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Reimbursement of transport costs by health insurance

Verified 01 January 2023 - Directorate for Legal and Administrative Information (Prime Minister)

Health insurance can cover your transportation costs, subject to certain conditions. For example, if you are travelling to receive care, have a medical check-up or respond to a regulatory review.

The following persons may be entitled to transport costs:

  • You and right holders
  • A possible escort when the sick person is under 16 years of age or needs the assistance of a third person. In this case, the reimbursement is only for public transport costs.

Operation

Your transportation costs can be covered if you are prescribed by your doctor.

Your doctor prescribes the nearest health care facility, tailored to your health.

If you are called to a review, the summons or notice of hearing takes the place of a prescription.

In the event of an emergency, the medical prescription can be established later.

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

Medical Prescription

A medical prescription (form to be completed by the doctor and sent by the patient to the doctor advising his CPAM: titleContent) is sufficient for transport, in particular for the following reasons:

  • Hospitalisation (hospital entry and/or exit), regardless of duration (full, partial or outpatient)
  • Long-term condition (ALD) if your health condition does not allow you to travel by yourself
  • State warranting extended transport or constant monitoring (ambulance)
  • Regulatory Control (summons for medical check-up, expert doctor, or approved equipment supplier)
  • Care in relation to accident at work or occupational disease
  • Home Returns in the context of exit permissions for patients under 20 years hospitalised 14 days and more

Prior Agreement

For some transports, the cost of the transport needs a medical prescription with request prior agreement.

The health care professional completes a specific form and hands it to you to send to the medical service of your CPAM.

These include:

  • Long distance, more than 150 km
  • Serial, when you have to make at least 4 times a journey of more than 50 km one way, over a period of 2 months, for the same treatment
  • Children and adolescents welcomed in the centres for early social and medical action (CAMSP) and the centres for medical and psycho-education (CMPP)
  • Regular aeroplane or liner

Failure to respond 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 will provide the following information:

  • Mode of transport best suited to your health
  • Transport Reason
  • If your health status allows shared transport

The means of transportation that can be covered by Health Insurance are as follows:

  • Ambulance (example: you need to be stretched or monitored)
  • Professional seated transport: light sanitary vehicle (VSL) or certified taxi
  • Public transport on land (bus, metro train...), plane or regular line boat
  • Individual means of transport (you can travel alone or with a loved one)

FYI  

Emergency pre-hospital transport, including private transport, is fully covered by compulsory health insurance.

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

For a certified taxi, contact your caisse.

Who shall I contact

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

Address your CPAM: titleContent the following documents:

  • Medical transport requirement (form cerfa n°11574).
    A specific form exists for an exit permit for those under 20 who are hospitalised 14 days or more.
  • If necessary, medical prescription for carriage with prior approval (form cerfa 11575)
  • Payment vouchers, i.e. depending on your method of transport, either an invoice from the carrier or a statement of your charges (form cerfa 11162) with the titles used (proof of transport, tolls...)

Please note

this form concerns the personal vehicle and/or public transport. If you are paying by taxi, VSL or ambulance, you should ask the Health Insurance for the medical prescription and the invoice.

Reimbursement Rate

65% within the limits of the Social Security rates, different conditions depending on the mode of transport.

In some situations, your fees can be covered 100% within the limits of Social Security rates. Examples:

  • Pregnant woman
  • Newborn under 30 days
  • Work-related injuries or occupational disease
  • Long-term condition (ALD)
  • Children and adolescents are accommodated in centres of early social and medical action (CAMSP) and in medical and psycho-educational centres (CMPP).
  • Recipient of complementary health solidarity (CSS) or State Medical Assistance (EMA)

Check with your caisse.

Who shall I contact

Franchise

Except in case of emergency or exemption, you will have to pay an interest, called medical franchise, on transport by registered taxi, VSL and ambulance. This contribution is deducted from the refund.

This franchise is €2 by health transport within the €4 per day. Its amount shall be €50 per person per year.

FYI  

the exemption does not apply to personal transport, public transport or emergency transport (call to the Samu, centre 15).