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Costs for ambulance transport to be borne by residents as Velbert senior center closes

The senior center in Velbert is located on Wordenbecker Weg. Photo: Mathias sweeping

Velbert. As a result of the upcoming closure of the Velbert senior center, all residents of the home will have to move to a new care facility. Anyone who is dependent on ambulance transport for the move must bear the costs themselves. The Super Tipp has now found out when asking the AOK Rhineland/Hamburg.

The senior center in Velbert will close on June 15 as a result of the Convivo insolvency. About 100 residents are affected, who are now forced to look for a place in another facility.

“Some were lucky enough,” Manuela Kauhaus reported to the Super Tipp editorial team last Thursday. After a “telephone marathon” together with her brother, she has also found a new place for her mother. The move is scheduled for early next week.

But immediately after this success, the relatives got a damper again. Because: “My mother is dependent on an ambulance for the move,” says Kauhaus, “but the health insurance company refuses to cover the costs.”

The Super Tipp editors contacted AOK Rheinland/Hamburg, Ms. Kauhaus’s insurance company, with the question of why those affected had to pay for an ambulance transport themselves.

In essence, the health insurance company’s response states that travel expenses are only reimbursed for “compelling medical reasons”, such as for inpatient hospital treatment. The case described is considered a change of residence. This does not result in a “socio-medical reason” for the assumption of costs.

The health insurer relies on “nationwide legislation and guidelines” in its assessment. The regulation should therefore affect those with statutory insurance from all health insurance funds.

Here is the statement of the AOK in the wording:
“The insolvency of a care facility is always a difficult situation for those affected. Within the scope of our possibilities, we offer our insured persons help in the search for a new care place.

As far as financial support is concerned, national legislation and guidelines determine which services are reimbursable by statutory health and long-term care insurance.

Social Security Code V regulates that travel costs in connection with a service provided by the health insurance company are only covered for compelling medical reasons. Accordingly, they represent an ancillary service to a main service provided by health insurance, such as a trip to full in-patient hospital treatment.

The situation described is a transfer of residence (relocation) from one inpatient facility to another (nursing home) without a socio-medical reason, so that the trip does not represent a benefit from statutory health insurance.

The Social Security Code XI (long-term care insurance) also has no legal basis according to which removal trips are to be taken over. As a result, costs cannot be covered under health or long-term care insurance.”

2023-06-02 16:17:59
#Home #closure #bankruptcy #Insurance #pay #ambulance #transport

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