The insured person travels by ambulance from abroad to Luxembourg after a scheduled treatment. Coverage for such ambulance transport is subject to certain conditions. (The insured must be in possession of a valid S2).
Conditions of coverage
For any reimbursement of transport costs for scheduled treatment, the insured must have a certificate of coverage issued by the CNS.
This request is made by issuing a medical prescription indicating the medical reasons justifying the need for transport in a lying or semi-seated position. The doctor who insured the treatment abroad, or the doctor who authorised the hospital release, is responsible for issuing this prescription.
Certificate of coverage
In order to obtain this certificate of coverage, the doctor who undertook the treatment abroad, or the doctor who authorised the hospital release, must submit the application to the CNS by issuing a medical prescription stating the medical reasons justifying the need for transport in a lying or semi-seated position. The request does not have to be made prior to transport if the S2 form is in order.
This prescription must be submitted to the CNS. The CNS carries out an administrative check of the file. If this check is satisfactory, the CNS issues a certificate of coverage, which is sent to the insured person.
Reimbursement / Coverage
The insured may:
- hand over the certificate of coverage to the approved transport provider and ask him to apply for coverage through the third-party payment system. If all the conditions are met, the insured person only pays to the provider the part of the costs not covered by the health insurance.
- advance the costs and subsequently request reimbursement from the CNS. The documents to be included are the paid invoice from the approved transport provider and the valid certificate of coverage.
The third-party payment system can only be operated by the CNS with providers approved by the CNS. The insured person must advance the costs if he is transported by a foreign transport company.
Simple transport by ambulance is covered at the rate of seventy percent (70%) of the invoices established on the basis of:
- of a minimum of thirty-nine euros and seven cents (€39.07) per trip,
- or of an amount of one euro and twenty-nine cents (€1.29) per kilometer
For the calculation of the route, the shortest distance is taken into account between:
- the normal station of the ambulance closest to the insured's departure,
- the place of departure of the insured,
- the place where he receives treatment,
- the place to which the insured person returns, if necessary, after receiving treatment,
- the place where the ambulance is normally stationed.
For simple transport by ambulance abroad, 30% of the statutory tariff remains payable by the insured. To this participation are added possible supplements charged by the transport companies. If possible, find out about the prices charged by the transport companies before choosing a provider.
Transport costs are only covered up to a maximum distance of 600 km on the outward journey.
In other words, if the S2 authorisation is granted for treatment in a hospital at a distance of more than 600 km, the certificate of coverage is only granted for a maximum distance of 600 km.