Reimbursement of travel and transportation costs
Entitlement to reimbursement of travel and transportation costs
Under special conditions, an insured person is entitled to the reimbursement of travel costs when diagnostics, treatment or rehabilitation following an illness or injury at work requires travel to a medical services provider outside of the person’s place of residence. This right applies to travel to and from the nearest provider of medical services to which the insured person is referred, or to a service provider of psychiatric, oncological or orthopaedic medicine. This right also applies if the ZZZS refers or requires an insured person to attend a location for treatment outside their place of residence for the purposes of exercising rights deriving from compulsory health insurance.
An insured person is entitled to the reimbursement of food costs in the case of absence from home due to medical treatment exceeding 12 hours per day. When medical treatment requires the insured person to stay temporarily at the location where the treatment is performed, they are entitled to the reimbursement of accommodation costs. An insured person is entitled to this reimbursement only upon presentation of the appropriate invoices.
When approved by a personal or appointed physician, or by the health committee of the ZZZS, a person assisting the insured person is also entitled to the reimbursement of travel costs.
For children under the age of 15, and for older children or adolescents with advanced or severe physical and mental disorders, the need for an assistant is assumed.
An assistant of an insured person is also entitled to the reimbursement of food and accommodation costs for the duration of their temporary stay outside their place of residence.
Amount of reimbursement
The insured person is entitled to the reimbursement of the costs of travel by public transport upon presentation of the ticket for the shortest distance to the nearest physician or health care institution, reduced by 3% of the minimum wage valid in that particular month; since 1 January 2013, this amount has been limited to 23.51 EUR.
If the insured person does not provide a ticket, the costs of travel by car are calculated for the purposes of reimbursement.
An insured person travelling to another location by car is entitled to the reimbursement of travel costs equal to 10% of the price of a litre of premium petrol per kilometre in an individual month, reduced by 3% of the minimum wage valid in that particular month.
A person assisting an insured person is entitled to the reimbursement of travel costs equalling the actual cost of public transport upon the presentation of a ticket for the distance between the insured person’s residence to a health-care provider located outside the place of residence. If the insured person and assistant travel by car, the ZZZS reimburses travel costs as explained in the paragraph above.
For an insured person absent from home for more than 12 hours, food costs are reimbursed at 60% of the per diem reimbursed to officials of the state administration. Accommodation costs are reimbursed in full, and do not exceed the cost of a single room in the cheapest 3-star hotel in the place of treatment; in the absence of such a hotel in the place of treatment, the amount reimbursd is equal to the cost of a 3-star hotel in the nearest location. An insured person is entitled to such reimbursement only upon presentation of the appropriate invoices.
Children up to 7 years of age are entitled to the reimbursement of 50% of food and accommodation costs incurred in a place outside the place of residence.
Where and how to submit an application
An insured person submits the reimbursement application to the ZZZS or the applicant’s employer. The application must be accompanied by a “Certificate of entitlement to travel costs – assistance” issued by the personal physician. The date or time of the insured person’s medical examination or treatment in a place outside the place of residence must be indicated on the certificate and approved by the physician who conducted the medical examination or treatment.