Administratives
02.12.2002
INTERINSTITUTIONS, TOUS LIEUX D'AFFECTATION + pensionnés + écoles européennes
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| Informations Administratives 02.12.2002 | N° 96-2002 INTERINSTITUTIONS, TOUS LIEUX D'AFFECTATION + pensionnés + écoles européennes |
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The medical officers, with the consistent backing of the Medical Council, do not see spas as providing primary treatment, which generally involves medication and regular physio-/kinesitherapy over a period of time. Thermal cures can only therefore be justified if normal treatment has been insufficiently effective, something it is up to the medical officer to assess. Applications must be accompanied by "the medical prescription and a detailed medical report, attesting the necessity of the spa treatment" (point XI of Annex I to the Rules). The prescription may not date from more than 3 months before the application. The report must detail the patient's history, the specific treatments undergone during the previous year (medication, type and frequency of physio-/kinesitherapy, etc.) and the pathology's recent evolution, highlighting the factors justifying a cure. The application must specify the spa, the length of the cure and the nature of the treatments envisaged. In the case of follow-up cures, the impact of the previous ones on the pathology will be considered. To allow the medical officer to obtain any additional assessment data he/she may need, applications must reach the Settlements Office at least a month and a half before start of the cure. Cures undergone before receiving authorisation will not be reimbursed. (As thermal cures do not qualify as urgent, the Settlements Office does not accord retroactive authorisations.) Patients are free to choose their spa on condition it is one approved by the competent national authorities (an attestation to this effect is required for establishments outside the EU), it has medical supervision and the treatments provided are in line with their pathology. Thalasso-/balneotherapy institutes, swimming pools, lakes, gymnasia and other fitness facilities, do not qualify as spas and authorisations will not be provided in respect of them. In such non-eligible establishments, only physio-/kinesitherapy sessions will be reimbursed and provided all the usual conditions are met (doctor's prescription, treatment by qualified therapists, invoice drawn up by therapist with his/her qualification clearly indicated, cost broken down by treatment and number of sessions with dates, a maximum number of sessions per annum, etc.). Reimbursement covers both accommodation and treatment costs, subject to submission of a duly completed cure medical report. If the cure was unauthorised or its authorisation has been cancelled, reimbursement only extends to the treatment costs - subject, again, to compliance with all the usual conditions. An authorised cure will not be reimbursed if the cure did not involve at least two appropriate treatments daily or if it lasted less than 10 days. In the latter case, however, a doctor's certificate justifying the interruption of the cure may lead to reimbursement being accorded. | |
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Editeur : Personnel et Administration Direction C.4 : Logistique et Services | |