What kind of therapies/surgeries are covered?

The most general rule is that any therapy or surgery that is not for beauty reasons is covered by the GHS (GeSY). If you are not sure, you can ask your doctor… he is supposed to gather the necessary info for you.

However, GHS covers admissions in the Intensive Care Unit (ICU) and or common room and from admission for a few hours to several tens of days.

My doctor is GHS contracted, can I go to the hospital?

In order GHS to cover hospitalization, the doctor who will undertake the operation/therapy and the hospital must be contacted with the GHS.

With the same reasoning, a hospitalization will not be covered if the doctor is not contracted with the GHS.

Can I upgrade the room in the hospital? What will I pay?

GHS covers hospitalization as a package which is called DRG but not individual charges (e.g. room). However, we know that a room up to double room is covered. So the hospital can ask you to pay the difference from double to single room… or even suite if you want!

I must have a referral to be covered?

Yes. In case of planned treatment, you should have a referral from a doctor (for example your personal doctor or from a specialist). In case of an emergency (e.g. accident), you will go to the emergency department and then the doctors will order a referral for admission.

I need a special and expensive drug or implant, will it be covered?

The truth is that in many cases an expensive drug or specialized implant is necessary for treatment. Such cases are examined and if approved are grouped in a special catalogue called “Z Catalogue” and you can find it in the GHS webpage here. Again, your doctor can guide you better.

Should I pay my doctor for the therapy?

The fee of the doctor and any other medical specialities involved is covered in the “package” offered by GHS to the hospital for your treatment. There is no copayment and you do not need to pay anything else.

Is the childbirth covered by GHS?

This is a common question and the short answer is YES. Both the normal birth and the caesarean section are covered. The GHS will also cover the paediatrician’s fee during childbirth.