Apply for travel expenses for ambulance services
Description
The health insurance companies cover the costs for trips to inpatient hospital treatment, rescue trips and patient transport.
There is also a right 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 it cannot be carried out.
Otherwise, the health insurance companies cover the travel costs for outpatient treatment only in exceptional cases determined by the Federal Joint Committee (for example, dialysis treatments, chemotherapy, mobility restrictions, certain degrees of care).
A patient transport can be prescribed if it is absolutely medically necessary in connection with a service of the statutory health insurance. This includes:
- Trips to the hospital for inpatient treatment,
- journeys to pre- or post-hospital treatment,
- Trips to an outpatient operation that replaces inpatient treatment,
- Rescue trips.
Journeys in connection with outpatient treatment can be prescribed – in some cases subject to the approval of the health insurance company – in the following exceptional cases:
- Transport of persons in need of care and severely disabled persons, in particular persons with recognised severe disabilities (mark "aG", "Bl" or "H") or persons in need of care with care level 3 in the event of permanent mobility impairment and with care level 4 or 5.
- An approval by the health insurance company is not required if an ambulance ride is prescribed, for example, with a taxi or rental car.
- However, a permit is required if the transport must be carried out with an ambulance due to the required medical-professional care or professional storage 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 harm to life and limb. This applies, for example, to trips to dialysis or to radiation or chemotherapy for cancer patients.
- Patients whose treatment does not correspond to the above-mentioned case studies can apply for approval and examination of their individual case by the health insurance company.
- Medical prescription for patient transport
- Journeys in connection with outpatient treatment sometimes require the approval of the health insurance company
Insured persons have to bear 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 replacing wards.
If you have little or no income, you can be exempted from the co-payment on request. Please contact your health insurance company.
none
If the health insurance company rejects the benefit, you can object to it. If the objection is not remedied, you can take legal action against it before the Social Court.
Rescue trips are to be requested from the control center of the district or the district-free city under the uniform emergency number 112.
For other ambulances or ambulance journeys, please contact your doctor. Your doctor will issue you with a corresponding prescription, regardless of the means of transport to be chosen.
For transport to outpatient treatments, the approval of your health insurance company is also required.
Please inquire with your health insurance company or your attending physician.
Please check with your health insurance company.
Lower Saxony Ministry of Social Affairs, Health and Equality
07.05.2021
The text was automatically translated based on the German content.
