Reimbursement of transport costs by the Health Insurance

The following persons may benefit from the payment of transport costs:

• You and your rights-holders
• A possible companion when the sick person is under 16 years of age or needs the assistance of a third person. In this case, the reimbursement relates only to public transit costs.

Your transport costs can be covered provided you are prescribed by your doctor.

Your doctor will prescribe the nearest healthcare facility that is appropriate for your condition.

If you are summoned to a review, the summons or notice of hearing is the statute of limitations.

In case of emergency, the medical prescription can be established afterwards.

The transport costs to get to a thermal cure (and back) are supported based on your resources.

Prescription

A medical prescription is sufficient for transport which includes the following reasons:

• Hospitalization (hospital entry and/or discharge), regardless of duration (full, partial, or outpatient)
• Long-term disorder (ALD) if your health does not allow you to travel on your own
• Condition warranting prolonged transport or constant monitoring (ambulance)
• Regulatory control (convocation of a medical examination, of an expert doctor, or of a supplier of approved equipment)
• Accident at work Care related to an occupational disorder
• Home Returns as part of discharge permissions for patients under 20 years hospitalized 14 days and more.

A medical prescription is a form completed by the doctor and sent by the patient to the doctor advising his CPAM: titleContent.

Prior agreement

For certain types of transport, the cost of transport must be covered by a medical prescription with request prior agreement.

The healthcare professional fills out a specific form and gives it to you for sending to your CPAM medical service.

These include:

• Long distance, more than 150 km
• Series, when you need to make at least 4 times a trip of more than 50 km one way, over a period of 2 months, for the same treatment
• Children and adolescents accommodated in centers for early medical-social action (CAMSP) and medical-psycho-pedagogical centers (CMPP)

• Regular airliner or liner.

The absence of a response from your cashier 15 days after sending your request means that it is accepted.

In case of refusal, you receive a letter from the Health Insurance.

Your doctor tells you the following information:

• The mode of transport best suited to your health
• Reason for transport
• Shared transportation if your health allows it.

The means of transport that can be covered by the Health Insurance are:

• Ambulance (e.g. you must be lying down or monitored)
• Professional seated transport: light sanitary vehicle (LSV) or contracted taxi
• Public transport by land (bus, metro train...), plane or regular boat
• Individual means of transport (you can travel alone or accompanied by a relative).

To find a VSL or ambulance, you can consult the website Ameli Health Directory.

For a contracted taxi, contact your cash register.

You must follow the instructions of your doctor who gives you the medical prescription for transport for your gait. This The prescription is valid for one year.

You are sending the following documents to your:

• Medical prescription for transport (form cerfa n°11574). A specific form exists for an exit permit for those under 20 years of age hospitalized for 14 days or more.
• Medical prescription for transport with request of prior agreement, (form cerfa n°11575) , if necessary
• Proof of payment, i.e. according to your mode of transport, either an invoice from the carrier or a statement of your expenses (form cerfa n°11162) with the tickets used (proof of transport, tolls...)
• Transport invoice (cerfa n°11163) for a transport light sanitary vehicle (VSL) and ambulance.

Reimbursement rate

The refund rate is 55% within the limits of Social Security tariffs, under different conditions depending on the mode of transport.

In some situations, your expenses may be covered at 100% within the limits of Social Security tariffs. Examples:

• Pregnant woman
• Newborn less than 30 days old
• Occupational injury or disease
• Long-term illness (ALD)
• Children and adolescents accommodated in early medical-social action centers (CAMSPs) and medical-psycho-pedagogical centers (CMPPs).
• Recipient of the Solidarity Health Supplementary (CSS) or the State Medical Aid (AME).

Ask your cash register for more information.

Franchise

Except in cases of emergency or exemption, you will have to pay a contribution, called a medical deductible, on transportation by contracted taxi, VSL and ambulance. This participation shall be deducted from the reimbursement.

This deductible is €4 by sanitary transport up to €8 per day.

Its amount shall not exceed €50 per year per person.

The exemption does not apply to transport by personal vehicle, public transport or emergency transport (Samu call center 15).