قوانين العناية الصحية في بلجيكا

أقيم في بلجيكا، هل لدي الحق بالحصول على العناية الصحية ؟
هل يتوجب علي الإنتساب إلى الضمان الصحي ؟ بماذا ينفع الضمان الصحي ؟
أي ضمان صحي علي أن أختار ؟ كم سيكلفني ؟ كيف بإمكاني الإنتساب ؟
كيف يعمل نظام السداد ؟
ما هي حقوقي كمريض ؟
إلى أين يجب أن أتوجه إذا ما واجهتني مشكلة طبية أو مرضت ؟
متى يتوجب علي الذهاب إلى المشفى ؟
وإذا مرضت مساءً أو خلال عطلة نهاية الأسبوع ؟
هل يوجد أماكن أخرى حيث يمكنني الاستطباب ؟

أقيم في بلجيكا، هل لدي الحق بالحصول على العناية الصحية ؟

في بلجيكا، يحق للجميع الحصول على العناية الصحية. يُدفع جزء من هذه العناية عن طريق الضمان الصحي. يحق للأشخاص الغير مسجلين في الضمان بالحصول على عناية الطبية عن طريق الـ CPAS أو مكتب الـ « المساعدة الطبية الطارئة  [?].

انتبه : لا ينتمي الأشخاص القادمين بتأشيرة دخول سياحية أو مهنية إلى هذه الفئة إذ أن عليهم تحمل تكاليف عنايتهم الطبية شخصياً.

هل يتوجب علي الإنتساب إلى الضمان الصحي ؟ بماذا ينفع الضمان الصحي ؟

إن الضمان الصحي هو منظمة خاصة تُرجع تكاليف العناية الطبية إلى المريض بشكل كلي أو جزئي. كما تدفع التعويضات في حالة العجز عن العمل، وتزودك بالمعلومات و بالإجابات عن الأسئلة المتعلقة بموضوع الصحة.

إذا ما انطبقت عليك الشروط، عليك الإكتتاب لدى الضمان الصحي.

إذا لم يكن بمقدورك الحصول على تغطية الضمان الصحي، هناك نظام يسمح عبر الـ CPAS بتحمل أعباء العناية الصحية.
إذا كنت من دون أوراق نظامية، لديك الحق بما يسمى الـ « مساعدة الطبية الطارئة [?] »

أي ضمان صحي علي أن أختار ؟ كم سيكلفني ؟ كيف بإمكاني الإنتساب ؟

هناك العديد من شركات الضمان الصحي. تقدم جميعها الخدمات نفسها بشكل أو بآخر. في النظام العام لا يوجد هناك رسوم اشتراكات. إذ يتم اقتطاع مبلغاً من أجرك (اشتراكات الضمان الإجتماعي) أو عن طريق اتفاقيات مع منظمات أخرى.

تقدم شركات الضمان الصحي أيضاً تأميناً تكميلياً لتغطية بعض الرسوم التي لا تسترد في التغطية الأساسية. هذا التأمين مدفوع وهو إلزامي.

لإيجاد مكتب بالقرب من مسكنك، قم بزيارة الموقع الإلكتروني :

www.mutsoc.be
www.mc.be
www.mloz.be

كيف يعمل نظام السداد ؟

عندما تزور الطبيب، يعطيك شهادة تثبت أنك قمت باستشارته. إذا وضعت هذه الشهادة لدى مكتب الضمان الصحي، سوف تسترد قيمة استشارة الطبيب، بشكل كامل أو جزئي. بشكل عام، جزء من الرسوم الطبية تدفع من قبل شركات الضمان الصحي وتدفع أنت الجزء المتبقي. ينطبق هذا الأمر أيضاً على الأدوية، إلا أن استرداد القيمة يغطي فقط بعض الأدوية حيث يطبق الصيدلي تخفيضاً على سعر الدواء.

ما هي حقوقي كمريض ؟

يمكنك اختيار طبيبك وتغييره في أي وقت تشاء.
يحق لك الإستعلام حول حالتك الصحية، العلاجات الممكنة والمخاطر المحتملة. يجب على الطبيب أخذ موافقتك قبل البدء بالعلاج.
يمكنك طلب رؤية ملفك الطبي.
لديك الحق بالسرية الطبية.
إذا صادفتك صعوبة في التحدث أو فهم اللغة، يمكنك استدعاء خدمة متخصصة في الترجمة الكتابية والشفهية (فورية). تكلم مع محاورك حول هذا الموضوع في (المشفى، المستوصف، الخ…).

إلى أين يجب أن أتوجه إذا ما واجهتني مشكلة طبية أو مرضت ؟

استشر في البداية طبيب عام الذي بدوره سيوجهك إلى اختصاصي أو إلى مستشفى في حالة الضرورة.

إذا كنت لا تعرف أين تجد طبيب عام، استعلم لدى أقرب صيدلية إلى مسكنك.

تجنب الذهاب إلى قسم الطوارئ في مستشفى ما لكل مشاكلك الصحية إلا في الحالات الإضطرارية جداً. سينصحك الطبيب العام الذي تستشيره بما يجب فعله.

من الأفضل دائماً استشارة الطبيب نفسه. بذلك تتعرفون على بعضكم بعض بشكل أفضل، وستبنون معاً علاقة ثقة متبادلة. كما أنه سيقوم بتحديث ملفك الصحي بشكل دوري.

متى يتوجب علي الذهاب إلى المشفى ؟

حين يقرر طبيبك أنك بحاجة إلى عناية اختصاصي، قد يحيلك إلى مشفى. أغلبية المشافي تحوي على عيادة طبية شاملة حيث يمكنك استشارة أطباء من مختلف الإختصاصات. تنظم المشافي بما في ذلك استشارات أطباء الأسنان، العيون، المعالجات الفيزيائية، الخ… تخصص ساعات محددة لهذه الإستشارات أو تكون حسب موعد في غالب الأحيان وعليه لا يمكن استقبال حالات الطوارئ.

وإذا مرضت مساءً أو خلال عطلة نهاية الأسبوع ؟

إذا ما مرضت مساءً، ليلاً أو خلال عطلة نهاية الأسبوع، يمكنك التوجه إلى الطبيب المناوب أو الطلب منه القدوم إلى منزلك في حال لم تكن قادراً على التنقل.

لإيجاد طبيب مناوب بالقرب من مسكنك، اتصل هاتفياً بطبيبك العام المعتاد (سيزودك تسجيل صوتي برقم الطبيب مناوب).

سيقرر الطبيب المناوب فيما إذا كانت حالتك طارئة، حينها سينصحك بالذهاب إلى قسم الطوارئ في المستشفى.

في بروكسل، يمكنك أيضاً الإتصال بـ SOS Médecins (اس او اس ميديسان) : 02/513 02 02 www.sosmedecins.be

هل يوجد أماكن أخرى حيث يمكنني الاستطباب ؟

يمكنك أيضاً الإستطباب في المستوصف القريب من منزلك. هناك سيتاح لك استشارة أطباء عامين، مساعدين أجتماعيين، محللين نفسيين، أطباء أسنان، أطباء نساء، وأطباء أطفال.

www.maisonmedicale.org

تدير أغلب شركات الضمان الصحي عيادات طبية شاملة، حيث يمكنك استشارة أخصائيين، أطباء عامين، أطباء أسنان، أطباء نساء، وأطباء أطفال.

لمعرفة المزيد استعلم لدى مكتب ضمانك الصحي.

أين يمكنني الحصول على مساعدة حول المشاكل المرتبطة بالأزواج والعلاقة الجنسية ؟

في مركز تنظيم الأسرة، وبأسعار بمتناول الجميع، يمكنك استشارة طبيب والحصول على نصائح إختصاصيين حول وسائل منع الحمل، العلاقات الجنسية، الإجهاض، الأمراض الجنسية المعدية، العنف الزوجي. يلتزم الإختصاصيون باحترام السرية المهنية، بما في ذلك سرية القاصرين.

www.loveattitude.be

في بلجيكا، يحق للمرأة اتخاذ القرار فيما إذا كانت تريد إنجاب أطفال أو لا، ويحق لها استخدام وسائل منع الحمل.

في حال حمل المرأة دون رغبتها، يمكنها إتخاذ قرارٍ بالإجهاض قبل نهاية الأسبوع الثاني عشر من فترة الحمل.

أنام بشكل سيئ،عندي قلق، أنا مكتئب. من يمكنني أن أستشير ؟

من المفيد أحياناً التكلم إلى اختصاصي عن مشاكل النوم، نوبات الخوف، الحنين إلى الوطن، الشعور بالوحدة، استعادة الصدمات النفسية التي قد مررت بها… في بلجيكا، ينصح الطبيب العام في هذه الحالات غالباً باستشارة اختصاصي. إن مساعدة المحلل النفسي قد تكون أيضاً مفيدة لأطفالك. مثلاً، إذا واجهوا مشاكل في المدرسة أو لاحظت تغير في سلوكهم.

استعلم حول الخدمات المتوفرة بالقرب من مكان سكنك، مثلاً مراكز الصحة النفسية.

يمكنك أيضاً التكلم حول هذا الموضوع مع طبيبك العام.

أنا من ذوي الإحتياجات الخاصة. أين يمكن الحصول على مساعدة لي ولعائلتي ؟

إذا كنت من ذوي الإحتياجات الخاصة، من المحتمل أن تواجهك مشاكل في التنقل، إيجاد عمل، وإنشاء علاقات اجتماعية، أو أن تكون مستقلاً… توجد منظمات تهتم بذوي الإحتياجات الخاصة وترشدهم. يمكن لهذه المنظمات مساعدتك شخصياً ومساعدة عائلتك.

لمعرفة المزيد :

في بروكسل : Phare (لذوي الإحتياجات الخاصة الباحيثن عن استقلالية) : www.phare.irisnet.be
في والونيا : AWIPH (الوكالة الوالونية لإندماج ذوي الحاجات الخاصة في المجتمع) : www.awiph.be

ما هي الوثائق المهمة التي تتعلق بصحتي ؟

Carte SISبطاقة الـضمان الصحي « Carte SIS » (كارت سيس) : وهي هويتك الإجتماعية. تحتوي هذه البطاقة على كافة المعلومات المفيدة لمؤسسات الضمان الإجتماعي. يتوجب عليك إظهارها في الصيدلية، في المشفى ولدى مكاتب الضمان الصحي. للحصول عليها يجب طلبها من مكتب الضمان الصحي.

لصاقة المعلومات المصغرة : وثيقة تحتوي على معلومات الضمان الصحي المتعلقة بك. عليك إلصاقها على الوثائق الموجهة إلى الضمان الصحي (شهادات الرعاية الطبية، وصفات الصيدلية). للحصول عليها يجب طلبها من مكتب الضمان الصحي.

وصفة طبية : وثيقة يكتب فيها الطبيب لائحة من الأدوية والمعالجات التي تحتاج إليها. عليك تقديم هذه الوثيقة إلى الصيدلية عند شراء الأدوية. عندها ستقوم بدفع جزءاً من ثمن الدواء فقط حيث أن ضمانك الصحي سيقوم بدفع الجزء المتبقي من سعر الدواء المعتاد.

شهادة طبية : هي الشهادة التي يحررها الطبيب بعد استشارتك له. يجب تسليمها إلى مكتب الضمان الصحي وعليه تسترد جزءاً من المبلغ الذي دفعته كلفة هذه الإستشارة.

بطاقة التأمين ضد الأمراض الأوروبية (CEAM) : للقادمين من البلدان الأوروبية أو من البلدان التي هي جزء من الإتفاقية الدولية للتأمين ضد الأمراض.

أرقام الهواتف في حالات الطوارئ ؟

خدمة الطوارئ الطبية، سيارات إسعاف أو رجال إطفاء : 100 أو 112
الشرطة : 101
مركز مكافحة السموم : 542 542/070

مصدر http://www.belgique-infos.be

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