Health Insurance

Legal Status ADELI Center

The ADELI Medical Center is a nationally recognized clinic for rehabilitation, neurology, paediatrics, clinical speech therapy, physiatry, rheumatology, balneology, and intensive care. The organization has a state license to operate a day care center and it has contracts with payers in the country and abroad.

State licenses in the original, Slovak language and in German language, legalized by the health and justice ministries can be provided to you, if your insurance provider requests them.

Your European Rights

Initiative of the European Commission on patients’ rights in cross-border healthcare

Most patients find the desired health care in their home country. Occasionally, however, the best care is available abroad. In cases of a highly specialised care or in the border regions, the nearest and the most appropriate medical facility can be, indeed, located abroad.

The current rules for the use of cross-border healthcare and reimbursement of costs are not always easy to understand. Therefore, the European Commission has prepared a proposal for a legislative act which is intended to illustrate the possibilities of medical treatment in other European countries. The proposal also clarifies who is responsible for quality and safety of care in the cross-border cases. Finally, it is the cooperation in various fields – between networks of centers of reference for specialized care – that is encouraged.

This proposal will, on one hand, help the patients to get the health care they need, and on the other, encourage the Member States to be able to guarantee accessibility, quality and financial sustainability of health care systems as well as to preserve the welfare of its citizens.

The following flowchart, created by the European Commission, summarizes the way in which the health care costs may be met and reimbursed.

REIMBURSEMENT OF COSTS FOR EU/EEA CITIZENS

According to the EU Cross Border Healthcare Directive, you have the right to apply for healthcares in any EEA state you choose but you must comply with certain requirements to qualify for reimbursement of your treatment by your health care provider. The „Directive route‟ is based on an individual exercising his or her rights to obtain health services on the open market within the EU, under article 56 of the Lisbon Treaty. It has been called the „Article 56 route‟ previously. You will normally have to pay for all of your treatment upfront and claim reimbursement from your insurance provider when you return.

ADELI Medical Center will provide you with appropriate invoices/receipts to facilitate the reimbursement process, however, we cannot guarantee that your home insurance provider will reimburse any of the treatment costs. You can always inform yourselves (by contacting your personal coordinator) about your chances of reimbursement before or during your stay in the Center as some of the EU insurance companies are willing to consider reimbursement, under certain conditions.