travel expenses

Prerequisites

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

• trips to the hospital for inpatient treatment,
• Journeys to a pre- or post-hospital treatment in the hospital,
• Trips to an outpatient operation that replaces inpatient treatment,
• rescue trips.

Trips in connection with outpatient treatment can be prescribed in the following exceptional cases - sometimes subject to the approval of the health insurance company:

• Medical transport of people in need of care and severely disabled, namely people with a recognized severe disability (code "aG", "Bl" or "H") or people in need of care with care level 3 in the case of permanent mobility impairments and with care level 4 or 5.
• Approval from the health insurance company is not required if a patient trip is prescribed, for example with a taxi or rental car. • However, a permit is required if the patient has to be transported in an ambulance due to the required medical care or professional positioning of the patient.
• If there is a disease that requires high-frequency treatment over a longer period of time and this treatment or the course of the disease leading to this treatment affects the patient in such a way that transport is essential to avoid damage to life and limb. This applies, for example, to trips to dialysis or to radiation or chemotherapy for cancer patients.
• Sick people whose treatment does not correspond to the case studies mentioned can apply for approval and examination of their individual case by the health insurance company.

Documents required

• Medical prescription for patient transportation
• Trips in connection with outpatient treatment sometimes require the approval of the health insurance company

Please note

This service is not offered in Hamburg.

Deadlines

no

Procedure

Please inquire with your health insurance company.

Processing time

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




Processing time: 3 weeks

Fees

• Insured persons have to pay 10 percent of the fare themselves as a statutory additional payment, at least 5 euros and a maximum of 10 euros per trip, but never more than the actual costs incurred.


• These additional payments must also be made for children and young people. In the case of 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 replacing a ward. If you have little or no income, you can apply to be exempted from the co-payment. Please contact your health insurance company for this

Legal remedies

• If the health insurance company refuses the service, you can appeal against it.


• If the objection is not remedied, you can appeal to the social court

Legal basis

Social Code (SGB) Fifth Book (V) - statutory health insurance


URL: https://www.gesetze-im-internet.de/sgb_5/__60.html

The health insurance companies cover travel costs that are medically necessary in connection with a health insurance service