Dies ist die interne Entwicklungsumgebung des FIM Portals. Bitte nutzen Sie die produktive Umgebung.

Fahrkosten für Krankenversicherte Übernahme

Mecklenburg-Vorpommern 99134032068000, 99134032068000 Typ 2/3

Inhalt

Leistungsschlüssel

99134032068000, 99134032068000

Leistungsbezeichnung

Travel costs for insured persons Covered by health insurance

Leistungsbezeichnung II

Travel costs

Leistungstypisierung

Typ 2/3

Begriffe im Kontext

nicht vorhanden

Leistungstyp

Leistungsobjekt mit Verrichtung

Leistungsgruppierung

Krankenversicherung (134)

Verrichtungskennung

Übernahme (068)

SDG Informationsbereiche

nicht vorhanden

Lagen Portalverbund

nicht vorhanden

Einheitlicher Ansprechpartner

Nein

Fachlich freigegeben am

05.07.2021

Fachlich freigegeben durch

Lower Saxony Ministry of Social Affairs, Health and Equality Ministry of Economics, Labor and Health M-V

Teaser

The health insurance funds cover travel costs that are medically necessary in connection with a health insurance benefit.

Volltext

The health insurance funds cover the costs of journeys to inpatient hospital treatment, ambulance journeys and patient transport.

Likewise, there is an entitlement to travel to outpatient treatment as well as pre- and post-inpatient hospital treatment, including outpatient surgery, if this avoids or shortens inpatient treatment or if this cannot be carried out.

Otherwise, the health insurance funds only cover travel costs for outpatient treatment in exceptional cases determined by the Federal Joint Committee (for example, dialysis treatment, chemotherapy, limited mobility, certain degree of nursing care).

Erforderliche Unterlagen

  • Medical prescription of transport for the sick
  • Journeys in connection with outpatient treatment partly require the approval of the health insurance company

Voraussetzungen

Medical transport can be prescribed if it is absolutely medically necessary in connection with a benefit provided by the statutory health insurance. This includes:

  • Journeys to hospital for inpatient treatment,
  • journeys to a pre- or post-hospital treatment in the hospital,
  • journeys to an outpatient operation - replacing inpatient treatment,
  • ambulance journeys.

Journeys in connection with outpatient treatment can be prescribed - partly subject to the approval of the health insurance fund - in the following exceptional cases:

  • Medical transport of persons in need of care and severely disabled persons, namely persons with a recognised severe disability (registration mark "aG", "Bl" or "H") or persons in need of care with care degree 3 in the case of permanent mobility impairment as well as with care degree 4 or 5.
    • Approval by the health insurance fund is not required if a medical journey is prescribed, for example, by taxi or hire car.
    • However, authorisation is required if the transport must be carried out using a patient transport vehicle due to the required medical-professional care or professional positioning of the patient.
  • If there is an illness which requires high-frequency treatment over a longer period of time and this treatment or the course of the illness leading to this treatment affects the patient in such a way that transport is essential to prevent harm to life and limb. This applies, for example, to journeys to dialysis or to radiation or chemotherapy for cancer patients.
  • Sick persons whose treatment does not correspond to the above-mentioned case examples can apply for approval and examination of their individual case by the health insurance fund.

Kosten

Insured persons must pay 10 percent of the fare themselves as a statutory co-payment, at least 5 euros and a maximum of 10 euros per trip, but never more than the actual costs incurred. These co-payments must also be made for children and young people.

For journeys in connection with inpatient treatment, insured persons pay a co-payment for the first and last journey. This also applies to journeys in connection with outpatient operations in lieu of hospitalisation.

If you have little or no income, you can apply for exemption from the co-payment. Please contact your health insurance company for this.

de.xoev.schemata.xzufi._2_2_0.StringLocalized@4f919f76

Verfahrensablauf

Please check with your health insurance provider.

Bearbeitungsdauer

3 Woche(n)
If approval is required, the health insurance company must decide within a period of 3 weeks from receipt of the application.

Frist

none

de.xoev.schemata.xzufi._2_2_0.StringLocalized@b59e7e6

Weiterführende Informationen

nicht vorhanden

Hinweise

nicht vorhanden

Rechtsbehelf

If the health insurance fund refuses to pay the benefit, you can lodge an objection. If the objection is not upheld, you can take legal action against it before the social court.

Kurztext

The costs of travel to an outpatient or inpatient treatment can be covered by the statutory health insurance funds under certain conditions.

Travel costs in connection with outpatient treatment are only covered in special exceptional cases.

Ansprechpunkt

nicht vorhanden

Zuständige Stelle

The responsibility lies with your health insurance company.

Formulare

Please check with your health insurance company or your attending physician.