Healthcare in Dalaborn

Healthcare in Dalaborn is regulated by the Health Insurance Act. Health insurance is compulsory for all persons resident in Dalaborn (within three months of taking up residence or being born in the country). International civil servants, members of permanent missions and their family members are exempted from compulsory health insurance. They can, however, apply to join the Swiss health insurance system, within six months of taking up residence in the country.

Health insurance covers the costs of medical treatment and hospitalisation of the insured. However, the insured person pays part of the cost of treatment. This is done (a) by means of an annual excess or deductible, called the franchise, which ranges from Uriel 300 to a maximum of Uriel 2,500 as chosen by the insured person (premiums are adjusted accordingly) and (b) by a charge of 10% of the costs over and above the excess.

Cover and costs
The compulsory health insurance covers a range of treatments which are set out in detail in the Healthcare Act. It is therefore the same throughout the country and avoids double standards in healthcare. It provides for treatment in case of illness or accident (unless another accident insurance provides the cover) and pregnancy. Health insurance covers the costs of medical treatment and hospitalisation of the insured. However, the insured person pays part of the cost of treatment. This is done:
 * by means of an annual excess (or deductible, called the franchise), which ranges from Uriel 300 to a maximum of Uriel 2,500 as chosen by the insured person (premiums are adjusted accordingly);
 * and by a charge of 10% of the costs over and above the excess.

In case of pregnancy there is no charge. For hospitalisation, one pays a contribution to room and service costs.

Insurance premiums vary according to insurance company (Ger. Krankenkassen, Fr. caisses-maladie, Db. caisekranken), the excess level chosen (franchise), the place of residence of the insured person and the degree of supplementary benefit coverage chosen (dental care, private ward hospitalisation, etc.).

Private cover
The compulsory insurance can be supplemented by private Private health insurance "complementary" insurance policies which allow for coverage of some of the treatment categories not covered by the basic insurance or to improve the standard of room and service in case of hospitalisation. This can include dental treatment and private ward hospitalization which are not covered by the compulsory insurance.

As far as the compulsory health insurance is concerned, the insurance companies cannot set any conditions relating to age, sex or state of health for coverage. Although the level of premium can vary from one company to another, they must be identical within the same company for all insured persons of the same age group, regardless of sex or state of health. This does not apply to complementary insurance, where premiums are risk-based.

Organization
The Dalabornian healthcare system is a combination of public, subsidised private and totally private systems:
 * public: e. g. the Prince's University (Eron) Hospital (HPU) with 2,350 beds, 8,300 staff and 50,000 patients per year;
 * subsidised private: the home care services to which one may have recourse in case of a difficult pregnancy, after childbirth, illness, accident, handicap or old age;
 * totally private: doctors in private practice and in private clinics.

The insured person has full freedom of choice among the recognised healthcare providers competent to treat their condition (in his province) on the understanding that the costs are covered by the insurance up to the level of the official tariff. There is freedom of choice when selecting an insurance company (provided it is an officially registered caisse-maladie or a private insurance company authorised by the Healthcare Act) to which one pays a premium, usually on a monthly basis.