Everyone who’s eligible for treatment under the National Health Fund (NFZ) can also receive a partial refund on, for instance, an orthopaedic prosthesis. The list of devices eligible for refund and the limits of financial contribution are set out by a Regulation of the Minister of Health.

The Regulation specifies a list of refunded orthopaedic devices and aids, the amount of the refund, a list of medical specialists that can prescribe orthopaedic devices and aids, and also indicates how frequently one can buy the equipment with a refund.

The currently applicable Regulation of 6 December 2013 on the list of prescribed medical devices introduced some changes to the rules on refunding, including, but not limited to, an increased refund on arm and leg prostheses, hearing aids and special wheelchairs. For instance, the refund limit was increased for hearing aids, which now can be prescribed by audiologists and phoniatrists as well. The requirement of being professionally active to receive a refund on prosthetic hearing aids for two ears has also been lifted.

For information on where to fill in a prescription, go to NFZ branches and their respective websites.

Requirements for receiving a refund from the NFZ

The primary condition for receiving a refund from the NFZ is a prescription issued by a physician who specialises in the relevant field and has signed a contract with the NFZ. Such a prescription must be confirmed in an NFZ branch or its regional office.

For aids which come in a monthly supply (e.g. incontinent briefs, stoma equipment, catheters), the prescription can be issued for a period of up to three months. For those who are entitled to a monthly supply, the NFZ can issue a “Monthly supply card" which is valid for a year. With this card, patients don’t have to confirm their prescriptions with the NFZ every three months. Prescriptions for orthopaedic items and medical devices supplied on a cyclical basis, rather than once every month, are valid for up to 30 days from their issue. The collection date specified on the prescription is deemed to be the date of the benefit being provided. It is from this date that a specific period has to lapse in order for the patient to be again eligible for a refund.

Refund limits

The NFZ provides a refund on orthopaedic items and medical devices up to the limit set out by the Minister of Health. The patient has to pay out of his/her own pocket the difference between the set limit and the product price.

For some medical devices, the Regulation also specifies, as a percentage, the own contribution of patients within the public refund limit.

Individuals with a recognised disability may seek a refund from the State Fund for the Rehabilitation of Disabled Persons (PFRON). Such funds are distributed by the District Family Support Centres. Refund limits and income criteria apply for these as well.

Special privileges for war veterans

The entitlement to obtain free of charge (up to the limit) medical devices is given to war- and military-disabled persons, blind civilian casualties, and persecuted persons, and also to soldiers, employees and injured veterans within the treatment of injuries and diseases sustained or contracted while performing actions abroad.

If such individuals want to purchase equipment priced outside the set limits, they have to cover the difference out of their own pockets or seek financial contribution from other sources in line with the relevant rules as applicable to everyone.

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