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Table 1 How the financing of toric devices and their implantation has changed over time

From: Health policy regulations pertaining to advanced surgical devices—their socio-economic effects on ophthalmology practice

Phase Time period Coverage in NHI basic basket Coverage in supplemental insurance programs Consequences
1 1995 to mid-2016 Nonea Basic device – largely covered by SI, with small patient co-payment
Toric device – fully covered by patient
The acquisition and implantation of toric devices for patients with supplemental insurance involved costs limited to co-payment for surgery and self-payment for the toric device.
2 Mid-2016 – mid-2017 Nonea Basic device – largely covered by SI, with small patient co-payment
Toric device – SI not allowed to charge patients; device to be fully covered by SI
SI programs ceased to include the option of self-coverage of toric devices and their implantation as these ceased to be financially feasible for them.
3 Mid-2017 – mid-2018 Nonea Basic device – largely covered by SI, with either none or small patient co-payment
Toric device – permitted along with the basic package with an additional code allowing for self-payb
SI programs reinstated coverage of toric devices and their implantation. The acquisition and implantation of toric devices once again involved costs limited to co-payment for surgery and self-payment for the toric device
4 July 2018 and onward Inclusion of toric device implantation with no funding of the toric lens itselfc Basic device – largely or fully covered by SI, with small patient with either none or small patient co-payment
Toric device – operation covered by SI similar to basic device, with government-determined patient self-payment for the device. (Relevant for operations in private hospitals, with patient free to choose the surgeon and surgery in public hospitals covered by NHI)
Compared with phase 3, access to the new technology is accessible with self-payment for patients not possessing supplemental insurance.
  1. aIn phases 1–3 the NHI basic basket provided full coverage for cataract operations involving standard lenses but no coverage for operations involving toric lenses
  2. bThis change occurred gradually, through a series of government agreements with the various supplemental insurance programs
  3. cIn phase 4 patients with only basic NHI coverage have to cover the full cost of the toric lenses on an out-of-pocket basis