Rehabilitation

After an acute episode of a chronic disabling disease, cancer, a serious pathology or a major surgical operation, the insured person can, under certain conditions, benefit from physical or post-oncological rehabilitation in Colpach. In addition, the National Centre for Functional Re-education and Rehabilitation (CNRFR) offers people who have suffered an accident in life specialised care, especially in the field of functional re-education and neurological and traumato-orthopaedic rehabilitation, both in an inpatient and outpatient setting.

National Centre for Functional Re-education and Rehabilitation

If the insured person wishes to pursue both outpatient and inpatient treatment at the CNRFR, their affiliation must be in order.

As of 01.10.2023, authorisation from the Medical Board of Social Security (CMSS) is no longer required for a stay at the CNRFR. If you are planning a stay at the CNRFR, your doctor will give you a prescription for a consultation at the CNRFR. At the end of this consultation, the CNRFR will inform you of the medical decision concerning the continuation of your treatment.

The costs will be covered in the same way as for hospitalisation. You will find more information on this subject on our  page "Hospitals in Luxembourg".

Outpatient treatment

Outpatient treatment is subject to prior authorisation by the CMSS. The authorisation is granted upon application sent by the CNRFR, supported by a detailed medical report containing:

• the diagnosis
• the treatment plan with the detailed number of treatment sessions
• the frequency of application per week
• a motivation justifying the treatment in an outpatient setting

The authorisation is granted on the advice of the CMSS for an initial maximum period of two months with the possibility of extension up to two times. These extensions are also subject to prior authorisation and are granted according to the same procedure as the initial request. The request for extension must contain the updated elements of the initial request. Each extension can be granted for a maximum of two months.

The restrictive list of pathologies that allow for additional extensions of outpatient treatment at the CNRFR can be found in Annex I of the CNS statutes.

Outpatient treatment is only covered if the treatment is a continuation of inpatient treatment in the previous year. It is limited to a maximum of sixty (60) days of treatment spread over a continuous period of six months. Exceptions are possible, however, on the advice of the CMSS.

Geriatric rehabilitation and cardiac rehabilitation

The membership of the insured person who wishes to continue geriatric or cardiac rehabilitation must be in order.

Outpatient geriatric rehabilitation

Outpatient treatment in a geriatric rehabilitation unit is subject to prior authorisation (APCM). This authorisation is granted on request supported by a detailed medical report containing

• the diagnosis
• the treatment plan with the detailed number of treatment sessions
• the frequency of application per week
• a motivation justifying the outpatient treatment

Outpatient geriatric rehabilitation treatment is only reimbursed if the treatment is a continuation of inpatient treatment in the previous year.

The inpatient treatment preceding the outpatient treatment must have lasted at least seven days. It may not exceed a maximum duration of two months. Outpatient treatments in geriatrics cannot be extended.

Inpatient geriatric rehabilitation

Inpatient treatment in a geriatric rehabilitation unit is subject to authorisation by the CMSS (ACM).

The request for authorisation must be submitted to the CNS within three working days of hospital admission.

The authorisation is granted on the basis of a request supported by a detailed medical report which must contain an assessment of the patient's motor and cognitive functions by means of a MIF instrument (functional independence measurement) at the time of admission.

The detailed medical report must also contain:

• A diagnosis
  
• The patient's anamnesis
• The detailed treatment plan with
  • The number and nature of treatment sessions per day and week
  • The purpose and expected duration of the treatment

Inpatient treatment in geriatric rehabilitation services is covered for a maximum of 90 days. Two extensions, each of up to 30 days, may be granted. Applications for extensions must be submitted to the CMSS in advance.

Outpatient cardiac rehabilitation

Cardiac rehabilitation is carried out in an outpatient setting only. It is subject to authorisation by the CMSS. Authorisation is granted on the basis of a written declaration supported by a medical prescription containing

• The diagnosis
• A motivation justifying the treatment in an outpatient setting.

The first authorisation is given for a period of two months. With a justified prescription presented to the CMSS, the treatment may be extended for subsequent two-month periods.

Physical and post-oncological rehabilitation

The Colpach Castle Rehabilitation Centre houses two national rehabilitation services:

• the National Physical Rehabilitation Service (Service National de Réhabilitation Physique (SNRP)) and
• the National Post-Oncological Rehabilitation Service (Service National de Réhabilitation Post-Oncologique (SNRPO))

The SNRP mainly serves patients who need to be rehabilitated after an acute medical or surgical condition or who have just overcome an acute phase of a chronic disabling disease. Patients who have a functional deficit as a result of an oncological disease or a health event related to such a disease are covered by the SNRPO.

The membership of the insured person who wishes to pursue physical or post-oncological rehabilitation must be in order.

A request for admission must be submitted to the doctor in charge of the national rehabilitation service concerned, either by the hospital's specialist or by the insured person's general practitioner who wishes to undergo rehabilitation at the Centre of Colpach Castle. The Centre's doctor decides whether the request is justified. If he finds that there is a need for rehabilitation, the Centre sends a request for admission to the CNS by secure e-mail, explaining in detail the reasons for such a stay.

The CNS checks whether the insured person has already undergone rehabilitation in Colpach during the current year and if so, for how many days. The duration of the treatment depends on the insured person's state of health and the progress that can still be made in rehabilitation. Rehabilitation should not be less than 5 days. The CNS covers a maximum period of 30 days per calendar year and per health event for inpatient treatment and a maximum period of 10 days per calendar year and per health event for outpatient treatment. Beyond the 10 or 30 days per calendar year, rehabilitation can only be granted if the doctor has ticked the box on the application form to indicate that it is for a different pathology.

Inpatient and outpatient treatment in the national post-oncology and physical rehabilitation service is covered on the basis of prior authorisation by the CNS (APCNS).

Moreover, the request for inpatient or outpatient treatment in the national post-oncology rehabilitation service is only admissible if the following conditions are met

• according to the certificate of the attending physician, the protected person has functional limitations, co-morbidities or an alteration of the general state of health attributable to the cancer or resulting from the therapy pursued
• the clinical condition of the protected person is stable
• the start date of the requested rehabilitation is within three (3) months after the end of the acute cancer therapy.
  

If the request meets all the requirements, the CNS issues a certificate that is sent to the Colpach Castle Rehabilitation Centre. A copy is also sent to the doctor who made the request.

Coverage of costs

Because the CNRFR is classed as a hospital, the costs of services rendered at the Centre are paid directly by the CNS, without the insured having to pay upfront (third-party payment system). This also applies to geriatric and cardiac rehabilitation in a hospital as well as physical and post-oncological rehabilitation in the Colpach Castle Rehabilitation Centre. The CNS also contributes to the costs of the stay through the third-party payment system.