Insuree
How to go to a spa as an insuree
Spa treatment as an essential part of necessary healthcare is covered either in full (comprehensive spa care – CmSC) or in part (contributory spa care – CnSC) by health insurance companies.
Comprehensive care
- Intended for patients with a doctor's recommendation
- Spa treatment, accommodation and meals are covered by health insurance
- Patients pay a fee for their stay and any additional charges for above-standard services or accommodation
- Length of stay: 21 days (28 days in some cases)
Contributory care
- Partially covered stay with a contribution from the insurance company for spa treatment
- Length of stay: usually 14 days
Consult your doctor, who will recommend the appropriate type of stay and prepare a proposal for the insurance company.
Care application process
Step 1
A proposal for spa care covered by health insurance can be made by a general practitioner on the recommendation of a specialist, an outpatient specialist or the attending physician during hospitalisation. At the same time, the lead doctor will suggest the type of spa treatment (comprehensive or contributory) and a location suitable for the treatment of the disease (indication).
Step 2
Comprehensive or contributory spa care is approved by the health insurance company's reviewing physician.
Step 3
In the case of comprehensive spa care, the health insurance company sends the approved proposal directly to the spa, which calls the patient to come in. CmSC is used by a patient during sick leave. The health insurance company pays for the spa treatment, full board and accommodation.
Step 4
An approved proposal for contributory spa care is sent to the spa through the health insurance company or patient. In the case of contributory spa care, the health insurance company contributes to the medical part of the total cost of the spa stay. Accommodation and meals are paid for by the person being treated and he/she is not on sick leave during the stay. A stay – spa inpatient care – can only be provided by a registered inpatient healthcare facility according to the legislation in force. It is not possible to divide a stay into parts, to receive treatment in a healthcare facility and to stay outside the healthcare facility or to receive treatment from home. In such a case, the care would be outpatient care, either with direct payment or at the insurance company's expense, if the care is ordered using an FT or K request form.
Step 5
If the health insurance company does not approve comprehensive or contributory spa care, a client can stay at a spa as a self-payer.
How to proceed in case of refusal
I'm a self-payerIf your request for spa care covered by insurance is not approved, don't despair. Even in this case, you have the option to use the spa treatments and stay as a self-payer, where you pay for the services yourself.
Self-pay stays offer the same comfort, quality accommodation and treatments as standard spa care. You can choose the length of stay, type of treatments and additional services according to your needs and preferences. This method is ideal for prevention, recovery or if you want to combine spa care with leisure activities in the area in a flexible way.
Self-pay stays offer the same comfort, quality accommodation and treatments as standard spa care. You can choose the length of stay, type of treatments and additional services according to your needs and preferences. This method is ideal for prevention, recovery or if you want to combine spa care with leisure activities in the area in a flexible way.
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