IKA in Greece, Greek Social Insurance Institute

IKA was absorbed into EFKA in 2017

UPDATE: The Social Insurance Institute (IKA) was once Greece’s largest state social insurance organization. Established in 1934, it actually began operations in 1937.

IKA had its own health care units until 2012, when it was merged with EOPYY. In 2017, IKA was fully absorbed into EFKA, an entity that consolidated various social insurance funds.

Financially, IKA faced ongoing challenges and relied on a 2.6 billion euro state bailout in 2009. The media often portrayed the institution as a financial “black hole”.

The EFKA consists of a main insurance and other benefits branch, which includes the following institutions, with their branches, sectors and accounts as follows:

Social Insurance Institute (IKA – ETAM)
Unified Insurance Fund for Media Personnel
Organization for the Insurance of Self-Employed Professionals (OAEE)
Agricultural Insurance Organization (OGA)
Sailors Pension Fund (NAT), including the Seamen’s Unemployment – Sickness Fund
Unified Insurance Fund for Bank Employees
Public Sector Insurance Organization

*The following older information applies to IKA, the former Social Insurance Institute. Parts of it apply also to EFKA, the newly established social insurance entity in Greece.

IKA in Greece is the largest social security institution. It covers 5,530,000 workers and employees and provides retirement pensions to 830,000 pensioners.

The Social Insurance Institute of Greece (IKA) covers those who are employed in Greece or abroad for an employer established in Greece, as well as those who provide full-time or part-time personal services on a contract basis and are not insured with any other main insurance institution.

The Social Insurance Institute of Greece also covers certain groups of persons who offer their labor to different employers at different times and whose insurance is provided by their trade unions or insurance associations (e.g. porters, newsstand vendors, slaughterhouse workers, etc.) or by special provisions (e.g. exclusive nurses).

The main function of social insurance is to provide protection to its members through various benefits. The IKA meets the needs of its members in terms of medical care and benefits. Beneficiaries of medical care are the directly insured persons and their family members, provided that the insured persons have completed at least 50 working days in the last year or in the previous 15 months, not counting the last three months.

Other beneficiaries are old-age or disability pensioners and their family members, as well as those receiving death benefits. Directly insured persons (employees) are eligible to receive benefits if they meet the eligibility requirements.

Medical Care Covers

Medical examinations by doctors in local IKA clinics, general practitioners and rural doctors, as well as IKA-affiliated doctors who examine patients in their private practices.
General or specific examinations and treatments carried out by laboratories of the Social Security Organization or others under contract with the IKA.
Expenses, based on the rates established by the State, for the fee paid to a private practitioner for a visit or medication administered in an emergency, provided that the necessary documentation is submitted to the IKA within the prescribed period.

Medication

Prescribed medications are administered by physicians of IKA in Greece for the purpose of restoring the health and full recovery of the insured. The doctor’s instructions must be strictly followed in order to complete the treatment.

Prescriptions must be filled within five working days of their date of issue, otherwise they are invalid. Insured members pay a co-payment of 25% of the cost of medicines. Exceptions apply in certain cases.

A reduced contribution of 10% is also paid by pensioners entitled to an EKAS allowance and their family members as of January 1, 1999.
Special diets are provided free of charge to clients suffering from metabolic diseases or who have problems with food absorption.

Hospital Care

The Social Insurance Organization of Greece covers the hospitalization needs of directly insured clients, pensioners and their families:

In IKA hospitals, public hospitals and private clinics under contract with IKA, as well as in clinics for chronic diseases and disabled children.
Abroad, for diseases that cannot be diagnosed and treated in Greece due to the lack of appropriate scientific means or specialized doctors.
In independent clinics and treatment centers – not affiliated with IKA – in case of emergency. The case must be reported directly to the Social Insurance Institution within three days so that the emergency can be assessed and confirmed and the need for hospitalization can be determined by the Social Insurance Institution’s medical examiner. The necessary documents for the reimbursement of hospital expenses must be submitted within six months from the date of hospitalization, otherwise the submission of such documents is considered overdue.

The Social Insurance Organization of Greece has also signed contracts with private cardiac surgery centers – in addition to public hospitals – for open heart surgery.