Conditions of repayment
In the cluster headache, for patients who meet the diagnostic criteria of the IHS and on the basis of a report from a physician specialising in neurology or neuropsychiatry.
On the basis of a report from the general practitioner attesting that these conditions have been met, reimbursement may be granted up to a maximum of 7 packagings for a maximum period of one month.
- This reimbursement authorisation may be renewed for each subsequent algic cluster serie on the basis of a reasoned request from the attending physician, up to a maximum of 7 packages for a maximum period of one month. Reimbursement is granted provided that a minimum period of 6 months has elapsed since the end of the reimbursement of the previous cluster treatment.
- If the treatment of an algic cluster serie is necessary for a period exceeding one month, the renewal of the authorisation shall be requested for a maximum of three consecutive months by the neurologist or neuropsychiatry specialist up to a maximum of seven packages per month.
If the neurologist or neuropsychiatry specialist is convinced that, for certain patients, it is indicated and without risk to reimburse more than 7 packages per month, he must explicitly request this in a detailed medical report. This is possible for a maximum period of 3 consecutive months and up to a maximum of 30 packages per month, each time on the basis of a new detailed medical report.
Source : INAMI (french)
Documents concerning the reimbursement :
Application for reimbursement
To be filled in by a specialist in neurology or neuropsychiatry and sent (without delay) to your mutual insurance company.
The reimbursement authorization document
This document is sent to you by your Mutual following the above reimbursement request.
Attention ! the delay can be enormous: several weeks, even more than a month. !!!
Give this document to your pharmacist for reimbursement.
(Don't hesitate to ask your pharmacist to keep your prescriptions on hold for as long as you need to obtain the form from the Mutual)
Sample of the authorization document of the Partenamut mutual company for 7 packages