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Source: Zuständigkeitsfinder Schleswig-Holstein (Linie6PLus)
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).
Please check with your health insurance company.
The responsibility lies with your health insurance company.
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.
Which documents are required?
- Medical prescription of transport for the sick
- Journeys in connection with an outpatient treatment partly require the approval of the health insurance company.
What are the fees?
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.
What deadlines do I have to pay attention to?
If the health insurance company 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.
Applications / forms
Please enquire with your health insurance company or your attending physician.
The text was automatically translated based on the German content.
Technically approved by
Lower Saxony Ministry of Social Affairs, Health and Equality
Professionally released on