Chronic condition status
Persons with a chronic condition who meet the conditions may be entitled to chronic condition status.
The chronic condition status is automatically granted and has two further advantages:
- The co-payment ceiling for the maximum invoice is reduced. You may be reimbursed for (more) co-payment.
- You only have to pay the co-payment at the GP, specialists and dentists . The fee is paid directly by CM to the (dentist) doctor. However, the (dentist) doctor is not obliged to apply this scheme.
- The status is automatically extended in the event of high medical expenses or if you receive the healthcare lump sum.
- In the case of a rare disease, the status can be extended for five calendar years . During the last year that you have the status, provide a new certificate 'Notification of the rare disease or orphan disease' to the advising doctor.
You will receive the status
The status is automatically granted for two years. As soon as you have the status, CM will inform you about this.
You have high healthcare costs for eight consecutive quarters.
- For the quarters of 2021: at least 335.04 euros in medical expenses.
- For the quarters of 2022: at least 337.69 euros in medical expenses.
- For the quarters of 2023: at least 365.18 euros in medical expenses.
- The eight quarters must span two consecutive calendar years. The amount is indexed annually. To calculate your healthcare costs, the reimbursement from the health insurance and the co-payment are added together. Are not eligible for the calculation: services and medicines not reimbursed by health insurance and supplements.
Or you have a rare disease and high healthcare costs.
The rare disease is listed on the Orphanet website. Your healthcare costs are at least equal to the above minimums for eight consecutive quarters.