If you are expecting a baby and are insured under the Commission JSIS scheme, you are most likely familiar with the Intracomm page, which provides details on what the scheme reimburses and at which rate.
You may have spotted that, under our insurance scheme, prior authorisation is needed if you wish to carry out some genetic tests, such as the Non-invasive pre-natal test, or NIPT. This test has been recently introduced in the healthcare systems, or at least in the Belgian one: the test works by examining the small fragments of DNA floating in the mother’s blood (as a proportion of them comes from the placenta and carries the DNA of the foetus) and enables the early detection of genetic anomalies, such as the Down syndrome, Edwards syndrome and Patau syndrome. NIPT is safer compared to amniocentesis, as it is done via a simple blood test thus bearing no risks for the mother or the baby, and it is more reliable than the classical methods of the triple test or the nuchal translucency scan, with more than 98% accuracy and less false-positives. All this comes (as no surprise) at the relatively high price of 260-290 euros.
You may have seen that the reimbursement rules are quite strict, especially for young expecting mothers, who may hope to obtain reimbursement only if considered at high risk. Yet, if you live in Belgium, you may have also read that the Belgium national health insurers reimburse the NIPT almost in full, no matter the level of risk or the age of the mother. We are asking PMO to clarify the reasons for diverting so much from the policy implemented by the Belgium national scheme and for accepting to reimburse only in deuxième ligne.
Websites consulted:
- https://www.fmsb.be/news/ce-qui-a-change-au-1er-juillet-2017
- https://www.mc.be/mes-avantages/naissance-enfance/besoin-aide
- http://www.rapid.nhs.uk/guides-to-nipd-nipt/nipt-for-down-syndrome/
- http://www.ulb-ibc.be/niptest-non-invasive-prenatal-test/
- https://www.uzleuven.be/en/nipt
HARD TO FIND
