Greek National Organization for Health Care Provision (EOPYY)
The provisions of the present Regulation are applicable directly to the insured members of the Health Insurance organizations, which are part of EOPYY, in accordance with the provisions of the Law 3918/2011, as well as the members of their families, as specified in the individual regulations thereof, which are valid until the entry into force of the present Regulation.
More specifically, they are applicable to:
A. - The insured members of the IKA-ETAM healthcare department
- The insured members of the OAEE healthcare department
- The insured members of the OGA healthcare department
- The insured members of OPAD and the OPAD Healthcare department for Community and Municipal Employees.
B. The family members of all the above insured persons.
As family members are considered: a) husband/spouse, when they are not insured by their own right to another insurance organization,
b) unmarried children (legitimate or children legitimated, recognized or adopted or their ancestors), the natural children of an insured or retired member due to disability or old age, the sponsored children, whose custody is held by the insured sponsor upon a legal act, until they are 18 years old or until they are 24 years old and unemployed or if undergraduate, and if they continue their studies up to 2 years after the end of their studies, however not after the completion of the 26th year of age,
c) the children of the directly insured who have disabilities sixty-seven percent (67%) and above reserve the right to receive benefits as family members, even if they work or are still employed to gain their living or are under an occupational therapy. The aforementioned disability is assessed by the competent health board,
d) the natural or adoptive parents, with the requirements of the Article 48, § 10 of the Law3996/2011 (A. 170),
e) the orphaned grandsons and brothers by father and mother, as well as the orphaned grandsons and brothers by father or mother, in accordance with the requirements of the Article 48 § 10 of the Law 3996/2011,
f) the brothers of directly insured members, who have a disability of sixty-seven percent (67%) and above, with an attestation of a medical committee, given that they do not have the same healthcare right in another insurance organization,
g) the unmarried daughters and sisters of the directly insured NPDD employees, which are over forty (40) years old, who had a health booklet by the government until the 03/13/2004, when the No. 2/190/0094/28-1-2004 Joint Ministerial Decision was applied by the Minister of Economy and the Minister of Health and Social Solidarity, reserve the right to health care, provided they do not reserve the same right to healthcare provisions by another insurance organization
h) the uninsured divorced husband/spouse may reserve their healthcare insurance rights if at the time of marriage dissolution the other member of the couple was insured and the following conditions are met:
• the marriage was dissolved after the completion of the 35th year of their age,
• they do not have direct or indirect rights to illness provisions by the government or other insurance organization,
• submits an application to maintain the right within one year from the date of the final judgment of the divorce and
• Pays the insurance contributions to the healthcare department of the insurance organization, due to the status of the divorced husband/spouse as follows:
1. the insured members of OPAD pay a contribution equal to the 5% of the total monthly remuneration of a regular civil servant, with an introductory grade of the DE field with no dependents.
2. The insured members of the healthcare insurance organization for employees pay the sum of employee and employer contributions in kind to the fund of the healthcare department, that is, the wage of the unskilled worker.
3. The insured members of the healthcare insurance organization for self-employed or freelance professionals pay their contributions that correspond to the lowest insurance category or their monthly contribution when there are no insurance categories.
For the enforcement of the provisions of the present Regulation as to the insurable persons, the individual provisions of the Regulations of the Health and Social Security Departments, as well as the Regulation of OPAD included in EOPYY, are applied, pursuant to the provisions of the Law 3918/2011 (A’ 31).