A reimbursement system for a defined group of people, e.g., those covered by a defined social health insurance fund or other public payer. Eligibility for a reimbursement scheme may depend on the profession of the insured, the region where they live or their family status (e.g., a relative of the insured. In a country, several reimbursement schemes may be in place in parallel, and legislation may allow for different coverage decisions per reimbursement scheme. Some countries also apply the term “reimbursement scheme” to different types of medicines (e.g., a separate reimbursement scheme for expensive medicines) or different indications.
Last update: 20 November 2024
Source: PPRI