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.
Important :
- 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.
Do you have a rare disease?
Have the certificate 'Notification of the rare disease or orphan diseas ' completed by a specialist doctor. Provide the certificate to CM's consulting physician. The status is then granted for five years.
What are the conditions?
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 will receive the care allowance.
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.