Referrals to a sanatorium. Everything you need to know about them [EXPLAINED]

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Receiving a referral to a sanatorium for spa treatment is an opportunity to improve your health, take advantage of medical treatments, strengthen your body and rest. The condition for receiving a referral from the National Health Fund, ZUS or KRUS is the appropriate state of health of the patient. It should be operational, capable of self-service, but requiring medical treatment. How to get a referral to a sanatorium step by step?

Spa treatment – for whom?

Sanatoriums are a special type of spa facilities that offer health care to people suffering from various diseases. They are located in spa towns, distinguished by their natural and climatic values, which have a beneficial effect on the body. Characteristic for health resorts is access to mineral waters, brines, mud and thermal waters. For this reason, sanatoriums are often located in the mountains or by the sea.

Most often, spa treatment is used by people with chronic diseases, as well as those in need of rehabilitation after injuries or serious diseases. FROM sanatorium treatment can be used by children, adolescents, adults and seniors if there are appropriate medical indications. They are verified by a doctor who issues a referral to a sanatorium.

Treatment in the sanatorium is possible:

1. on the basis of a referral from the National Health Fund;
2. on the basis of a referral from ZUS;
3. on the basis of a referral from KRUS;
4. for a fee in institutions offering private services.

Referral to a sanatorium at the National Health Fund – how to get it step by step?

1. Step one – a visit to the doctor

A referral to the National Health Fund (NFZ) to a sanatorium may be issued by the family doctor who treats the patient on a regular basis, or by a doctor of another specialization who carries out the therapy of a given patient. In the application to the sanatorium, the doctor describes the patient’s health condition, including the results of recent tests (morphology, ESR, urine analysis, ECG, X-ray). If the patient has recently undergone hospital treatment, he / she attaches an information card from the hospital to the application.

Before receiving a referral to a sanatorium, the patient may suggest to the doctor the spa town or region where he would like to go, provided that the sanatorium in question carries out treatments related to the patient’s illness. However, it is not binding on the National Health Fund.

2. Step two – application to the NHF branch

The application filled out by the doctor should be delivered to the provincial branch of the National Health Fund. You can send it by mail or take it in person. If the application is correctly completed, contains all the necessary data, it is registered and given a number. If it needs to be refilled, it is either returned to the patient immediately or mailed.

Within 30 days, a balneologist employed by the National Health Fund decides whether the application is justified, i.e. agrees (or not) to sanatorium treatment. The decision is communicated to the patient by post. The balneologist also immediately decides about the place of treatment.

3. Referrals to the sanatorium – waiting list

The waiting list for a trip to the sanatorium is very long. Usually from NHF referrals until departure is about two years (in individual voivodeships the time may be longer or shorter). As each NFZ applicant receives a number, he can check on the NFZ website at what stage his application is, and how quickly the waiting list is moving. Thus, it can approximately predict the time of departure.

It happens that one of the waiting people resigns from the trip, then a place in the queue becomes available. The National Health Fund may propose another patient a trip without having to wait a long time.

4. Step Four – Notice of Departure

14 days before the start date National Health Fund sanatorium stay sends a departure notification by post. A patient who is referred to a sanatorium, for justified reasons, such as hospital treatment, deterioration of health or important family matters, may resign from this date. He must notify the NFZ branch about it. Then the date of departure will be postponed. If, on the other hand, the refusal to travel is unjustified, e.g. the patient does not like the time of the year, then the application must be resubmitted.

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How much does a stay in a sanatorium in the National Health Fund cost?

Issuing a referral from the National Health Fund is free, as are treatments and medical consultations during the stay in the sanatorium. However, the patient incurs the following costs:

1. the cost of travel to the sanatorium,
2. partial payment for accommodation and meals.

The price for accommodation depends on the season and the standard of the room (single or multi-bed, with or without a bathroom, etc.) and may range from PLN 10 to PLN 36 for each day of stay. There are no fees for children and adolescents up to the age of 18 (or up to 26 in the case of students).

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Referral to a sanatorium at ZUS

Sanatorium treatment reimbursed by ZUS is a specific form of rehabilitation addressed to a specific group of patients – working people who are at risk of losing their ability to work or are unable to work at the moment as a result of an illness, but rehabilitation in a sanatorium gives a chance to recover. Such treatment is referred to as ZUS disability prevention. In order to receive a referral to a sanatorium from ZUS, one of the additional conditions must also be met:

1. be insured by the Social Insurance Institution;
2. receive a periodic disability pension;
3. receive a rehabilitation benefit or sickness benefit;
4. apply for a disability pension or a rehabilitation benefit.

If we want to apply for the possibility of staying in a sanatorium as part of disability prevention, we must submit an appropriate one application at a ZUS office. It is also possible for the patient’s doctor to issue the application. We will receive a referral to a sanatorium under the Social Insurance Institution (ZUS) if a ZUS certifying physician (based on an examination or medical documentation) issues a decision confirming the need for rehabilitation. The waiting time for a referral from ZUS is eight weeks, which is less than in the case of treatment at the National Health Fund.

Referral to the sanatorium on KRUS

Persons insured in KRUS may apply for medical rehabilitation in a sanatorium, which will be completely free, as in the case of ZUS disability prevention. The patient must meet certain conditions and receive a medical referral. You must be fully covered by KRUS social insurance or you must be entitled to a temporary agricultural pension due to incapacity for work. The third option is sickness, accident or maternity insurance, which is valid for at least 18 months before the date of submission of the application.

If the patient meets the requirements necessary for sanatorium treatment, he should:

1. go to a doctor who will write out an application for a referral, on the basis of which KRUS may be referred to a sanatorium;
2. submit the application and medical documentation to the appropriate KRUS facility;
3. if the application is approved, the patient will be offered a trip to the sanatorium;
4. after confirming the trip, the patient will receive a referral to a specific spa center.

Private treatment in a sanatorium

An alternative to a fully or partially reimbursed stay in a sanatorium is a paid spa treatment. This solution makes it possible to skip the lines to the sanatoriums, as well as the need to wait a long time for departure. You can wait even 12-18 months for a trip to a sanatorium under the National Health Fund. When choosing a private spa, you have the freedom to adjust the place and the center to your health needs. We will also decide on the length of stay depending on our financial capabilities and we will adjust the date with greater freedom.

A trip to a fully-paid sanatorium is also a convenient solution for people who want to alleviate recurring physical ailments, minimize stress and fatigue. We can be a form of vacation that will take into account pro-health treatments. The offer of a given health resort may also include SPA services.

The cost of rest in a private sanatorium depends on the treatment offer, room standard and duration of stay. Prices start from about PLN 120 for a multi-bed room to PLN 250 for a better standard. That is, for the weekly stay in a fully-paid sanatorium we can pay an average of PLN 800-1500.

Sources: zus.pl, nfz.gov.pl

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