Treatment in the spa is a continuation of hospital treatment. So what is worth knowing when applying for a stay in a sanatorium? How is the whole procedure going? Is a referral to a he alth resort issued by a primary he alth care physician? These and other questions are answered by Rafał Janiszewski, the owner of the Advisory Office providing services in the field of he althcare organization for he althcare entities and patients' rights.
Anna Tłustochowicz: Who is en titled to a sanatorium? In the common mind of seniors, because it is our grandparents who go to the sanatorium or traveled.
Rafał Janiszewski:This is because seniors usually have many different diseases - mainly diseases of the musculoskeletal system and ailments related to diseases of old age, and then such improvement is due to them. However, it is not that only our grandparents are en titled to it!
So: how to go for spa treatment?
First of all, you need a referral. You must remember thatthis referral is dictated by the need to regain fitness.
Eg. after orthopedic surgery?
After illness, accident or surgery. Generallyis about regaining fitness after some treatment . For example, in a hospital where we had operations in connection with an accident. Of course you are.
What kind of doctor can give us such a referral?
Everyone who gave us benefits under the contract with the National He alth Fund. The doctor issues a referral and sometimes he sends it to thebranch of the National He alth Fund , and sometimes we - personally or by post - pass it to the Fund. It is important that the referral is received within 30 days from the date it was issued.
In what cases does the doctor deal with it, and when do we?
There is no rule here. There are just some doctors who take it upon themselves. And when the referral goes to the branch of the Fund, there isanalyzed together with our medical records , because the referral includes information about our he alth.
All thisgoes to the hands of a physiotherapy specialist appointed by the National He alth Fund , who assessesvalidity of such spa treatment from the clinical point of view. If he decides that there are contraindications …
Please tell me immediately what these contraindications could be?
Various, e.g. the patient was referred for spa treatment in connection with a car accident and requires limb rehabilitation, but at the same time his medical records show that he has an unstable coronary disease. Of course, there may also be other diseases that are a contraindication to spa treatment.
Sure.
Well, if the doctor decides that such contraindications exist, or if the doctor decides that the referral is unfounded, becausethe patient does not require improvement, then a decision will be made that the spa treatment will not be financed by the National He alth Fund .This decision is final. It cannot be challenged or appealed against. If, on the other hand, our referral is considered justified and there are no contraindications, then the specialist will indicate in which spa it will be best for us to conduct the therapy.
Does this mean that the patient cannot ask for it to be Ciechocinek?
These types of suggestions may be taken into account by the qualifying physician, provided that the preferred place by the patient corresponds to the resources and activity profile of the procedures that he needs, and if the earliest date is available there.
Because the Fund wants us to start improving as soon as possible.
So, if the date in Rabka is closer than in Ciechocinek, we will be sent to Rabka. This way, we moved smoothly to the next stage, i.e.waiting for an appointment . The facilities receive and improve patients on an ongoing basis, so queuing is a natural thing. And when our time comes, then the NHF branch will deliver us a confirmation, indicating the place and date of starting the spa treatment.We will receive this information no later than 14 days before the date .
Can we disagree with this term?
According to the provisions on waiting lists, we can notify you before starting treatment that this date does not suit us, but only ifthe cause is important life events or if we have other treatment scheduled. However, remember that in such a situation we have to take into account that we will have another date for starting the spa treatment. And it does not have to be a close date. And it does not have to take place in the same facility.
How often can we apply for a sanatorium?
Adults may take advantage of treatment and rehabilitation in a sanatoriumno more than once every 18 months.But this does not mean that the next referral cannot be submitted earlier.
Referral to the next stay may be submitted one year after the end of the previous treatment.
Is such treatment paid?
The rehabilitation treatment is financed by the National He alth Fund. The adult stays in the spa hospital for 21 days and the child for 27 days andthese stays are free . The child stays in the sanatorium for 21 days and no fees are charged for his stay, while his guardian's stay there is partially paid. A stay in a sanatorium during spa rehabilitation for an adult patient lasts 28 days and is partially payable.
What money are we talking about?
The payment mainly applies to the additional payment for the room and depending on its type, whether it is a single or multi-bed room, and whether it has a bathroom or not - it iscost from 10 to 39 PLN per night . The amounts also vary slightly depending on whether the stay is in high season or in low season. There are also costs that the National He alth Fund does not bear at all, such as travel to spa treatment, partial payment for meals and a tourist tax, which is charged for some places.
Some patients also pay extra for the treatments.
Of course! If these aretreatments not related to the disease and they were not planned for him.So if the patient has a leg rehabilitation on the referral and therefore he / she is en titled to, inter alia, massage, but only the lower limb, and the patient would also like a back massage, of course, he has to pay for such a massage himself.
And if the spouses would like to go to the sanatorium together, is it possible?
If they have the same disease and at the same stage of advancement, there is a chance that they will be qualified for treatment in the same center.
But you can go with your spouse at your own expense?
Definitely yes.Sanatoriums and he alth resorts are also selling their services by commerciale. We can go without a referral, but of course then we pay one hundred percent for accommodation, meals and all treatments that we choose for ourselves.
Expert
Rafał Janiszewski, owner of the Advisory Office providing services in the field of he althcare organization to he althcare entities
Speaker, organizer of many training courses and conferences on securityhe alth and patients' rights. In the years 1998-1999 an employee of the Office of the Government Plenipotentiary for the Implementation of the General He alth Insurance. Author of over 20 books on he althcare organization and he alth care financing standards. In 2005-2007, he was an expert of the Presidium of the Parliamentary He alth Committee, as an advisor on he alth services. Co-author of the general study as part of the Pharmaceutical Pricing and Reimbursement project for the European He alth Commission.
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