Transportation by ambulance refers to transportation carried out by an ambulance in situations other than those of vital distress, when that ambulance is used
- by public services under the jurisdiction of the State or the communes;
- in a commercial capacity by private individuals or commercial companies;
- by public service establishments or non-profit organisations working in the field of health or assistance and rescue.
Transportations within the country carried out by establishments from the hospital sector for transporting persons between these establishments do not fall within the scope of the following stipulations.
Conditions for coverage
The "File B6" from annex A of the CNS statutes provides for the situations where the health insurance covers transport and travel services. In all situations covered by the file B6, travel and transportation costs are not covered beyond a distance of a maximum of 400 km for the outbound journey. In exceptional cases, the CNS can authorise coverage requested with a detailed medical report issued by the treating doctor and with a prior authorisation from the CMSS for travel and transportartion costs up to a distance of 600 km for the outbound journey.
Simple transport within the country
Simple transportation by ambulance within the country is covered, provided that a medical prescription issued by the doctor in charge of treatment certifies, that for medical reasons it is indispensable that the patient is kept in a reclining or immobilised position on the outward journey and on the return journey too, as the case may be.
When the medical prescription has not been issued prior to transportation, it must be issued within three days at the latest of the time of transportation. However, this is not a requirement in those cases where the doctor, in charge of treatment, certifies that the insured has been admitted to a polyclinic.
Simple transport abroad
Transportation by ambulance of an insured person temporarily staying in a Member State of the European Union (EU), the European Ecomonic Area (EEA) and Switzerland, from a clinic abroad to a hospital in Luxembourg for continuing an inpatient treatment is covered, provided that the means of transport and the hospital of destination are documented on a medical prescription issued by the doctor abroad, who has authorised the patient's discharge from the hospital.
Simple transportations by ambulance abroad are covered only if a prior medical prescription, issued by the treating doctor on a special form and previously accepted by the Medical Board of the Social Security, specifies for both the outbound and the return journey, the medical reasons which make a reclined or immobilised position indispensable.
Prior authorisation from the Medical Board of the Social Security
With the exception of emergency cases duly justified or except if the CNS statutes provide for a specific derogation, a prior authorisation from the Medical Board of the Social Security CMSS is always required in order to cover transport services abroad.
Terms of coverage
The portion of the costs covered by the health insurance can be paid by the CNS directly to the transporter if, at the request of the insured person, a certificate of coverage (titre de prise en charge) has been issued prior to transport and if this certificate has been accepted by the transporter within the framework of the agreements provided for by the Social Security Code or, in the absence of an agreement, within the framework of the conditions for approval which define the relations between the CNS and the transporters.
The costs relating to transportation paid upfront by the insured persons are covered upon presentation of paid and receipted invoices, accompanied by the prescription and, if applicable, the required authorisations.
The burden of proof that the transportation was carried out in order to receive services covered by the health insurance in the situations provided in the CNS statutes, lies with the person claiming such costs.