Free blood tests through CAS: coverage and waiting

Yes, blood tests can be free (0 lei) through the Health Insurance House (CAS) — if you’re insured, have a bilet de trimitere (referral) for paraclinical investigations from your family doctor or a specialist, and present yourself at a laboratory under contract with CAS. The obstacle is usually not the referral, but the laboratory’s monthly ceiling: when it runs out, you hear “we’re out of funds this month” and the waiting lists appear.

What “free tests through CAS” means

Laboratory tests are paraclinical investigations covered from the National Unique Health Insurance Fund, on the basis of the framework contract (Contractul-cadru) and the CNAS rules. For them to be free for you, three conditions must be ticked:

• you are insured (up-to-date insured status);
• you have a valid referral for paraclinical investigations;
• you go to a laboratory contracted with CAS (not every private laboratory has a contract).

If all three are met, you pay 0 lei.

Which tests are covered

The basic package covers the common laboratory tests, prescribed by the doctor depending on your situation. The most frequent:

• complete blood count;
• blood glucose;
• ESR and other common inflammatory markers;
• total cholesterol, HDL, LDL, triglycerides (lipid profile);
• transaminases (AST/ALT) and other liver tests;
• creatinine, urea (kidney function);
• urinalysis;
• other tests from the framework-contract lists, depending on the indication.

What exactly you’re prescribed is decided by the doctor, within the limits of the covered lists. Some more special tests (for example certain hormonal or immunological markers) have conditions or are recommended by a specialist.

How to get the referral

The key step is the referral. In practice:

1. Go to your family doctor. They assess the situation and, if appropriate, issue the referral for paraclinical laboratory investigations.
2. The referral can also be issued by an outpatient specialist, for the tests needed for your condition.
3. The referral lists the recommended tests — you have the ones ticked there done.

The referral has a validity period, so don’t let it expire. Details on when you need a referral and how long it’s valid are in the guide on the referral.

How to book at a contracted laboratory

With the referral in hand:

• call or go to a laboratory under contract with CAS;
• ask explicitly whether they still have a CAS ceiling (funds) for that month;
• confirm which documents they require: referral, ID, health card;
• ask how to prepare — for some tests (for example blood glucose, lipid profile) you need to come fasting.

Collection takes a few minutes, and results are released after a few hours or days, depending on the test.

Why the queues and “we’re out of funds” appear

This is the crux of the problem, just like with MRI and CT through CAS. CAS allocates each laboratory a monthly ceiling (budget) for covered tests. When the ceiling runs out in a month, the laboratory can no longer cover tests until the following month — hence the answer “we’re out of funds this month”.

Practical consequences:

• CAS appointments run out quickly, sometimes in the first days of the month;
• it’s worth calling several contracted laboratories; where the ceiling isn’t used up, you’ll get an appointment faster;
• at the start of the month new ceilings are released, so slots open up;
• if you can’t wait, you can have the tests done privately, for a fee — the cost depends on the tests and the laboratory, so ask for the price in advance.

Tests in the prevention package

You don’t necessarily have to be ill to have covered tests. Through the preventive services package from the family doctor, for certain age groups and at set intervals, a set of screening tests can be covered (for example blood glucose and lipid profile), as part of the preventive consultation or the risk-assessment consultation.

• ask your family doctor whether you qualify and when your next preventive assessment is due;
• the set of tests and the intervals are set by the CNAS rules and can change — check at the practice.

Check your insured status first

Reimbursement only works if you are insured and up to date. Before booking:

• check your insured status on the CNAS online platform or ask at CAS;
• if you work under a contract, the contribution is withheld automatically; if not, you may need to pay the contribution at ANAF (the tax authority);
• special categories (children, pupils/students, pregnant women, some pensioners, people without income under certain conditions) are insured without paying the contribution.

Without insured status, even with a referral, the tests are not covered and you pay for them in full.

Quick summary

• Laboratory tests = 0 lei through CAS, with a referral from a doctor, at a contracted laboratory.
• The referral is issued by the family doctor or the specialist; it has a validity period.
• The monthly ceiling per laboratory produces the queues and “we’re out of funds” — call several.
• There are also prevention tests covered, for certain ages and intervals.
• Check your insured status before booking.

Sources

• The framework contract (Contractul-cadru) on the conditions for providing medical assistance and the CNAS methodological rules — the covered paraclinical laboratory investigations, the referral, the prevention package and the per-provider ceilings.
• Law no. 95/2006 on healthcare reform.
• CNAS — cnas.ro and the Cluj Health Insurance House — casan.ro (the lists of covered tests and contracted providers are updated periodically; check before booking).