L’Assurance maladie takes care of 5 nights for pregnant women away from a maternity hospital

The decree of 14 April 2022, published in the Official Gazette of 15 April 2022, provides for the provision oftemporary non-medical accommodation turn them pregnant women away from a maternity wardprovision originally provided for in the Social Security Financing Act (LFSS) for 2020.

The decree lays down the conditions for access and financing of this service and specifies the pricing arrangements for transport charges for correspondents.

TO NOTE

As the accommodation is non-medical, no treatment can be provided (except in an emergency).

Non-medical temporary accommodation: who can benefit from it?

Pregnant women living more than 45 minutes away from an obstetric gynecology facility can now benefit, if they so request. temporary non-medical accommodation.

By way of derogation, accommodation may be proposed for pregnant women who are exposed to the circumstances of a conjunctural nature (climatic conditions, heavy road traffic, etc.).

Accommodation is limited 5 nights consecutive maximum. They must necessarily precede the estimated date of delivery.

In case of medical necessity, this duration may be extended until the effective date of the agreement. Similarly, in the event of a pathological pregnancy, this benefit may be offered throughout the pregnancy. Its necessity and duration are then left to the medical discretion under conditions that will be defined by order.

TO NOTE

For pregnant women residing in Guyana, specifics apply.

Accommodation can be arranged within the obstetric gynecology facility in premises identified and separate from the care and hospitalization areas or outside the facility in accommodation facilities located nearby.

La femme enceinte hébergée may decide to share the room with one or more companions (le conjoint for example). However, this possibility is limited to the accommodation capacity of the accommodation structure.

Also, the performance of this service may be entrusted to a third party (another health facility or any legal person under public or private law) by agreement.

A prize for social security

Non-medicalized accommodation is funded by Health Insurance for all pregnant women receiving health care. For all others, the service will be charged to them (as well as that for any accompanying persons).

Pick-up is provided in the form of a flat rate per night and no additional accommodation contributions can be requested. An order will set the conditions for this financing and the amount of the package.

In the case of transportation from the place of residence to the place of temporary non-medical accommodation or the obstetric gynecology unit of the pregnant woman, he is also in charge of the Health Insurance under certain conditions. Upon request, it is possible to transport this transport by an approved company or by a taxi company which has concluded an agreement with a local health insurance body.

In order to benefit from this award, you will have to apply for the Health Insurance agreement in advance.

TO NOTE

How to request a prior agreement with the Health Insurance?

  1. The doctor must give you a request for prior agreement, which is valid for a medical prescription for transportation.
  2. You complete and send this request for prior agreement to the doctor’s advice of your health insurance fund.
  3. After your submission, no reply within 15 days is valid. In case of refusal, you will receive a courier from l’Assurance Maladie.

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