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