Everyone receives reimbursement automatically for most medicine when it has been prescribed by a doctor. But this is not the case for all types of medicines. In some cases, you can only get reimbursement if you received a special grant from us called "single reimbursement".
It is your doctor who applies for single reimbursement to us on your behalf. He or she can do so electronically or by filling out an application form.
The doctor describes your need and your medical history based on which we assess your application. Your economic situation has no impact on the assessment.
Some doctors charge a fee for single reimbursement applications. They do so on their own choice and also decide how much to charge. Ask your doctor if you are unsure.
To find out whether you could be awarded single reimbursement, we have compiled a list of guiding criteria against which single reimbursement is awarded. These criteria are written for doctors, so you need to speak to your doctor to find out whether you meet the criteria.
It usually takes us about 14 days to reply to an application for single reimbursement submitted by a doctor. But, if the application needs special evaluation, it could take up to two months. If your application is granted, you will receive a licence by ordinary mail, and the pharmacy can see your grant in the CTR register at the same time.
Only your doctor is informed if your application for single reimbursement has been refused. The doctor is given an explanation why it was refused.
How does the licence work?
A single reimbursement grant (also called a licence) is personal and entitles you to reimbursement for a particular medicine. When your medicine purchases are reported to the CTR register, your reimbursement is determined based on your CTR balance and the corresponding rate of reimbursement that appears from (table 1).
For how long is my licence valid?
The licence is usually valid for life. However, for some type of medicines, the grant might be limited in time. This could be the case for medicines that should only be used for a few years. If a licence was issued to you before 1 March 2000, it is still valid, but the reimbursement rate depends on your CTR balance. The rate written on the licence no longer applies.
What does the licence cover?
The medicine for which single reimbursement has been granted is written on the licence. It also covers medicines with different names, as long as they contain the same active substances and are taken in the same way.
Reimbursement with retrospective validity
You can receive a single reimbursement grant with retrospective effect. It means that if you bought the medicine before you received the licence, the reimbursement amount can subsequently be paid out to you at the pharmacy.
You need to bring the receipts from previous medicine purchases when you go to the pharmacy. The pharmacy will then report the purchases to the CTR register, and the amount that you are entitled to will be paid out to you.
You can receive a single reimbursement grant retroactively for a maximum of 180 days.