Important InformatIon on health and medIcal care IMPORTANT: If you are a citizen
of the EU/EEA and can present a
valid European health insurance card
(EU-card) or are nationally registered
in Sweden you are covered by the
healthcare offered by the County
Council of Västerbotten.
You might also be covered by this
healthcare if you are a non EU/EEA
citizen. You must then have a residen-
ce permit for more than a year and be
nationally registered in Sweden. The
When you need
national registration is issued by the Population Register at the Swedish Tax Authority. If you are staying less than a year, if your residence permit and support
is for less than a year and you are not nationally registered in Sweden you If you need medical advice, call the healthcare hotline. It's available twenty-four hours a day by phone – are not covered by this healthcare. In that case you must check the agre- ements between your home country Calling the hotline costs the same as a local call, no matter where and Sweden or get an insurance that you call from in the county. The advice, however, is free.
will cover the costs for healthcare When you call, explain your problem to one of the hotline's while you are in Sweden.
experienced nurses who will provide advice about what to do. You If you are a citizen of the EU/EEA, may learn how to take care of your problem on your own or the if you have a valid European health nurse may recommend that you visit the medical centre or the insurance card, and are temporarily emergency room at the nearest hospital. staying in Sweden you can get acute, Unless it's an emergency, always call the healthcare hotline before going to the emergency room to receive the most efficient care pos- necessary dental care offered by sible and to keep the waiting time at the emergency room as short the County Council of Västerbotten. as possible.
Being nationally registered in Sweden The healthcare hotline has units in Lycksele, Skellefteå, and does not give you the right to full Umeå. When you call, you always reach the closest available nurse. treatment dental care, you must also In some cases, the nurse can also help you contact your healthcare be registered by the Swedish Social Insurance office. Foreign students in Don't call the healthcare hotline for an extension of your certifi- Sweden are never registered by the cate of illness or for prescription renewals; instead, contact the care Swedish Social Insurance Office.
provider who put you on sick leave or wrote your prescription.
You have the right according to a national fee schedule. You may choose anyhealth care centre or clinic in the country without areferral.
After receiving a referral, you may choose to arrange an •to influence your own care appointment with providers of outpatient specialist care All medical care is voluntary and all treatment should be anywhere in the country. Specialist care refers to a hospi- provided with your consent, with the exception of com- tal-based clinic or private care provider that has an agree- pulsory mental care, forensic psychiatric care, and some ment with the county council or is reimbursed according care as stipulated in the Communicable Diseases Act.
to a national fee schedule.
Indeed, you have the right to refuse treatment and When the care provider determines that you need some medication or to participate in scientific studies, such as treatment or surgery, you may choose to go anywhere in testing new treatment methods. In order for you and the the country for your treatment or surgery; however, you medical personnel to feel that you receive good, meaning- must always have approval in advance from the equivalent ful care and treatment, you should be involved in the health centre or clinic in your home county council before decisions you make, of course, within certain limits. You a referral. Your medical records can be sent to the hospital cannot receive a specific treatment if your doctor does of your choice. Once your records are sent to the facility not feel it is appropriate or if it is in conflict with "science you choose, you will be removed from the queue in your and proven experience".
home county council. In other words, you can only wait You are assigned an attending doctor and/or nurse when in one queue.
you are admitted to the hospital, which is especially im- Despite your right to freedom of choice, you may be portant if you receive treatment involving several care units denied care in another county council at the expense of and doctors. The attending doctor has primary respon- the home county council in cases where the home county sibility for your care and you have the right to know both council's doctor makes a different medical diagnosis or if the doctor's name and work phone number. You can other medical indications are noted.
consult with him or her about your situation for adviceand information.
Exception from freedom of choiceYou do not have the right to freedom of choice for regio- •to be presented information nal or highly specialised care such as heart surgery andtransplantations. In addition, freedom of choice does not in an understandable way apply for just an examination, such as an x-ray exam.
To receive the best treatment, it is important that you tellthe medical personnel everything about your problem.
You pay for travel and living expenses You have the right to receive answers to your questions.
The county council pays for your medical expenses when The information should be presented in understandable you choose to exercise your freedom of choice. You, terms. This applies to both children and adults.
however, are responsible for other costs such as travel and You have the right living expenses. You also have to pay the fees in the county • to be informed about your state of health; council where you are visiting or receive treatment, even • to receive information about a study or treatment; if they differ from the fees in Västerbotten.
• to receive information about other possible examinations or treatments; and Your responsibility • to receive information about methods to prevent Freedom of choice includes planned care where you are illness and injury.
responsible for finding and choosing care providers.
In most cases you are entitled to read or copy your pa- You have to make your appointments with the care tient chart. You can also receive a printout or a copy of provider you chose. You are also responsible for contacting your chart for a set fee. People who have problems under- the hospital department in Västerbotten where you are standing the Swedish language are entitled to assistance on the waiting list so they can send a referral and your from an interpreter. Healthcare personnel will arrange for medical records to the selected care provider.
an interpreter and the assistance of an interpreter is free.
Patients who are deaf or hearing-impaired are also entitled •to an appointment within to the services of an interpreter free of charge. The nursing a specific amount of time staff can help to arrange for an interpreter through thecounty council's listing of interpreters.
The appointment guarantee means that the care will beginwithin a specific period.
•to freedom of choice 1. If you are ill and seek contact with primary care on the same day, you will talk to personnel at a health care centre by telephone or have an appointment there.
Freedom of choice means that you can seek care outside 2. If you do not see a doctor during your initial en- the county on the same terms as in your home county counter with a health care centre and the health care cen- council. Your choices include care providers from all tre feels that you need to see a doctor, you will be scheduled county councils and private care providers that have for an appointment within seven days after this contact.
agreements with the county council or are reimbursed You cannot be guaranteed an appointment with a specific doctor, such as your family doctor. If you want to makean appointment for a procedure that does not involvedirect medical care, such as a physical examination orcertificate, the guarantee does not apply.
3. If you are referred for specialist care at a hospital – assuming that the medical treatment is needed – you willreceive an appointment for a first visit within three monthsfrom the time that the referral reached the hospital.
4. If the county council cannot fulfil the appointment guarantee according to the above criteria, you may askanother care provider within the county or in anothercounty council.
If you choose to exercise the appointment guarantee, the care unit will write a referral/acknowledgment of debtto another county council in accordance with yourrequests.
The home county council must always approve costly treatments in advance.
You schedule your own appointments if you wish to visit another health care facility. You will pay the patientfee according to the fee schedule that applies where thehealthcare is provided.
Note the appointment guarantee is not the same as the •to get a second opinion treatment guarantee. At this time, Västerbotten County On occasion, a patient may want a second doctor to Council does not have a treatment guarantee. As a pa- evaluate a diagnosis and recommended treatment options.
tient, however, you may choose to receive treatment in In such cases, we usually talk about a second opinion. If another county council.
the care provider cannot medically justify the need for asecond opinion, you will have to pay for the trip and your Waiting time in healthcare appointment with another care provider. Your doctor In a few specialities or operations, the waiting time in should indicate that the referral is written at your request Västerbotten is long. These long waiting times mainly and that it does not involve any obligation for payment affect patients with lower priority medical care needs.
by the county council.
The county council's long-term objective is for all When choosing a treatment method, sometimes sci- patients to be offered an appointment for an office visit ence and proven experience do not provide clear guidance.
or procedure/surgery within three months.
In such cases, your requests for a second opinion will be In Västerbotten, collaboration among county hospit- approved in life-threatening situations, or if a serious illness als is growing; for example, more Umeå residents are being or injury is involved where you face the choice of a risky offered appointments for surgery in Skellefteå and Lyck- treatment, or if the choice of treatment is highly significant to your future quality of life.
Preferably, this second evaluation should take place in our own county. Your doctor is obligated to ensure that if you have the right to a second opinion that you also have The telephone numbers of all county councils the opportunity to this by referring you to an appropriate are listed at under the heading care provider. Your treating physician or the administra- County Councils/Regions and Addresses.
tor at the health care centre will consult with you and Information about waiting times for a then decide where to send the referral. You will be offered selection of clinical procedures and operations the treatment indicated by the second opinion.
at different hospitals in Sweden is posted on The county council pays for the expenses, excluding the Internet (
the patient fee and reimbursement for the trip, excluding This information is also available via the your co-pay.
county council's website,ård ochhälsa. If you do not have access to the Internet,you can request the information by telephone For more information
from your own county council.
For questions about freedom of choice, theappointment guarantee, referral rules, andpatient fees, contact Eva Grahn, 090-785 70 86or Mona Karlsson, 090-785 70 85 (applies tocitizens and patients). County councilpersonnel may contact Kenneth Öberg,090-785 71 58.
You have the right Mostly rights– but also •to decide about your samples Sweden has a law concerning biobanks that says that thesamples you submit in medical care may only be saved ifyou consent. You also have the right to decide how thesamples may be used.
So far this guide has mainly dealt with patients' rights; The purpose of the law is to strengthen your position however, you also have some obligations in your health as a patient and increase your influence over your care care. We present some of them here.
and treatment. It will also make it easier for researchers to When you visit a health care facility, you must pay the gain access to valuable material for research and clinical patient fee according to the established fee schedule, unless you are entitled to free medications, are younger than 20, Informed consent means that you received and under- or if you seek care in accordance with the Communicable stood the appropriate information before making any Diseases Act.
decisions regarding the saving of your samples.
You must be on time for your appointment. If you will If you say yes without restrictions, the sample will be be late or cannot keep an appointment that you made saved for care, treatment, and activities related to treat- with care providers, you must notify the personnel as soon ment, such as training of medical personnel and quality as possible. If you do not cancel the appointment, you and development work within healthcare. The sample may will still have to pay the patient fee.
also be used for research and clinical trials that are approved When you visit a health care facility, you are usually by a research ethics committee. If you say yes, you can required to give your name and civic registration number always change your mind later.
and to show some form of identification that includes You may also choose to omit any of the purposes this information.
mentioned above.
There are also a number of restrictions and exceptions You can also choose to say no completely, and then the that are good to know. Your right to decide about the sample is discarded after analysis. This means that the content of care is limited. You cannot demand to receive sample is destroyed or made anonymous so that it cannot a treatment or examination that the doctor does not feel be linked to you. Information provided by the sample is is warranted or is in conflict with "science and proven then lost forever.
experience". The doctor's professional opinion is the final If you do not want your sample to be saved at all or for some special purpose, you must fill in a form saying no.
No one has the right to have actively assisted euthanasia.
If you are unsure, the sample will be saved just to be sure,until you make up your mind.
To read your medical records Your consent will be noted in your referral or other You can be denied the right to read all or part of your patient records. Each time you give a sample that may medical records if the doctor feels that it would seriously need to be saved, you will receive information and be asked interfere with your treatment.
for your consent. Under a cohesive treatment period, you The same applies if it is likely that someone's personal may give your consent once and it will apply to all samples safety is placed in danger, for example, someone who is taken during this period.
mentioned in the chart or who has commented about the A patient who is unconscious or for some reason can- not make a decision may not give consent. In such cases, If you are not permitted to read your medical records the sample is saved until further notice for the patient's within the county council's health care, you can turn to the administrators of the unit where you requested to readyour records for information about how to proceed. Youcan also find this information on the county council's For more information
If you have questions on biobanks, "no" forms, If you are not permitted to read your medical records research at biobanks, etc, contact Johanna at a private practitioner's office, contact the National Board Åkerlund, Biobankscentrum, 090-785 85 62.
of Health and Welfare.
You can read more about biobanks Communicable Diseases ActThe Communicable Diseases Act and compulsorypsychiatric care include exceptions to the right to refusecare and treatment.
The Communicable Diseases Act helps society avoid or limit epidemics and the spread of dangerous diseases.
Infectious diseases are divided into diseases that aredangerous to society and other infectious diseases. Diseasesthat are dangerous to society include hepatitis (jaundice), HIV, chlamydia, gonorrhoea, polio, tuberculosis, menin- gitis, and salmonella.
If you suspect you have been infected with an illness that is dangerous to society, you must see a doctor for tests and examination. You are also required to followbehavioural guidelines from the doctor and provide in-formation about the person from whom you may have Everyone who lives in Sweden and belongs to the Swe- caught the infection and whom you in turn may have dish insurance office is protected by the high-cost limit, which sets a maximum amount that patients pay for For more information, you can turn to the county medi- cal officer at the county council's infectious disease unit.
People from the Nordic countries, countries within the EEC, and certain other countries are also entitled to this benefit if they require urgent care and medication while If you are hospitalised in compliance with the Compulsory in Sweden. These prescriptions must be ordered in Mental Care Act (LPT) or the Forensic Mental Care Act (LRV), you do not have the same rights to refuse care and The high-cost limit is in effect for twelve months from treatment, but you do have the right to appeal the treat- the first purchase and you pay a maximum of SEK 1,800 ment and the actual decision for commitment to a men- during this period. After this time, a new twelve-month tal hospital. You have the right to contact the National period begins the next time you buy prescription medi- Board of Health and Welfare, the Parliamentary Ombuds- man, a legal representative, etc. The patient committee All children under the age of 18 in a family are counted can appoint a support person, someone who can give you together and are included in a common high-cost limit.
personal aid while you are hospitalised.
Consumables that are needed to administer medications Remember that medical personnel are required to in- included in the high-cost limit or that are needed for self- form you about your rights. The Health and Medical monitoring of medications are free.
Services Act also applies to patients who have been com- The high-cost limit applies to most prescription drugs, mitted to care.
birth control medications, and consumables needed forcolostomy in order to administer medications or for self-monitoring of medications.
Apoteket Card (Apotekskortet)When you buy prescription drugs, you will receive an"Apoteket Card" to track your medications purchases. Thepharmacy registers your purchases so that you will receivethe right discount each time you buy prescriptionmedications.
The information recorded includes your civic registra- tion number, card number, amount of co-pay paid, pur-chase dates, amount spent against your high-cost limit,and the starting date for an initiated high-cost limit. Thehigh-cost limit database does not include informationabout which drugs you received or which doctor prescribedthe medication.
If you do not want an Apoteket Card, you have to save your receipts for the high-cost limit. Always have theApoteket Card with you and show it when you buyprescription drugs in order for the pharmacy to track yourdiscount level.
For more information
If you have any questions about medications,
you can ask at your pharmacy. You can also call
0771-450,450 or visit Apoteket's website
in outpatient care Each time you visit a care provider at the county council's Below is a summary of the fees for outpatient care health care centres or hospitals or a care provider in private (all care except when you are hospitalised): practice who is reimbursed by the county council you areentitled to have the fee you paid recorded on a high-cost card. The card is available at any medical office.
• Health care for children and adolescents The high-cost limit for medical care and some dental through age 19.
care means that you only pay a maximum of SEK 900 in • Office visits to and home visits by public health nurse, patient fees over a twelve-month period. After this, you nurse, or LPN in primary care; certain exceptions apply.
are entitled to a free card for medical care, which is issued • Emergency referral to specialist.
at one of the county council's medical offices or at one of • Antabuse treatment.
the private care providers that you visit. The card is valid • Ambulatory care for people admitted for rehabilitation.
for the time remaining on the twelve-month period, • Office visit, paediatric and maternity care facilities.
calculated from the first visit.
• Specialist maternity care.
As previously, preventive care such as physical exami- • Office visit, adolescent health clinic.
nations, mammography screening, pap smears, certificates, • Referral appointments for x-rays and lab tests.
vaccinations, fees for missed appointments, and inpatient • House call at the initiative of medical personnel.
care do not count for the high-cost limit.
• House call in municipal assisted living facilities.
You, however, may include dental care for which medi- • Prescriptions and renewals in municipal assisted cal care system fee schedules are in effect in the high-cost living facilities.
limit (see page 11).
• Visit to/by patient who is mentally disabled.
In order to receive free care at all of the county council's • Complex home care.
outpatient clinics and from private care providers, you • Refill of tablet dispenser.
have to show the free card at the first visit.
• Injection of psychotropics.
• Wound care supplies for the chronically ill.
Thirty-minute rule • Incontinence supplies.
If you have an appointment and do not meet any of the • Pap smear for 23- and 26-year olds.
care providers within thirty minutes without anexplanation, you are entitled to a refund of your patient fee. Request this refund at the time of the visit.
• A county council employed doctor or private doctor connected to the reimbursement system phones in Charge for invoice a prescription.
• Prescription renewal (not in connection with If you want an invoice with a payment slip, you will be doctor visit).
charged a fee of SEK 50.
• Testing and adjustment of assistive technology.
If you pay with cash or a credit card, no extra fee is • Lab work (not in connection with doctor visit).
Fee SEK 100 for(These fees are in effect beginning at the age of 20)• Office visit to doctor at health care centre or house doctor.
• Office visit to doctor: geriatrics, psychiatry, rehab centre, behavioural medicine, and stroke centre.
• Treatment by care provider other than doctor (nurse, occupational therapist, social worker, dietician, physicaltherapist, psychologist, etc). The fee applies to bothoffice visit and home visit.
• Mammography.
• Pap smear.
• Visit to/by incontinence, asthma, diabetes or heart failure nurse.
• Visit to physiotherapist.
• Visit to licensed psychotherapist.
• Physical examination (what was previously called the Västerbotten project).
• Visit to chiropractor/physiotherapist/psychotherapist who has agreement with the county council.
(These fees are in effect beginning at the age of 20.)• Office visit to doctor, daytime, outpatient clinic at a hospital.
• Office visit to doctor, after hours and Saturdays, Sundays and holidays.
The county council reimburses some of your expenses • Home visit by doctor.
for travel to and from medical care appointments as part • Office visit to doctor, specialist in private practice of the National Insurance Act.
(not psychiatry).
The most common appointments that are reimbursed • Office visit to doctor, emergency room.
are visits to the doctor, dentist, or physiotherapist.
• Reimbursement is always calculated and paid based Examples of other fees on the least expensive method of transportation (in most and certain types of assistive technology cases bus or second class train ticket).
• Sterilisation (the fee is SEK 1,800).
• A co-pay of SEK 60 (one way) is deducted for all travel.
• If you miss your appointment without notification, you must pay the applicable patient fee.
Travel reimbursement • Vaccinations. The office visit fee is SEK 300 at the Travel reimbursement is paid and calculated based on the doctor's office and SEK 100 at another care provider's least expensive mode of transportation after you complete office, plus the fee for the vaccine. These fees do not and submit a form. You receive this form when you pay apply to vaccinations in the paediatric care programme for your medical visit.
and certain other vaccinations for which other decisions If travel reimbursement is less than SEK 50, it is allowed are in effect.
to accumulate and paid when the level reaches SEK 50; • Crutches and ice cleats that you need, for which however, payment is issued twice a year even if the total you pay cost.
amount does not reach SEK 50.
• Co-pay for bicycles that are prescribed: SEK 500 Reimbursement is always calculated and paid based on for children and SEK 1,000 for adults. The co-pay the least expensive method of transportation (in most cases is charged with each prescription.
bus or second class train ticket). If you are evaluated andneed your own car for medical reasons, reimbursement is Patient fees for inpatient care paid at the rate of SEK 10 per 10 km.
If you are admitted to one of the hospitals in Västerbot- When you exercise your right to choose a care provi- ten, you must pay SEK 80 for each day of hospitalisation.
der, you must pay for your own travel and housing costs, The fee is the same regardless of income.
The county council has implemented a high-cost card, which means you do not have to pay more than SEK 1,200 per thirty-day period hospitalised. Early retirement In most cases, you must pay a co-pay for the trip. The co- pensioners under the age of 40 pay half of this fee (SEK pay is SEK 60 one way, regardless of method of transpor- 40 per day). No fee is charged for children and young tation. Patients with a free card for medical care or who people under the age of 20.
are entitled to para-transit services pay half the co-payper one-way trip. The co-pay is deducted from the travelreimbursement.
For more information
If after medical assessment you are approved to travel See box on page 3. You will also find informa- by taxi, fixed-route vehicle, or special vehicle, the co-pay tion about current patient fees on the county is paid directly to the driver.
Outpatient visits are exempt from the co-pay as follows: • paediatric and adolescent rehabilitation;• paediatric and adolescent psychiatry;• dialysis treatment; and• visits covered by the Communicable Diseases Act (reimbursed by the insurance office).
Patient transport by taxiIf after medical assessment by medical personnel you areapproved for a method of transportation other than theleast expensive, you must make arrangements through thecounty council's Travel Service.
Travel to the health care facility must be ordered through Travel Service (020-22 10 20) at least two working days(Monday–Friday 7 am –7 pm) before the first visit.
You have the right to receive help from the taxi driver to and from the medical department/office or equivalent andto and from your home. Medical personnel will also ass-ess the need for an attendant.
The trip from the health care facility must be ordered by the health care facility's personnel through the Travel are not satisfied? Service that is responsible for coordinating and orderingtaxis. If you order a taxi by some other means than throughthe county council's Travel Service, you have to pay the Although healthcare employees always try to do their best, you may be dissatisfied. Start by discussing the problem Don't forget to cancel or change the trip through the with the personnel with whom you have been in contact.
Travel Service if your appointment is cancelled or the time If this does not solve the problem, contact the responsible senior doctor/family doctor or administrator.
If you find it difficult or unpleasant to speak directly to the doctor and other personnel, you can contact the If you become acutely ill and need an ambulance, call the patient committee (patientnämnden).
emergency number 112.
Depending on the nature of your complaints, you can If you become ill and after medical assessment you are also contact the senior consultant, the Medical Responsi- considered to need a taxi, call the Travel Service.
bility Board (HSAN), the National Board of Health and The main rule – use the least expensive method of Welfare, PSR Personskadereglering AB, or Pharmaceutical transportation – applies even if you are referred outside If your concerns relate to the municipality's healthcare If the medical assessment shows a need for some other services, you can contact the municipality's nurse with method of transportation, such as by air, arrangements special medical responsibility (MAS).
are made through the Travel Service.
Lower co-pay for people seeking asylum patient committee Beginning on 1 January 2005, the co-pay for patient tran-sports for people seeking asylum has been reduced to SEK The county council has a patient committee whose 40 because of a recent agreement between Sweden's county primary responsibility is supporting you as a patient. You councils and local authorities and the Migration Board.
can contact the committee personally or let a relative doso on your behalf.
The patient committee consists of politicians. It's pur- For more information
pose is to support and assist individual patients while Questions about patient transports can be contributing to improving quality of care. The committee answered by the Travel Service office in your can provide information about your possibilities, straigh- district, 0950-390 00, 0910-77 10 00, or 090- ten out problems, and try to help arrange the contacts 785 00 00. In more complicated cases, you can you need in the healthcare system. The committee also contact Alf Holmberg, Travel Service, informs those responsible for healthcare of observations [email protected], 090-785 85 70 or 070- and deviations that are important for patient safety. Your opinions or complaints could indeed help others.
Patients committed to psychiatric care are entitled to a support person, someone who can assist in a difficult si-tuation. The patient committee appoints this supportingperson.
Just like all healthcare personnel, the patient committee, the politicians, and the administrators must observeconfidentiality.
The patient committeeoperations in the municipalitiesThe municipalities provide healthcare services and gene-ral care in facilities such as nursing homes, assisted living,and group housing. Even here committees have the taskof helping and supporting patients and residents.
Most municipalities in the county have delegated these activities to the county council's patient committee. Askthe receptionist at your municipal office who handlespatient committee activities in the municipality.
cil. If you were injured as a result of treatment by someother private care provider (e.g., private dentist) or in the Medical Responsibility Board municipality's healthcare system, you should find out whatinsurance company they use.
This insurance coverage includes surgical procedures If you feel that a healthcare provider has committed a as well as injuries related to taking samples, donating mistake or been negligent in their professional duties, you blood, physiotherapy, and other healthcare activities.
can register a complaint with the Medical Responsibility Injuries may be due to examinations, treatment, incorrect Board (HSAN). The medical responsibility board informs diagnosis, incorrect medications, infection, or accidents the person who was reported of the complaint.
in certain situations. Compensation is not awarded for The complaint to the board must be in writing and all injuries. For example, no compensation is paid for can be submitted by the patient or in some cases by a injuries in situations where providers must take great risks close relative. You should submit your complaint as soon in emergency situations or to treat an extremely critical as possible since a number of investigations have to be conducted. The person reported must be informed by Complaints should be submitted as soon as possible HSAN about the complaint within two years from the and usually no later than three years after the time that date the incident occurred. You can get the form for you realize that your injury could be due to treatment, reporting complaints at HSAN's website ( but no later than ten years after the incident. You can or from the patient committee, where you can also obtain obtain the form for reporting the injury from social work- more information about the rules that apply.
ers or the patient committee.
Pharmaceutical Insurance If you believe that you have sustained injuries from medi- of Health and Welfare cine that was sold or distributed in Sweden, you can sub- The National Board of Health and Welfare is the highest mit a claim to the Pharmaceutical Insurance.
jurisdiction for medical care. It also has central responsi- Whenever you take medicine, there is always some risk bility for ensuring that the patient's rights are respected of side effects that can cause injuries. This insurance, from a medical, legal, and social standpoint.
therefore, only applies if a drug causes an unexpectedphysical injury or illness. No compensation will be award- Patient associations ed if the injury was caused by misuse of the medicine.
You must file your complaint within three years from and organisations the time that you learned that your injury was probably for people with disabilities caused by the medication. You can usually get the form If you have sustained a chronic illness or a permanent from a social worker or from the patient committee.
disability it could be helpful to contact other people in asimilar situation. There are many organisations for patients Patient Insurance and families that work with the special problems of various If you believe that you have sustained an injury in groups that can provide support and advice.
connection with treatment or an examination by health- You can find more information and addresses from the care provided by the County Council (at a hospital, health Swedish Disability Federation (HSO) and The National care centre, National Dental Service, or the College of Federation of Disabled Persons (DHR) or in the yellow Dentistry), you can submit a claim to PSR Personskade- pages of the telephone book under "Handikapporganisa- regling AB, which will determine whether you are entitled tioner" (Organisations for people with disabilities).
to monetary compensation. You can do the same if you The county council has a secretary for people with dis- feel you were injured as a result of treatment by a private abilities and each municipality has someone who can pro- care provider who has an agreement with the county coun- vide information on disability issues.
Freedom of choice for dentalcare with free dental carefor children and adolescentsFree dental care for children and adolescents is provideduntil the year they turn 19. In Västerbotten, people arefree to choose a dentist within the Public Dental Serviceor a dentist in private practice for their dental care. Peoplewho go to a private dentist complete a form when theyvisit the private dentist to transfer care to the private provi-der. People who do not actively choose will be called tothe public dental health service office for the area.
Emergency Dental careIf you need emergency dental care during the evening oron weekends, you should call 112.
All medical personnel and personnel in social services arerequired to comply with the Swedish Official Secrets Act Dental Insurance for everyone (Sekretesslagen) and observe confidentiality. The main ruleis that information about your state of health and other All adults are covered by the public dental insurance personal conditions may not be released if it could harm scheme. The local insurance office reimburses dentists to or cause discomfort for you or your relatives.
some extent by paying a fixed amount for preventive The definition of sensitive data may vary. Therefore, measures, repairing cavities, and emergency dental care.
the personnel must carefully become familiar with the Special reimbursement rules apply for measures such as individual patient's situation. As a patient, you can help braces, implants, crowns and bridges.
by identifying who may receive information about you After an evaluation, the local insurance office can pay a and what information may be released. For more infor- higher reimbursement rate for people who have an mation on confidentiality issues, you can contact your increased need for dental care because of certain chronic doctor, a social worker, or the patient committee's admi- medical conditions and disabilities. A special high-cost limit applies to people aged 65 and up. The local insurance Private healthcare has regulations about confidentiality office and your dentist can provide more detailed infor- in the Swedish Act on Professional Activity in Health and mation about this.
Medical Services.
Pricing is not regulated for dental care. The cost can vary depending on type of treatment and the dentist's fee.
Your patient chart However, in the public dental service in the county the The written chart is an important aid for medical same fee plan applies everywhere.
personnel. They record how you feel, results of various All dentists and dental hygienists must post their fees.
examinations, and the care, medicine, and treatment you Remember that you always have the right to an estimate of costs in writing from your dentist.
Because each health care centre or medical centre maintains its own medical records, you may have several Dental Care on subscription patient charts.
The Public Dental Service and certain private dentists Patient charts from the paediatric medical centre are and dental hygienists can offer dental care on subscription.
transferred, with parental approval, to the school health The patient pays a fixed total price for care over a two- service when the child starts school.
year period, regardless of the number of treatments. Askyour dentist and dental hygienist whether they offer this Who may read your chart? type of health-focused dental care.
As a patient, in most cases you have the right to read yourown chart or to get a copy of it.
Those who are responsible for your care are entitled to have access to the information that is relevant in order toprovide you with correct and safe care.
There are occasions when a patient may not share certain data in his chart. More about this and how you can appealif you are denied access to your medical records can befound on page 8.
County council'sdental care subsidy Dental care can be paid for according to the HealthcareAdministration's fee system for certain groups withextensive need for care and for certain specifically describedprocedures and medical conditions.
Outreach oral health assessmentThe county council is responsible for ensuring that certainelderly people and people with functional impairmentswith municipal health care and social services or similarare offered a free home visit to evaluate oral health andprovide advice and instructions pertaining to oral health.
The county council and the county's municipalitiestogether determine which groups should receive outreachdental care. The municipalities are responsible for ensuringthat these groups receive information and the offer forthis dental care assistance. Those people who are affected Surgical dental care in the hospital by the subsidy receive a certificate to this effect from their For certain more extensive dental and jaw operations that must be done in hospital, the same fee schedule applies as Patients must bring the original certificate with them for medical care in general.
to their dental appointment. The certificate can be issuedby caseworkers or LSS administrators in the municipal- ity, managers of assisted living facilities for the elderly and The annual outreach oral health assessment is free for people with functional impairments, and others.
people who qualify for the service. The fee for necessarydental care and dental care as part of treatment of illness Necessary dental care is SEK 100 for the appointment with the dentist and den- People who are offered an outreach oral health assessment tal hygienist. The fee for an appointment with a specialist are also entitled to assistance for "necessary" dental care.
It should help the individual eat and avoid pain and The fees may be counted in the medical high-cost li- mit, which is currently SEK 900 over a twelve-month Necessary dental care can also involve regular exams, period. If the patient has a free card, the visit is free.
preventive care, and fillings. More extensive treatmentsare reviewed by the county council in advance.
Freedom of Choice for dentistswithin the medical care system's fee scheme Dental care as a part of treatment Dental care where the medical system's rates are paid may of illness for a limited period be carried out by a public dental service dentist or by a When treatment by a dentist or dental hygienist is needed private dentist affiliated with the insurance office. Some in order to evaluate or treat an illness, you may receive in treatments require a specialist, which can limit the patient's some cases a subsidy support for this dental care, assuming freedom to choose a care provider.
that the patient has a referral from the doctor and thedoctor and dentist or dental hygienist agree to collaborateon the case.
For more information
The dental care must be medically motivated and be If you have any questions about the rules for included as part of the medical treatment and should be dental care you can contact Lars Sjödin, county completed during a limited period; for example, clearing council office, 090-785 71 95, up infection prior to major heart surgery. Only the den- tal care needed to treat the illness will be reimbursed. All Ann Sofie Strömsten, insurance office, major treatments will be reviewed in advance.
090- 10 50 38, will answer questions aboutdental insurance for people over the age of 65.
Dental care as a result of dryness of the mouth You can also ask your dentist or dental hygienist People who suffer from dryness of the mouth due to about what applies in your particular case.
Sjögren's syndrome or radiation therapy to the head and/ You are also welcome to log in at the county or neck that damages the salivary glands may be entitled council's website ( or the Insurance to have some dental care paid for according to the Office website (
healthcare administration's reimbursement rules.
Telephone and addresses County CouncilVästerbotten County Council, 901 89 UmeåStreet address:Landstingshuset, Köksvägen 11, UmeåTelephone: 090-785 70 00Fax: 090-13 68 82Text telephone: 090-785 70 10E-mail: [email protected]:


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WALTER HALLSTEIN-INSTITUT FÜR EUROPÄISCHES VERFASSUNGSRECHT HUMBOLDT-UNIVERSITÄT ZU BERLIN WHI – Materials 2/03 RALF KANITZ/PHILIPP STEINBERG (HRSG.) NEUE RECHTSPRECHUNG DER EUROPÄISCHEN GERICHTE (EUGH, EUG) EXAMENSRELEVANTE ENTSCHEIDUNGEN KOMPAKT DARGESTELLT, KOMMENTIERT UND RECHTLICH EINGEORDNET Ralf Kanitz/Philipp Steinberg (Hrsg.), Neue Rechtsprechung der Europäischen Gerichte (EuGH, EuG). Examensrelevante Entscheidungen kompakt, Berlin, April 2003 Kontakt: Walter Hallstein-Institut für europäisches Verfassungsrecht Juristische Fakultät Humboldt-Universität zu Berlin Unter den Linden 6 D 10099 Berlin Tel.: ++49 (0) 30 2093 3440 Fax: ++49 (0) 30 2093 3449 Email: [email protected] und [email protected]