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Wycena leczenia przez NHS przed wyjazdem

Pacjenci czekający na operację w kolejkach NHS, w ramach Dyrektywy, mają prawo wyjechać za granicę i tam poddać się operacji, w państwowej lub prywatnej placówce, z późniejszą refundacją kosztów leczenia przez NHS.

 

Aby kwalifikować się do leczenia za granicą, pacjenci muszą spełniać pewne kryteria, takie jak stały adres zamieszkania w Anglii i prawo do leczenia w NHS. Więcej na temat tego, kto kwalifikuje się do leczenia za granicą na koszt NHS, dowiedzieć się mogą Państwo z naszego poprzedniego artykułu: https://med4eu.co.uk/kto-kwalifikuje-sie-leczenia-za-granica-na-koszt-nhs

 

Jeśli spełniają Państwo powyższe kryteria, niewiadomą, która może Państwa powstrzymywać przed kupnem biletów lotniczych i umówieniem zabiegu, jest sprawa kosztów leczenia.

 

W ramach Dyrektywy, pacjenci sami płacą za leczenie, a koszty te są refundowane przez NHS po powrocie do domu. Zgodnie z dyrektywą transgraniczną, NHS zobowiązany jest refundować koszty leczenia za granicą jedynie do wysokości wyceny danej procedury medycznej w Anglii.  Oznacza to, że jeśli NHS wycenia leczenie na przykład na £1000, a pacjent zapłacił za nie £1200, to NHS zwróci mu £1000, zaś różnicę pacjent będzie musiał pokryć z własnych środków. W przypadku gdy koszt leczenia w Polsce jest niższy od wyceny NHS, NHS zapewnia pełną refundację kosztów.  

 

Czy istnieje możliwość uzyskania informacji na temat górnej granicy refundacji przed odbyciem leczenia? Tak!

 

Przed odbyciem leczenia, mogą Państwo złożyć do NHS aplikację z prośbą o wycenę leczenia. Wniosek aplikacyjny jest identyczny do wniosku używanego do rozliczenia post-operacyjnego. Wymagane są między innymi: numery NHS i NIN, dowód miejsca zamieszkania i list od lekarza potwierdzający potrzebę oraz plan leczenia. Im dokładniejszy list lub raport medyczny, tym dokładniej NHS może wycenić leczenie.

 

Po uzyskaniu pozytywnej odpowiedzi od NHS, po pierwsze refundacja leczenia jest gwarantowana, a po drugie, pacjenci wiedzą dokładnie jaka jest granica refundacji. Oznacza to, że pacjent może zdecydować jaki standard leczenia go interesuje. W wielu przypadkach, nawet koszty leczenia z najwyższej półki w Polsce nie przewyższają granicy refundacji NHS. W niektórych przypadkach jednak, pacjenci mogą zadecydować czy np. chcą dopłacić ekstra i wybrać protezę z lepszych materiałów, inny szpital itd. Jest to jedna z niekwestionowanych zalet leczenia za granicą na podstawie Dyrektywy – elastyczność wyborów w kwestii leczenia.

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