The insured person has repetitive medical treatment (serial treatment) abroad. Under certain conditions, serial transport by taxi can be covered by the health insurance.
Definition of repetitive/serial medical treatment
Conditions of coverage
The insured person must take the necessary preliminary steps for the treatment abroad to be covered by the health insurance.
Serial transport by taxi is covered on condition that a prior medical prescription, issued by the doctor in charge of treatment on a special form and accepted in advance by the CNS, specifies separately for the outward and return journey the medical reasons why travel by public transport is not advisable.
For prolongations in the case of chemotherapy, radiotherapy, dialysis or any other serial treatment, the request does not have to be made prior to transport, but must still be submitted to the CNS as soon as possible. Authorisation for treatment (request via S2 form) must be given prior to treatment. In the case of prolongation of treatment, the certificate of coverage for patient transport can only be issued for treatment periods covered by S2.
Serial transport by taxi abroad to a geriatric or cardiac rehabilitation service of a hospital is only covered for a maximum of 20 days of treatment.
Transport for post-organ transplant follow-up is only covered for a maximum of six months from the date of the organ transplant.
Taxi costs are covered only if the related benefits are provided by a provider approved by the Council of Administration of the National Health Fund.
Procedures
Certificate of coverage
For any coverage of serial transport costs, the insured must have a certificate of coverage issued by the CNS valid for the period during which the transport takes place.
To receive this certificate of coverage, the treating physician must complete the form "Request for coverage by the health insurance of the cost of serial transport" and indicate separately for the outward and return journey the medical reasons why travel by public transport is not advisable.
This form, which serves as a medical prescription, must be submitted to the CNS beforehand. The CNS carries out an administrative check of the file. If this check is satisfactory, the CNS issues a certificate of reimbursement, which is sent to the insured person.
Reimbursement / coverage
The insured may:
- give the approved transport provider the certificate of coverage as well as the document summarising the days and hours of attendance for the serial treatment (proof of attendance for the dates on which the transport took place) so that the transport provider can request 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 enclosed are the paid invoice from the approved transport provider, the document summarising the days and hours of attendance for the serial treatment (proof of attendance for the dates on which the transport took place) and the valid certificate of coverage.
Invoices for these costs can only be covered by the health insurance if they contain the following information for each transport made:
- the name of the company,
- the number plate of the vehicle used,
- the date and time of the transport,
- the places of departure and arrival,
- the kilometrage and the invoiced price.
Taux de prise en charge
Taxi transport is covered for the shortest route between the insured person's residence and the place where he or she receives care.
Coverage is based on:
- a minimum of six euros and fifty-six cents (€6.56) per transport;
- an amount per kilometre of one euro and sixty-four cents (€1.64) for a single transport;
- eighty-two cents (€0.82) per kilometre for a return journey from the person transported to the point of departure.
The waiting period is covered at the rate of twenty-eight cents (€0.28) per minute. It is only covered for return trips to the insured person's point of departure and only up to the maximum fare that can be covered for a simple transport.
For transport by taxi, there are often costs to be paid by the insured. Please find out in advance about the rates charged by the transport company.