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Oncologic Patient's Rights

Oncologic disease has a great impact on the life of patients and their families, with consequences in physical, emotional, economic and labour terms. Therefore, the law provides a set of rights and benefits to support and protect the patients during the evolution of the disease. These are some of the supports the patient is entitled to.

Multipurpose Medical Incapacity Certificate

It is required to be able to enjoy the rights and benefits granted by law to oncologic patients.

To get it, you should ask your assistant physician for form 919, a request to confirm the oncologic disease and the date of the diagnosis. The request should be accompanied by a medical report and reports of complementary diagnosis resources performed (in the case of cancer, the anatomopathological examination report is required ). With these documents you should go to your local Health Centre to ask for a medical board to be convened to assess your degree of incapacity before the district medical officer of health of your place of residence (find out more at your Health Centre). The medical board should summon you for an assessment within 60 days.

If you’re given an incapacity degree of 60% or more you are eligible for the benefits for people with disabilities set out in the legislation in force, including the benefits mentioned here and others, namely as to Personal Income Tax, car tax, single road tax (find out more in Instituto Nacional de Reabilitação).

Prosthesis and other technical aids

Wheelchairs and other means of support provided for in the law may be reimbursed by means of the assistant physician’s prescription and completing the “technical aid” allocation sheet .

Exemption from user charges

The oncologic patients are exempted from the payment of user charges for appointments and complementary procedures prescribed in the scope of the treatment and follow up of the oncologic disease.
Oncologic patients with an incapacity degree of 60% or more are exempt from the payment of any user charges in National Health Service, but should obtain the multipurpose medical incapacity certificate for that purpose.

Reimbursement of medicines expenditures

In the National Health Service hospitals, such as IPO, the medicines used for the treatment of cancer are supplied free of cost to the patients, both in the case of inpatient and outpatient treatment.
For the remaining medication the oncologic patients benefit from a special co-payment scheme, with four brackets:

Bracket A

State’s co-payment of 90% of the retail selling price;

Bracket C

State’s co-payment of 37% of the retail selling price;

Bracket B

State’s co-payment of 69% of the retail selling price;

Bracket D

State’s co-payment of 15% of the retail selling price.

The pain killers narcotic drugs (opioids), indispensable for the treatment of mild to strong oncologic pain, are co-paid according to Bracket A.

Pensioners and patients whose total annual income does not exceed 14 times the national minimum income or the value of the social support index in force benefit from a co-payment increased with 5% for medicines included in bracket A and 15% for the medicines of the other brackets.
To benefit from this co-payment increase it is necessary to provide proof of being an oncologic patient and request the change of the data in the Citizen Card or User Card at the Local Health Centre.

Travel expenses

National Health Service undertakes the responsibility of transporting oncologic patients in need of non-urgent healthcare for appointments and to receive medical treatment related to cancer, provided they are prescribed by their assistant physicians. The transport credential is always issued by the entity requesting the healthcare and a prescription by the assistant physician stating the medical reason is required
(check with your hospital). In IPO Lisboa, the management and scheduling of the transport of patients in need of non-urgent healthcare is ensured exclusively by Central de Transportes de Doentes, (patients’ transport station) operating 24 hours a day, every day of the week. To use this service it is mandatory to be a IPO’s patient and have the transport declaration issued by a doctor from IPO.

Medically Assisted Procreation

Some sorts of cancer and some treatments, including chemotherapy, radiotherapy, hormone therapy and bone marrow cell transplantation may interfere with fertility. If you were diagnosed with cancer and you still wish to have children, you should speak with your doctor about it before starting any treatment. National Health Service provides the possibility to men and women to preserve their fertility before they start the treatments.

Advance Healthcare Directive (vital will)

A document where the patients mention their will regarding the healthcare they are willing to receive or not in case of incurable illness in its terminal stage and in case they become unable to express their wishes. The patients may also appoint a healthcare proxy, who will make the decisions for the patient if/or when he/she is unable to express his/her will.
In the vital will it is the patient who states whether he/she wishes or not to be subject to to invaise means of artifical support of vital functions, artificial nutrition and hydration, experimental treatments, among others. This document is optional. For more information please refer to Registo Nacional do Testamento Vital (National Registry of Vital Will).

Second medical opinion

The patient is entitled to a second medical opinion about his condition, to be able to make a better informed decision about the treatment he/she will undergo. The second opinion should be justified based on information (assistant physician’s report and diagnostic examinations, if there are any) regarding a specific medical condition.

Medical reports

Any patient may ask for medical reports to submit to a medical board or other purposes. In IPO Lisboa, the request may be made by completing a specific form, available at the appointments secretariat.

Right of access to medical information

The patient has the right to access his/her health data (medical record, results of analysis and other tests, interventions, diagnosis, treatments, etc.) The user or the doctor appointed by him/her can access the information.

To access your data in IPO Lisboa, you should complete a specific form, available at the appointments secretariat.

Special protection during disability

In the cases when oncologic disease results in a permanent incapacity for work, the patients are entitled to special protection, and they may receive disability pension, or pension supplement. Seek further information with Social Security or Regional Centre of Social Security in your area of residence.

Protection during illness

Cancer is a serious illness, which may require long-term treatments and cause time away from work over an extended period of time. To compensate for loss of payment due to temporary incapacity to work, patients are entitled to sickness benefit. For this purpose, the assistant physician or family doctor have to complete the Temporary Incapacity Certificate, a document which shall be sent automatically via electronic system to social security. You should send a copy of the certificate to your employer.
During the sick leave you may be called to appear before a medical board to confirm the situation, by Social Security or your employer. It is mandatory to appear before the board.

Duties

1.  To respect the other users and health professionals’ rights with whom they relate.

2. To respect the rules governing the organization and operation of the departments and health facilities.

3. To cooperate with health professionals in all aspects regarding their situation.

4. To pay the costs incurred with the provision of healthcare, where appropriate.