What does a medical cart cost

Travel expenses for patient transport

1. The most important things in a nutshell

Health insurance companies only cover travel costs for medical transport that are medically necessary. Transports to inpatient treatment, to pre- and post-inpatient treatment, as well as to outpatient operations with pre- and post-treatment can be prescribed. For trips to outpatient treatment, different rules apply to the assumption of costs and approval by the health insurance company, depending on the means of transport selected and the patient's condition. In the case of medical trips without professional support, tickets, receipts and certificates must be kept; for rescue trips and ambulance transports, the means of transport usually bills the health insurance company directly. Patients usually have to pay up to € 10.

2. Basic requirements for the assumption of travel expenses

As a rule, the health insurance company only pays travel costs as part of hospital treatment or medical treatment under the following conditions:

  • Compelling medical necessity of driving.
  • The journey goes to next accessible appropriate treatment facility, unless there is a compelling medical reason for treatment at a more remote location.
  • The doctor prescribed the drive before - Including medical reasons for choosing the means of transport, depending on the state of health and walking ability.

Exceptions from the previous ordinance there is

  • for subsequent prescriptions in emergencies,
  • when traveling by private vehicle or public transport (without regulation) and
  • for outpatient or inpatient rehab. Instead of a doctor's prescription, the patient has to pay the travel expenses before rehab clarify with the health insurance company.

3. Ordinance on patient transport

The prescription is made on a special form (commonly known as a transport ticket). Sick transport can be prescribed by:

  • General practitioners,
  • Dentists,
  • Psychotherapists and
  • Hospital doctors.

4. Which journeys are covered by the health insurance

There are three types of journeys - depending on the equipment of the vehicle and the accompanying measures:

  • Rescue trips,
  • Ambulance and
  • Sick trips.

The conditions for the assumption of costs by the health insurance company differ.

4.1. Rescue trips to the hospital

Rescue trips are usually emergencies. The health insurance company pays the costs if the patient has to be transported with a qualified rescue equipment and with the care of a medical professional due to his condition. Such rescue equipment includes ambulances (RTW), emergency medical vehicles (NAW), emergency medical vehicles (NEF) and rescue helicopters (RTH). They must always be requested from the locally responsible rescue coordination center.

4.2. Ambulance

Ambulance transport is required if the patient is not an emergency but needs professional care or the special equipment of the ambulance (KTW), or if the spread of a serious, contagious disease must be prevented.

  • The health insurance company takes over ambulance transports to inpatient services, to pre- and post-inpatient treatment (§ 115 a SGB V) and to outpatient operations without prior approval.
  • Ambulance transport for all other outpatient treatments must first be approved by the health insurance company after the prescription.

4.3. Medical trips without professional support

All journeys without specialist medical care are considered to be patient journeys. They take place with public transport, private vehicles, rental cars, vehicles with handicapped facilities or taxis. The health insurance company pays for medical trips according to a doctor's prescription:

  • to stationary Benefits (Section 60 Paragraph 2 Sentence 1 No. 1 SGB V).
  • to pre- and post-inpatient Treatments if this avoids or shortens inpatient treatment.
  • to outpatient operations and related pre- or post-treatment only if this avoids hospital treatment or if it is not feasible.
  • to outpatient treatments at:
    • People with the mark aG (extraordinary walking disability), the mark Bl (blind) or the mark H (helpless) in the severely handicapped ID card.
    • Patients with care level 3, if there is also permanent mobility impairment. The latter does not apply if care level 2 was already in place on December 31, 2016.
    • Patients with care level 4 or 5.

 

For all other patients, the medical journey for outpatient treatment must be approved in advance by the health insurance company. This approval is usually only available from

  • Care including diagnostics in a geriatric institute outpatient clinic.
  • severely impaired mobility and long-term outpatient treatment.
  • Trips to frequent therapy for certain diseases (so-called. Series treatment). This applies to an underlying disease
    • that requires a specific treatment,
    • which must take place frequently and over a longer period of time,
    • and the course of the disease must affect the patient in such a way that transportation is essential.
      Such treatments are e.g. dialysis or radiation or chemotherapy for cancer.

4.4. Vehicle choice and costs

With public transport you have to Fare reductions be exhausted.

The health insurance company only covers costs for taxi or rental car if public transport is off compelling cannot be used for medical reasons.

There are tariffs for ambulance, ambulance, taxi and rental car trips that the providers negotiate with the health insurance companies.

The costs for the private car are reimbursed in accordance with Section 5 of the Federal Travel Expenses Act (BRKG): € 0.20 / km up to a maximum of € 130. However, reimbursement is only ever up to the amount of the other vehicle costs, i.e. usually the costs for public transport, and the additional payment (see below) is also deducted.

5. Additional payment for trips and transports

Each patient pays 10% of the travel costs for each type of transport, but at least 5 € and a maximum of 10 €. this applies also for children and young people.

The liberation of the co-payment is possible if the load limit is exceeded, more information under Exemption from co-payment health insurance.

6. Practical tips

  • For reimbursement of costs for public transport, taxi, rental car or private car, the following must be presented:
    • all tickets / tickets
      and
    • Confirmation from the clinic / rehabilitation clinic, doctor or therapist that the treatment took place and for what purpose.
  • In the case of serial treatment, patients with some health insurance companies only have to pay the additional payment for the first and last trip.
  • Since journeys by private car or public transport are not prescribed, patients should ask for a certificate of attendance during treatment so that the costs can be claimed from the health insurance company.
  • For travel expenses for accompanying persons, see accompanying person for more information. It is only possible to take it with you on rescue journeys in exceptional cases. In the case of ambulance transport, the accompanying person should be registered so that there is enough space in the KTW.

7. Travel expenses for visiting sick people

Health insurance can the cost of visiting trips to a
Take over the (rehab) clinic if it is not possible to take in an accompanying person and the presence of a person of trust is necessary for the patient for therapeutic and medical reasons. Can means that there is no legal entitlement, but approval is at the discretion of the health insurance company. Much is regulated in the statutes of the individual health insurance companies. The health insurance companies provide more information.

The medical need for the presence of the person of trust must be confirmed to the health insurance company by the attending doctor.

8. No assumption of costs

No assumption of costs

  • of the patient in the sense of expenses for food, accommodation, luggage transport, but reimbursement of travel expenses for trips in connection with medical rehabilitation.
  • a return transport from abroad.

9. Guidelines

The Federal Joint Committee has drawn up a guideline for the regulation of ambulance, ambulance and ambulance trips, download at www.g-ba.de> Information Archive> Guidelines> Ambulance Guideline.

10. Who can help?

Health insurance companies and the citizen hotline of the Federal Ministry of Health on the subject of health insurance 030 3406066-01, Mon-Thu 8 a.m.-6 p.m., Fri 8 a.m.-12 p.m.

11. Related links

Traveling expenses

Driving services

Disability> Public Transport

 

Source of law: § 60 SGB V