{"id":25194,"date":"2016-04-11T14:35:23","date_gmt":"2016-04-11T12:35:23","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=25194"},"modified":"2016-04-11T14:35:51","modified_gmt":"2016-04-11T12:35:51","slug":"jake-pomucky-zdravotni-pojistovna-proplati","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=25194","title":{"rendered":"Jak\u00e9 pom\u016fcky zdravotn\u00ed poji\u0161\u0165ovna proplat\u00ed?"},"content":{"rendered":"

OT\u00c1ZKA: N\u00e1\u0161 tat\u00ednek m\u00e1 u\u017e zna\u010dn\u00e9 probl\u00e9my s ch\u016fz\u00ed a rovnov\u00e1hou, a tak by n\u00e1s zaj\u00edmalo, jak\u00e9 pom\u016fcky typu chod\u00edtka nebo seda\u010dky do sprchy by mu mohla poji\u0161\u0165ovna proplatit.<\/strong><\/p>\n


\nODPOV\u011a\u010e:<\/strong><\/p>\n

Hned \u00favodem je t\u0159eba zd\u016fraznit, \u017ee poji\u0161\u0165ovna nem\u016f\u017ee vyhov\u011bt \u017e\u00e1dosti o proplacen\u00ed zdravotnick\u00e9ho prost\u0159edku v p\u0159\u00edpad\u011b, kdy si klient pom\u016fcku zakoupil z vlastn\u00edch prost\u0159edk\u016f. Jestli\u017ee pacient ur\u010ditou pom\u016fcku ze zdravotn\u00edch d\u016fvod\u016f pot\u0159ebuje, vystav\u00ed mu l\u00e9ka\u0159 poukaz.<\/p>\n

U n\u011bkter\u00fdch pom\u016fcek nen\u00ed ani nutn\u00fd souhlas revizn\u00edho l\u00e9ka\u0159e, aby mohly b\u00fdt hrazeny poji\u0161\u0165ovnou. Mezi zdravotnick\u00e9 prost\u0159edky, jejich\u017e indikace a \u00fahrada z prost\u0159edk\u016f ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed nepodl\u00e9h\u00e1 schv\u00e1len\u00ed revizn\u00edm l\u00e9ka\u0159em, pat\u0159\u00ed berle, hole, seda\u010dky na vanu, do vany, pod sprchu, n\u00e1stavce na WC, klozetov\u00e1 k\u0159esla. U t\u011bchto pom\u016fcek vystav\u00ed l\u00e9ka\u0159 stanoven\u00e9 odbornosti Poukaz na l\u00e9\u010debnou a ortopedickou pom\u016fcku a na z\u00e1klad\u011b poukazu je pak pom\u016fcka vyd\u00e1na v\u00fddejnou zdravotnick\u00fdch pot\u0159eb.<\/p>\n

Berle a hole p\u0159edepisuje smluvn\u00ed l\u00e9ka\u0159 zdravotn\u00ed poji\u0161\u0165ovny odbornosti chirurgie, rehabilitace, ortopedie, neurologie nebo praktick\u00fd l\u00e9ka\u0159. Ze zdravotn\u00edho poji\u0161t\u011bn\u00ed je hrazen maxim\u00e1ln\u011b 1 p\u00e1r berl\u00ed podpa\u017en\u00edch za 2 roky, 1 p\u00e1r nebo 1 kus berl\u00ed p\u0159edloketn\u00edch za 2 roky nebo maxim\u00e1ln\u011b 1 h\u016fl za 3 roky. Seda\u010dku na vanu a do vany, seda\u010dku pod sprchu nebo sprchovou \u017eidli, n\u00e1stavce na WC nebo klozetov\u00e1 k\u0159esla p\u0159edepisuje smluvn\u00ed l\u00e9ka\u0159 odbornosti geriatrie, rehabilitace, ortopedie, neurologie nebo praktick\u00fd l\u00e9ka\u0159. Ze zdravotn\u00edho poji\u0161t\u011bn\u00ed je hrazen maxim\u00e1ln\u011b 1 kus za 5 let, u n\u00e1stavce na WC je to max. 1 kus za 3 roky.<\/p>\n

U pom\u016fcek, jejich\u017e p\u0159edepisov\u00e1n\u00ed je podm\u00edn\u011bno souhlasem revizn\u00edho l\u00e9ka\u0159e, mus\u00ed l\u00e9ka\u0159 nejd\u0159\u00edv vystavit \u017d\u00e1danku o schv\u00e1len\u00ed\/povolen\u00ed a po\u017e\u00e1dat tak revizn\u00edho l\u00e9ka\u0159e o souhlas s \u00fahradou. Po\u017eadavek zde mus\u00ed z medic\u00ednsk\u00e9ho hlediska zd\u016fvodnit, co\u017e znamen\u00e1, \u017ee uvede hlavn\u011b aktu\u00e1ln\u00ed zdravotn\u00ed stav s podrobn\u00fdm popisem hybnosti a pohybov\u00fdch schopnost\u00ed. A\u017e n\u00e1sledn\u011b m\u016f\u017ee vystavit pacientovi Poukaz na l\u00e9\u010debnou a ortopedickou pom\u016fcku.<\/p>\n

Souhlasu revizn\u00edho l\u00e9ka\u0159e podl\u00e9haj\u00ed nap\u0159. chod\u00edtka. Existuje jich spousta variant (dvou-, t\u0159\u00ed- nebo \u010dty\u0159kolov\u00e9, \u010dty\u0159bodov\u00e9, kloubov\u00e9 \u010di s podpa\u017en\u00edmi podporami), tak\u017ee l\u00e9ka\u0159 mus\u00ed podle posti\u017een\u00ed pacienta vybrat to spr\u00e1vn\u00e9. P\u0159edepsat chod\u00edtko m\u016f\u017ee l\u00e9ka\u0159 odbornosti rehabilitace, ortopedie, ortopedick\u00e1 protetika \u010di neurologie. Ze zdravotn\u00edho poji\u0161t\u011bn\u00ed je hrazen maxim\u00e1ln\u011b 1 kus za 5 let. Chod\u00edtko m\u016f\u017ee b\u00fdt p\u0159edeps\u00e1no pacient\u016fm s funk\u010dn\u00edmi horn\u00edmi kon\u010detinami, omezen\u00fdm pohybem doln\u00edch kon\u010detin a p\u0159i sn\u00ed\u017een\u00e9 stabilit\u011b.<\/p>\n

Existuje i \u0159ada dal\u0161\u00edch pom\u016fcek, kter\u00e9 mohou usnadnit \u017eivot v dom\u00e1cnosti \u0161patn\u011b pohybliv\u00e9mu, resp. nepohybliv\u00e9mu pacientovi, nap\u0159. invalidn\u00ed voz\u00edk, polohovac\u00ed l\u016f\u017eko, antidekubitn\u00ed podlo\u017eky aj. I tyto pom\u016fcky mus\u00ed v n\u00e1vaznosti na zdravotn\u00ed stav pacienta p\u0159edepsat l\u00e9ka\u0159 stanoven\u00e9 odbornosti (v\u011bt\u0161inou intern\u00ed l\u00e9ka\u0159stv\u00ed, ortopedie, rehabilitace, neurologie aj.) a v\u017edy je mus\u00ed p\u0159edem schv\u00e1lit revizn\u00ed l\u00e9ka\u0159.<\/p>\n

Pokud l\u00e9ka\u0159 vystavuje poukaz na pom\u016fcku, kter\u00e1 je jen \u010d\u00e1ste\u010dn\u011b hrazen\u00e1, tak\u017ee by u n\u00ed pacient musel dopl\u00e1cet, mus\u00ed ho na to p\u0159edem upozornit. Ve v\u011bt\u0161in\u011b p\u0159\u00edpad\u016f se v\u0161ak d\u00e1 naj\u00edt pom\u016fcka, kter\u00e1 bude poji\u0161\u0165ovnou hrazen\u00e1 pln\u011b.<\/p>\n

Mgr. Old\u0159ich Tich\u00fd vedouc\u00ed tiskov\u00e9ho odd\u011blen\u00ed a tiskov\u00fd mluv\u010d\u00ed <\/p>\n","protected":false},"excerpt":{"rendered":"

OT\u00c1ZKA: N\u00e1\u0161 tat\u00ednek m\u00e1 u\u017e zna\u010dn\u00e9 probl\u00e9my s ch\u016fz\u00ed a rovnov\u00e1hou, a tak by n\u00e1s zaj\u00edmalo, jak\u00e9 pom\u016fcky typu chod\u00edtka nebo seda\u010dky do sprchy by […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":23970,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[18],"tags":[],"class_list":["post-25194","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-poradna"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/25194","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=25194"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/25194\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/23970"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=25194"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=25194"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=25194"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}