08-06-2007

The palliative care reimbursement:

This fixed amount of €483.39 is provided for the reimbursement of medications, health care products and aids needed for palliative care at home.

For what can this reimbursement be used?

This reimbursement is aimed at covering the following costs of palliative care at home:

. medications such as analgesics, antidepressants, anxiolytics, medications for dermatological use, …

. health care products such as incontinence products, antiseptics, probes, syringes, infusion bags, pain pumps, syringe drivers, …

. aids such as specialised mattresses and beds, hoists, commodes, backrests, …

This reimbursement comes in addition to any other reimbursements that have already been provided for by the regular nomenclature of health benefits.

Who is eligible to receive this reimbursement?

Any patient who suffers from one or more irreversible conditions with rapid progression, resulting in a serious deterioration of his physical and mental state

And:

. whose condition is no longer responding to medical interventions and rehabilitative therapies

. whose condition has a poor prognosis and whose death is expected to be imminent (life expectancy of more than 24 hours and less than three months)

The patient should have the intention to die at home and have severe physical, psychological, social and mental needs that require an important time-consuming and continuous commitment. If necessary, caretakers with specific qualifications or custom technical aids can be requested.

The prescribing doctor must confirm that the patient meets all requirements stated in the application form. 

Application process:

. The patient’s GP notifies the advising physician of the health insurance provider that said patient meets all conditions to receive the reimbursement. He will need to use the official application form. The receipt of this notification to the advising physician establishes the right to reimbursement (which is why the postmark or the proof of delivery are so important).

. Immediately after receiving the application, the health insurance provider will pay out to the bank account of the beneficiary.

The fixed reimbursement for palliative care at home will not be paid out if the patient in question was residing in a hospital, a home for the elderly or a residential or nursing care facility at the time of the application.

A second application for the reimbursement can be filed after 30 days, if said patient is receiving the necessary care at home.

Derived rights:

Patients who have received the reimbursement for palliative care are also eligible for the following reimbursements:

. full reimbursement of the official tariff for house calls made by a GP

. full reimbursement of the official tariff for house calls made by a physiotherapist

(since 01.09.2006)

. full reimbursement of the official tariff for house calls made by a home care nurse (or, if necessary, appointment of a specialist palliative care nurse).

Translation: Katia Ombelets

Source: Visie