Practical information on healthcare benefits for ALS patients in Serbia
Rilutek (Riluzole)
ALS/MND patients (diagnostic code G12.2) who are covered by mandatory health insurance receive this medication free of charge, funded by the Republic Health Insurance Fund of Serbia. The medication is introduced into therapy based on the opinion of three neurologists from the Neurology Clinics of the University Clinical Center of Serbia, the University Clinical Center of Vojvodina, the University Clinical Center Niš, or the University Clinical Center Kragujevac, and is prescribed to ALS patients who are not experiencing respiratory impairment.
The list of medicines prescribed and issued at the expense of mandatory health insurance funds does not include vitamins, coenzyme Q10, or other supplements, although their use is commonly recommended for people living with ALS.
Physical Rehabilitation
At the expense of the Republic Health Insurance Fund of Serbia (RFZO), ALS patients are entitled to inpatient physical rehabilitation once a year, for a duration of 21 days, at one of the designated spa rehabilitation centers. This type of therapy is proposed by the treating neurologist and a physiatrist from the relevant regional clinical or medical center. The final decision regarding inpatient rehabilitation, as well as the specific center where it will be carried out, is made by the medical commission of the regional RFZO branch. The same procedure applies to decisions concerning the approval of an accompanying person for patients undergoing inpatient rehabilitation.
Medical-Technical Aids
With regard to medical-technical aids, the types of aids covered by mandatory health insurance are defined by the Rulebook on Medical-Technical Aids. This rulebook contains all relevant information regarding the issuance of aids, their duration of use, as well as the procedures for procurement, maintenance, and replacement, including the method and process for exercising the right to use them.
For people living with ALS, the most commonly prescribed aids include manual wheelchairs, toilet wheelchairs, anti-decubitus mattresses (standard or with a compressor) and cushions, indoor patient lifts, walkers, peroneal orthoses, and hospital beds with trapeze bars. In order to obtain the right to these aids, an opinion from the treating neurologist and a physiatrist from the relevant regional clinical or medical center is required. Following this, the appropriate forms must be completed and submitted to the regional branch of the Republic Health Insurance Fund of Serbia (RFZO).
An exception applies to electric motorized wheelchairs with batteries, which may be approved in cases where patients have complete paralysis of the legs with partial weakness of the arms, enabling them to safely operate the wheelchair using their fingers. The use of these wheelchairs is proposed by a neurologist based on electromyoneurography findings of the arms and legs, along with a positive assessment by a psychologist regarding the patient’s ability to safely operate the wheelchair. As with other aids, the necessary forms must then be completed and submitted to the regional RFZO branch.
Mechanical Ventilation Devices – Breathing Support
The Rulebook on Medical-Technical Aids also provides for the possibility of obtaining mechanical ventilation devices (breathing support), namely ventilators for mask-based breathing (NIV) or via a cannula (IV), for home use at the expense of the Republic Health Insurance Fund of Serbia (RFZO). This requires a recommendation from a pulmonologist and a neurologist, followed by the completion of the appropriate forms and their submission to the regional RFZO branch, which then forwards the request to the RFZO central commission in Belgrade.
Social Insurance and Social Protection
The right to financial compensation
ALS patients with diagnostic code G12.2 may apply for financial compensation based on the degree of physical impairment. This right is exercised by submitting an appropriate request to the Institute for Social Insurance (Bačvanska 21, 11010 Belgrade, Republic of Serbia), while the types and levels of physical impairments to which this benefit applies are defined by the Rulebook on the Determination of Physical Impairments.
The right to financial compensation for assistance and care by another person may be granted if the treating neurologist at a regional clinical or medical center determines that an ALS patient requires daily assistance from another individual. After submitting the relevant request, the decision on granting this right, as well as the amount of compensation, is made by the medical commission of the regional branch of the Republic Pension and Disability Insurance Fund (PIO Fund).
The right to social assistance
ALS patients with poor financial means are entitled to social assistance. In order to exercise this right, patients may contact the social welfare sector in Belgrade (telephone: 011/3615146; email: zastitita@minrzs.gov.rs) or the Ministry of Labour, Employment, Veteran and Social Affairs.
ALS patients who live alone and are unable to function independently may seek support through home treatment and nursing services or residential care facilities. These services are available in larger cities, and information regarding eligibility and conditions for exercising these rights can be obtained from the patient’s regional health center.
Institutions providing support to people living with ALS
Support for ALS patients is available through the work of the following institutions:
- Institute for Geriatrics and Palliative Care, Belgrade
- Home medical treatment (visits by physicians and medical technicians),
- Home assistance and care for older adults and adults with disabilities,
- Residential care at the Bežanijska Kosa facility.
- Home care and nursing services within primary healthcare centers, available in all major cities and covering surrounding municipalities, including Belgrade, Novi Sad, Niš, Kragujevac, Čačak, Valjevo, and Subotica.
- Gerontological centers in Serbia (outside Belgrade), which provide residential care only for older persons and people with disabilities.
Detailed information on exercising social protection rights is available in the Rulebook on Detailed Conditions and Standards for the Provision of Social Protection Services.
Content Author: Zorica Stević
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