An insured who was evacuated and hospitalized
A person who was evacuated in a regular ambulance/intensive care ambulance/mobile intensive care unit and hospitalized
in a hospital located close to his place of residence is entitled to a full refund.
Transfer from one hospital to another
Below are the cases in which the insured is fully exempt from payment:
He was hospitalized in a hospital and transferred to another hospital, including to a rehabilitation hospital.
- He was transferred from an emergency room of one hospital to an emergency room of another hospital.
- He was transferred from one hospital to another for treatment during hospitalization (the transfer is usually at the expense of the hospital and sometimes at the expense of the health fund – the patient does not pay in any event).
The exemption does not apply to a transfer to a nursing home.
An insured who was evacuated and not hospitalized
If the evacuation was in a regular ambulance – the insured is not entitled to any refund.
If the evacuation was in an intensive care ambulance or mobile intensive care unit – the insured is entitled to a refund at 50% of the MDA rate.
The number of hours a person spent in the emergency room is immaterial. As long as he was not hospitalized, he is entitled/not entitled to a refund as explained in this chapter.
Evacuation from a clinic
An insured individual who visited a clinic and was evacuated on the instructions of the medical personnel by regular ambulance/intensive care ambulance/mobile intensive care unit to a hospital is not entitled by law to an exceptional refund.
Nevertheless, some health funds approve a full refund in these cases – details are available at the health fund branches.
Evacuation from the street
An insured individual who lost consciousness in the public domain and was evacuated to a hospital in a regular ambulance or intensive care ambulance or mobile intensive care unit that was ordered for him is entitled to a full refund, even if he was not hospitalized.
Transfer from the hospital to the insured's home
The insured bears the cost of transportation from the hospital to his home, and he is not entitled to participation from any entity, except for patients as detailed in the chapter "Travel Costs."
Removal of a deceased person's body
The health fund covers the cost of removal only where death occurred in the deceased's home during treatment by the medical team of the ambulance or during evacuation to the hospital.
Evacuation of a work accident victim
A work accident victim is entitled to a full refund of the cost of evacuation, whether he was hospitalized or only spent time in the emergency room.
Initial evacuation following the accident – Payment for this evacuation is made by the National Insurance Institute.
Additional evacuation on a day other than that of the accident – If the patient needs to be evacuated on a day other than that of the accident, he will receive the refund through the health fund. He must apply to the health fund in which he is insured and present a certificate from the National Insurance Institute confirming that the accident has been recognized as a work accident.
Evacuation to delivery room
The cost of evacuating a woman in labor is borne by the National Insurance Institute, which participates in the cost of transport to the hospital only if the distance between the location of the woman in labor and the nearest hospital to which she was evacuated is more than 40 kilometers.
If this distance is more than 40 kilometers, the woman in labor will pay for the first 20 kilometers, and the balance will be paid by the National Insurance Institute, which settles accounts directly with MDA.
Participation by the National Insurance Institute is conditional on the woman having delivered or an ultrasound test in the hospital showing that the woman had labor pains even if she did not give birth on the day of the evacuation.
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