Specialists: higher reimbursement after referral
If you were referred by your GP, you will be reimbursed more for a consultation with certain specialists.
After a referral to a specialist you can receive a higher reimbursement:
- 5 euros for normally insured persons;
- 2 euros for persons with increased allowance.
Important:
- The specialist may apply the paying third party scheme. In this case, you no longer need to submit the referral form to CM.
- Even when the specialist has a If you create an electronic certificate (eAttest), you no longer need to submit the referral form to CM. You pay the full amount to the healthcare provider and receive a refund from CM afterwards, taking the higher reimbursement into account.
For example, how much will you be reimbursed for a consultation with an accredited cardiologist who has accepted the agreement with the health insurance funds and can charge 44.56 euros? A comparative overview.
You are simply insured
reimbursement without referral: 32.56 euros
reimbursement with referral: 37.56 euros
You have VT
reimbursement without referral: 41.56 euros
reimbursement with referral: 43.56 euros
You provide CM with these documents
- the referral form from the general practitioner stating the specialty;
- the certificate for assistance provided , issued by the medical specialist
CM will pay you back
CM will deposit the refund into your account as soon as possible.
What are the conditions?
- You have a global medical file (GMD)
The referring GP does not necessarily have to be the doctor who maintains your GMD. - This concerns a first consultation for that specialty in the calendar year
- This concerns a referral to one of these specialists: cardiologist - dermato-venereologist - endocrino-diabeteologist - geriatrician - gynecologist - internist - pediatrician - gastrointestinal specialist - ear, nose and throat specialist - neurologist - neuropsychiatrist - ophthalmologist - pneumologist - psychiatrist - rheumatologist - stomatologist - urologist