Employees of the Ministry of Interior have been left without health insurance because contributions have not been paid for their colleagues who were reinstated through court rulings, according to the Health Insurance Fund (HIF).

In a statement to “Sloboden Peçat,” the HIF explained that the situation was not related to a technical fault or an outage in the Fund’s system. According to the Fund, health insurance is activated automatically as soon as the paid contributions are recorded in the system.

Records show that the Ministry of Interior registered employees who had returned to their positions on the basis of court rulings. However, for some of them, there is no record of the corresponding health insurance contributions having been paid for the period for which they are currently registered.

The Fund stressed that this is a system-defined mechanism that applies equally to all legal entities in the country. Employee registration and the calculation and payment of contributions are processed through the Public Revenue Office’s contribution collection system, while the HIF records insurance status based on data concerning completed payments.

When employees are retroactively added to a legal entity’s records for an earlier period, the payroll calculation for the relevant period must be corrected and contributions must be paid for the added individuals. Once the payment is recorded, health insurance is activated automatically.

According to the HIF, this does not constitute an individual administrative decision by the Fund, nor does it involve its employees manually removing insured individuals. The procedure is carried out systematically and automatically, and the rules apply without exception to every employer and institution.

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However, according to what “TV24” reports, some citizens have said that in some pharmacies they were told the medicine is still not being dispensed with a prescription, on the grounds that a notification from the Fund is still being awaited.

The Health Insurance Fund clarified that the medicine has been on the positive list since July 1 and that pharmacies are obliged to stock it and dispense it to insured persons who need it.

“As of July 1, 2026, the medicine enoxaparin (Clexane) has been provided through the Positive Drug List and can be purchased and dispensed at PHI pharmacies that have signed an agreement with the Fund. Under the provisions of the agreement concluded with the Fund, pharmacies are obliged to provide, that is, purchase and dispense medicines for the needs of insured persons, for specific medical diagnoses and within the framework of legal regulations.

In this way, insured persons receive the medicine at pharmacies that have an agreement with the Fund, based on a prescription issued by their chosen doctor, without first buying it and then submitting a reimbursement request,” HIF said.

The inclusion of Clexane on the positive list had been expected to happen last year, but the procedure was postponed due to technical and administrative difficulties.

The most recent expansion of the positive list with new medicines was made in 2024. That list included medications for high blood pressure, heart disease, depression and dementia.

In May this year, the prime minister announced that the list of medicines covered by the Fund would be expanded again, but so far there is still no concrete information on when the next update will take place./Telegrafi/

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The director of the Health Insurance Fund, Sasho Klekovski, said that they are awaiting the Ministry of Health’s approval of the protocols that will link the Fund’s system with that of the Ministry, which will pave the way for the issuing of electronic prescriptions. According to him, this mechanism is already in place for prescriptions issued for chronic illnesses.

Speaking about the ways prescription medicines are abused to the detriment of the fund, he said there are two most common forms of abuse, especially when patients ask for them, God forbid.

According to Klekovski, one form of abuse is linked to obtaining medicines “just to have them.” He stressed that in many households the medicine drawer is opened only once a year, and expired medications are thrown away at least once a year.

He also explained that the other category of abuse is related to the double billing of medicines.

“They are charged for false prescriptions, and these are billed both to the Fund and to the patient. The purpose of these checks is to avoid double billing, where a medicine is charged to the patient but not to the Fund, and vice versa,” Klekovski said.

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