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Legal

Legal status and patients' rights

The ADELI Medical Center is a state-recognized medical facility with the following areas of activity: therapeutic rehabilitation, neurology, pediatrics, clinical speech therapy, rheumatology, balneology, physiatry (physical medicine) and intensive care.

The facility has a license as a care center and has existing contracts with social insurance carriers, health insurance companies and other carriers at home and abroad. State licenses in original, Slovak or German, and legalized by ministries of health or justice, can be provided if your health insurance company requests it.

EUROPEAN PATIENT RIGHTS

European Commission initiative on patients' rights in cross-border healthcare.

Most patients receive the healthcare they need in their home country. However, sometimes the necessary and best care is only available abroad. In these cases, the nearest highly specialized treatment or most appropriate medical facility may be in border regions or across state lines.

The current guidelines for cross-border healthcare and reimbursement are not always easy to understand. Therefore, the European Commission has prepared a legislative proposal to clarify the treatment options in European countries. The draft also clarifies the distribution of responsibilities for quality assurance and safety in cross-border healthcare. The European Commission promotes cooperation between different health care sectors and centers.

The proposed legislation aims to provide patients with the healthcare they need on the one hand, and to encourage member states to guarantee access, quality and financial sustainability of healthcare systems on the other.

Source: European Union's Public Health

The ADELI Medical Center cannot guarantee that your health insurance will reimburse the treatment costs. You can inquire about the possibilities of reimbursement during your stay at ADELI Medical Center . Some European insurances reimburse treatment costs under certain conditions.

CROSS-BORDER HEALTH CARE

Politics

Several factors contribute to the increasing interconnectedness of health policies and systems within the European Union:

  • Patients also make use of medical care in other EU countries.
  • Personnel working in the healthcare profession work in various EU countries.
  • Expectations for health care have risen.
  • There are new developments in health technologies all the time.

Targets

  • The goals of cross-border healthcare are to have clear rules and reliable information about the possibilities of getting medical care in another EU country and getting this treatment reimbursed. New national contact points are intended to achieve this.
  • Patients' expectations of high-quality healthcare, which can be even higher when they receive treatment abroad, should be met. The NFPs provide information on the quality of healthcare and patient safety, helping patients to make informed decisions about treatment abroad.
  • Close cooperation between EU countries should be ensured in the interest of patients.
  • Longstanding legal uncertainties are to be eliminated. The new regulations are intended to strike a balance between the right of patients to receive treatment abroad and the need for sustainable healthcare systems.

EU LEGISLATION

Directive 2011/24/EU on the exercise of patients' rights in cross-border healthcare provides clarity on the regulation of access to healthcare in another EU country and the right to reimbursement for these services.

EU countries must adopt their laws to implement the directive by October 25, 2013.

Source: HEALTH EU - Portal for trustworthy information in the field of public health.

Learn more here >

LAW AND HEALTH INSURANCE

Reimbursement from health insurance companies

General information

The European Commission's new directive of February 2011 on "Patients' rights in cross-border healthcare" enables patients to be reimbursed for the costs of their stay at ADELI Medical Center .

This directive clarifies that patients have a right to access safe, high-quality healthcare abroad in the EU, as well as to be reimbursed for the services they receive. Importantly, patients now have the right to choose their healthcare provider and, in particular, travel for the treatment of rare conditions and diseases can no longer be refused.

Social Court orders health insurance company to reimburse costs at Adeli Center, Slovakia

Requirements

The first prerequisite is, of course, proof of the necessity or appropriateness of the rehabilitation - a a prescription from the attending physician. A person cannot use any medical service at home or abroad without the doctor's prior confirmation of the need for it. The prescription usually specifies the disease or condition, the recommended treatment with its extent and duration, and the purpose - for example, to prevent the disease from worsening or to improve the patient's condition.

There are TWO types of treatment: outpatient and inpatient.*

  1. In the outpatientrehabilitation, individual treatments are prescribed in exact numbers, for example ten times physiotherapy or five times speech therapy. The costs of treatment abroad are reimbursed to the insured up to the amount that would have been incurred for treatment in the home country.
  2. At inpatient intensive neurorehabilitation of at least three weeks is prescribed. The daily rates vary from fund to fund and range from 150 to 250 euros per day (including daily allowance for the person accompanying the patient).

* Outpatient care can be received by patients abroad without prior authorization under the new policy.

A planned inpatient stay still requires prior authorization. This authorization may only be denied in the following cases if:

  • The health care provider could demonstrably pose a risk to the patient; or
  • this care can be provided promptly in the home country.

To note

It is recommended that the use of the common but misleading terms "ADELI therapy," "ADELI treatment," or "ADELI method" be avoided in any instance.

Officially, a stay at ADELI Medical Center is an intensive neurological rehabilitation program. intensive, neurological rehabilitation. As part of this neurorehabilitation and in accordance with the state licenses of our institute, recognized medical services are provided, such as physiotherapy, speech therapy, proprioception, occupational therapy, neurophysiology or several types of electrical and magnetic stimulation. The rehabilitation program can be seen in the cost estimate and should be passed on accordingly. If you would like to abbreviate the numerous services of the ADELI Medical Center to "ADELI Therapy", it should be clear that this type of treatment is not included in the range of services or service catalog of the health insurance companies.

Cost absorption

Patients can only apply for cost coverage or a cost subsidy after the rehabilitation has taken place and has been paid for. Please note that the health insurance company will cover the costs of each treatment unit according to their own tariffs paid. This means that neither tariffs of ADELI Medical Center nor Slovak health insurance companies are valid for reimbursement.
Some health insurance companies require an application form, which you can get from your contact person at the insurance company. Other required documents are: the medical prescription/referral, our original invoice listing all services and our medical reports on the procedures performed, which should be attached to the application.

In case of rejection

Don't be annoyed, there are only people working at the health insurance company. It may be that the new legal regulations, although binding, have not yet been integrated into the system.
Please keep only written correspondence and collect all documents. collect all documents from correspondence with the health insurance company, please also make copies of your own letters.

The ADELI Medical Center is happy to advise and support you in case of difficulties in these matters: info@adelicenter.com

Our programs

For each age we offer a holistic program.

Our therapy programs are individually tailored to the needs of our patients.

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