Co-payment system - what do you have to pay for health care?

The referral system

Iceland Health subsidizes the following health services for individuals by referral

• Specialist medical services for children, research, radiology and diagnostic imaging

  - GP/GP issues a referral

• Physiological, speech and occupational therapy for all age groups
  - referral is issued by a doctor or physiotherapist in a clinic

• Child psychological services for psychologists with contracts with Iceland Health

  - a referral from specific reference teams or child psychiatrists

Co-payment for lens surgery, skin light treatments and specific plastic surgery is subject to prior approval by Iceland Health.

Referral to specialist physicians

• Pediatricians' emergency and on-call services, gynecologists' services and ophthalmologists' services will be free of charge for children, so there is no need for referrals

• There is still a need for referral of children (under 18) to other specialists

• A specialist doctor, who has received a referral from a family doctor or primary care doctor, can now refer a child to another specialist doctor if he believes that he needs a different type of specialist service

• A referral from a family or primary care physician is not required for imaging and research services

• A hospital doctor can now refer a child to a specialist

• A referral may be issued for children with chronic illnesses or disabilities that is valid until the age of 18 (in place of 10 years at a time)

Referral to physiotherapy

• A doctor or physiotherapist at the clinic issues a referral.

• A citation provides 15 time permission for one year from the start of treatment.

• Individuals choose physical therapists. A referral is returned to the physiotherapist or a physiotherapist will retrieve the referral electronically. A physiotherapist shall send a reference to the Health Insurance.

• Children under the age of 18 with referral from a doctor do not pay for the service based on the Health Insurance tariff.

• The payment status of the general user, the elderly and the disabled.

• The physical therapist assesses whether more sessions are needed to complete the treatment and applies to Iceland Health if necessary.
  

Referral to speech therapy

Participation in payments by Iceland Health regarding deviations in language development and pronunciation is restricted to children with major deviations. Further details on the definition of major variations in .

Agreements are in place on the involvement of municipalities in the speech therapy of children with less deviation and this treatment is therefore not covered by the payment contribution of Iceland Health.

• Children under the age of 18 with referral from a doctor and diagnosis and assessment by a speech therapist receive speech therapy free of charge if the conditions are met. Prior approval is required from Iceland Health.

• Users, the elderly and the disabled pay according to their payment status in the payment contribution scheme.

• A citation provides 15 time permission for one year from the start of treatment.

• An individual selects a speech therapist and refers to him/her.

• Iceland Health will participate in one diagnosis in each 12-month period and two consultations under further conditions in the framework contract for speech therapists.

• A speech therapist evaluates whether more exchanges are needed to complete treatment and applies to Iceland Health if this is necessary.

Referral to occupational therapy

• Children under the age of 18 with referral from a doctor receive occupational therapy free of charge, or they must be paid 30% of the price list.

• Users, the elderly and the disabled pay according to their payment status in the co-payment system.

• A citation provides 15 time permission for one year from the start of treatment.

• The contract is with Iceland Health for the services of occupational therapists at Æfingastöðin, Gigtarfélagið and Bjarg Akureyri.

• An occupational therapist evaluates whether more replacements are needed to complete treatment and applies to Iceland Health if needed.

Referral to skin treatment

• Doctor issues referral to light therapy

• Laser treatment is subject to prior approval by Iceland Health pursuant to Regulation 722/2009 on Plastic Surgery

Child psychological services

• Referral only applies to psychologists who have a contract with Iceland Health

• Referral must be from certain diagnostic teams or child psychiatrists
  

Plastic surgery

• Health insured persons are entitled to a contribution to the cost of necessary plastic surgery.

• Before the treatment begins, you must apply for the prior approval of Iceland Health. A response to the application is received in the applicant's Digital Mailbox..

• If an application is approved, it is paid according to status in the co-payment system.

Eye stone surgery

Individuals must meet certain conditions for lens surgery with the participation of Iceland Health.

Three parties have concluded an agreement with Iceland Health on payment contributions for lens surgery: Landspítali University Hospital (LSH), Akureyri Hospital (SAK) and Lentis ehf; Davíð Þór Bragason and Keith Fogg.

• LSH surgery: Iceland Health does not need to be contacted in advance.Billing is done according to payment status.

• Operation on SAK: The ophthalmologist shall send an application for payment to the Iceland Health for approval.

• If an application is approved, it is paid according to status in the co-payment system.