Greece offers universal coverage for health care. The insured persons have access to a unified benefit package which includes primary care, diagnostics, specialist outpatient and inpatient care. The statutory health insurance scheme offers health benefits at ESY urban facilities, health centres, local health units and EOPYY-contracted health providers.
Patients can directly access ambulatory care by visiting a physician in ESY urban facilities, rural health centres or hospital outpatient departments. The physician may prescribe necessary medications or tests or refer the patient to a specialist. Patients may choose to consult specialists contracted with EOPYY or a specialist at a public or EOPYY-contracted hospital for care.
Ambulatory care in rural and semi-urban areas is mostly delivered by a network of health centres staffed with GPs and specialists (paediatricians, gynaecologists, orthopaedists, ophthalmologists, urologists, dentists, general surgeons, psychologists, radiologists, physiotherapists, microbiologists, nurses, midwives and social workers). In addition, rural surgeries that are administratively linked to health centres are staffed with publicly employed doctors and medical graduates. The latter are required to spend at least one year in a rural area upon graduation and prior to enrolling for medical specialization. The number of available doctors in each health centre depends on the characteristics of the covered area (e.g. size, economic growth, epidemiological profile, access to hospital care etc).
In addition to public ambulatory care services, there are private practices, dental practices and diagnostic centres. The majority of private facilities are located in Athens and Thessaloniki. EOPYY contracts private practices, laboratories and diagnostic centres with the exception of dentists. A system of monthly caps operates on physician activity. Every doctor contracted with EOPYY has a limit of 200 visits per month (Ministerial Decision No. Y9a/oik.37139 of 9 May 2014) and there is also a monthly ceiling on the value of pharmaceutical prescriptions (Ministerial Decision No.Y9/oik.70521 of 18 August 2014). This means that those insured with EOPYY who are in need of a doctor’s visit or a prescription and choose to consult an EOPYY-contracted doctor must either find a physician who has not reached his or her ceiling or they will have to pay out-of-pocket.
Private facilities also offer services directly to patients on a fee-for-service basis, paid directly by patients or through private insurance.
Specialized ambulatory care is provided through private practices and outpatient departments of public hospitals. The outpatient departments of public hospitals provide specialized outpatient care within the ESY. They cover all specialties and are the major providers of ambulatory care services in urban areas. They provide free services during morning hours and visits are scheduled by appointment. Law 2889/2001 established afternoon services in hospital outpatient departments in which the same publicly employed doctors working in the hospital could provide private consultations on an appointment basis. They are paid directly by patients on a fee-for-service basis with the fee shared between the hospital (40%) and the physician (60%). The afternoon private consultation fees vary from €16 to €72, depending on physicians’ grades.
Inpatient hospital care
According to the type of services they offer, Greek hospitals are categorized as either general or specialized. The former include departments of medicine, surgery, paediatrics and obstetrics/gynaecology, supported by imaging and pathology services. Specialized hospitals are referral centres for a single specialty (e.g. obstetrics, paediatric care, cardiology or psychiatry). Hospitals linked to the country’s medical schools offer the most complex and technologically sophisticated services.
EOPYY-insured persons can access ESY hospitals free of charge while when they are treated at an EOPYY-contracted private hospital they are expected to pay part of the cost.
Main source: Economou C et al. (2017). Greece: Health system review. Health Systems in Transition, 19(5):86-89.