na urgentn\u00edm p\u0159\u00edjmu.\u00a0Nov\u011b novela umo\u017e\u0148uje\u00a0v\u0161eobecn\u00e9 nebo d\u011btsk\u00e9 sest\u0159e se specializovanou zp\u016fsobilost\u00ed nebo zvl\u00e1\u0161tn\u00ed odbornou zp\u016fsobilost\u00ed, v rozsahu stanoven\u00e9m o\u0161et\u0159uj\u00edc\u00edm l\u00e9ka\u0159em v doporu\u010den\u00ed dom\u00e1c\u00ed p\u00e9\u010de<\/b>\u00a0(sestra v dom\u00e1c\u00ed p\u00e9\u010di)\u00a0p\u0159edepisovat vybran\u00e9 zdravotnick\u00e9 prost\u0159edky<\/b>\u00a0(nap\u0159. kryc\u00ed a obvazov\u00fd materi\u00e1l, zdravotnick\u00e9 prost\u0159edky pro inkontinentn\u00ed pacienty a pro pacienty se stomi\u00ed, zdravotnick\u00e9 prost\u0159edky pro kompresivn\u00ed terapii). Dosud m\u011bli tuto kompetenci v\u00fdhradn\u011b l\u00e9ka\u0159i.<\/p>\n

U zdravotnick\u00fdch prost\u0159edk\u016f do\u0161lo k\u00a0roz\u0161\u00ed\u0159en\u00ed seznamu hrazen\u00fdch zdravotnick\u00fdch prost\u0159edk\u016f z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed.\u00a0Poji\u0161t\u011bnci maj\u00ed nov\u011b n\u00e1rok na \u010d\u00e1ste\u010dnou nebo \u00faplnou \u00fahradu<\/b>\u00a0(p\u0159i spln\u011bn\u00ed indika\u010dn\u00edch krit\u00e9ri\u00ed)\u00a0n\u011bkter\u00fdch zdravotnick\u00fdch prost\u0159edk\u016f, kter\u00e9 d\u0159\u00edve bu\u010f nebyly hrazeny v\u016fbec, nebo byly hrazeny za jin\u00fdch podm\u00ednek \u010di v jin\u00e9m rozsahu.<\/b>\u00a0Nap\u0159. individu\u00e1ln\u00ed terapeutick\u00e1 \u00faprava s\u00e9riov\u011b vyroben\u00e9 obuvi, prost\u0159edky pro lok\u00e1ln\u00ed kysl\u00edkovou terapii, p\u0159ibyly nov\u00e9 kategorie ort\u00e9z pro d\u011bti.\u00a0U n\u011bkter\u00fdch ji\u017e d\u0159\u00edve hrazen\u00fdch zdravotnick\u00fdch prost\u0159edk\u016f se \u00fahrada p\u0159izp\u016fsobila individu\u00e1ln\u00edm pot\u0159eb\u00e1m poji\u0161t\u011bnc\u016f, d\u00e1le do\u0161lo k\u00a0nav\u00fd\u0161en\u00ed \u00fahrad u jednotliv\u00fdch zdravotnick\u00fdch prost\u0159edk\u016f anebo ke zv\u00fd\u0161en\u00ed po\u010dtu hrazen\u00fdch kus\u016f.\u00a0<\/b>Nap\u0159. b\u00edl\u00e9 hole \u2013 signaliza\u010dn\u00ed a orienta\u010dn\u00ed a \u010dervenob\u00edl\u00e9 hole \u2013 pro hluchoslep\u00e9, roz\u0161\u00ed\u0159en\u00ed v\u011bkov\u00e9 skupiny (do 17 let) u br\u00fdl\u00ed a \u010do\u010dek pro korekci poruch zraku atd.<\/p>\n

V\u00a0neposledn\u00ed \u0159ad\u011b stoj\u00ed za zm\u00ednku oblast o\u010dkov\u00e1n\u00ed.\u00a0Roz\u0161i\u0159uje se spektrum nepovinn\u00fdch o\u010dkov\u00e1n\u00ed hrazen\u00fdch z\u00a0prost\u0159edk\u016f ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed a skupiny poji\u0161t\u011bnc\u016f, kte\u0159\u00ed maj\u00ed n\u00e1rok na n\u011bkter\u00e1 dal\u0161\u00ed o\u010dkov\u00e1n\u00ed hrazen\u00e1 z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed<\/b>. Nov\u011b\u00a0maj\u00ed hrazen\u00e9 o\u010dkov\u00e1n\u00ed proti kl\u00ed\u0161\u0165ov\u00e9 encefalitid\u011b<\/b>\u00a0lid\u00e9 star\u0161\u00ed 50 let. D\u011bti do jednoho roku maj\u00ed n\u00e1rok na vakc\u00ednu proti meningokokov\u00fdm n\u00e1kaz\u00e1m typu B<\/b>,\u00a0mezi prvn\u00edm a druh\u00fdm rokem na vakc\u00ednu proti meningokoku typu A, C, W, Y<\/b>.\u00a0D\u011bti<\/b>\u00a0ve v\u011bku\u00a0od<\/b>\u00a0dovr\u0161en\u00fdch\u00a014 let do<\/b>\u00a0dovr\u0161en\u00fdch\u00a015 let<\/b>\u00a0maj\u00ed hrazenou<\/b>\u00a0vakc\u00ednu proti ob\u011bma typ\u016fm meningokokov\u00fdch n\u00e1kaz<\/b>.\u00a0N\u00e1rok na vakc\u00ednu proti ch\u0159ipce<\/b>\u00a0pak nov\u011b\u00a0maj\u00ed zdravotn\u00edci a dal\u0161\u00ed odborn\u00ed pracovn\u00edci ve zdravotnictv\u00ed<\/b>. Ve v\u0161ech uveden\u00fdch p\u0159\u00edpadech je aplikace o\u010dkovac\u00ed l\u00e1tky uhrazena pln\u011b poji\u0161\u0165ovnou poskytovateli a vakc\u00edna je poskytovateli hrazena do v\u00fd\u0161e ekonomicky nejm\u00e9n\u011b n\u00e1ro\u010dn\u00e9 varianty (pokud je vakc\u00edna dra\u017e\u0161\u00ed, hrad\u00ed si doplatek poji\u0161t\u011bnec).<\/p>\n

<\/a>Ke zm\u011bn\u00e1m doch\u00e1z\u00ed i v\u00a0p\u0159\u00edpad\u011b nepovinn\u00e9ho\u00a0o\u010dkov\u00e1n\u00ed proti ch\u0159ipce u osob nad 65 let v\u011bku<\/b>\u00a0a\u00a0o\u010dkov\u00e1n\u00ed proti lidsk\u00e9mu papilomaviru<\/b>, pokud je aplikace provedena mezi 13. a 14. rokem. V\u00a0t\u011bchto dvou p\u0159\u00edpadech je z\u00a0ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed nov\u011b pln\u011b hrazena krom\u011b aplikace i o\u010dkovac\u00ed l\u00e1tka. Tedy o\u010dkovac\u00ed l\u00e1tky, kter\u00e9 ur\u010d\u00ed sv\u00fdm sd\u011blen\u00edm Ministerstvo zdravotnictv\u00ed \u010cR, jsou hrazeny v\u00a0pln\u00e9 v\u00fd\u0161i bez doplatku poji\u0161t\u011bnce.<\/p>\n

(tzvzp)<\/strong><\/p>\n

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