Dialysis transport in Nantes: arranging your journeys, session after session

A dialysis session cannot be moved. Three times a week, sometimes more, you have to be at the centre at the appointed time, stay connected for four hours, then travel home just as the tiredness hits. Over a year that adds up to around a hundred and fifty return journeys. Transport, in other words, is no small detail: it is what keeps the rhythm going, or what wears it down.

This article brings together what we explain every week to dialysis patients in Nantes and Loire-Atlantique, to their families and to the medical secretaries at the centres: what the prescription covers, what Assurance Maladie reimburses, how to set timings that leave no room for delay, and what changes when a driver knows your treatment.

Why dialysis calls for a special kind of planning

Ordinary medical transport is arranged case by case: an appointment, a journey there, a journey back. Dialysis, by contrast, imposes a rhythm. Sessions fall on the same days, at the same times, all year round, and every minute of delay shifts a schedule shared with other patients.

Three constraints come up every single time.

• The arrival time is not negotiable. Dialysis machines are booked by time slot. Arriving late means either cutting the session short or delaying everyone else.
• The timing of the journey home is uncertain. A session usually lasts four hours, but it can run on. The transport has to fit around it, not the other way round.
• The tiredness afterwards is real. A drop in blood pressure, heavy legs, nausea: this is not the moment to be looking for a taxi or walking across a car park.

That is why we treat dialysis as recurring transport rather than a one-off job: the journeys are set up once, then carried over week after week.

The transport prescription for a series of sessions

As with any covered medical transport, the starting point is the medical transport prescription, commonly known as the “bon de transport”. It is issued by your nephrologist or your GP, and it states the mode of transport suited to your condition: approved medical taxi, light medical vehicle (VSL) or ambulance.

For dialysis, this prescription does not cover a single journey: it is written for a series of transports, meaning all the return journeys linked to your treatment over a given period. So you do not have to ask for a new document before every session. The number of journeys and the period covered are stated on the prescription.

Two points deserve attention.

• Prior approval from your health insurance fund is required when the series includes at least four trips of more than 50 km one way over a two-month period. Transport linked to a long-term illness, which is the case with end-stage chronic kidney failure, is exempt from this formality.
• A prescription comes to an end. When it expires, a new one has to be requested. We give advance warning to the patients we carry regularly, but the best approach is still to think of it at a follow-up consultation.

If the bon de transport is not something you are familiar with, we have set it out in detail in a dedicated article: medical transport prescription, how to get your approved medical taxi covered.

What Assurance Maladie covers

Chronic dialysis comes under the long-term illness scheme. When the transport is linked to that illness and the conditions are met, the cost is covered at 100%, rather than at the general rate of 55%. In practice, for the vast majority of the dialysis patients we carry, there is nothing left to pay on the journey itself.

• No upfront payment. We bill your Assurance Maladie fund directly, and your complementary health insurer wherever direct billing (tiers payant) applies. You pay nothing in advance.
• A medical deduction (franchise médicale) of 4 euros per journey remains payable by you, up to a limit of 8 euros per day. It is taken from your reimbursements, not paid to the driver.
• Sharing the vehicle. The regulations allow several patients to be carried at the same time where the journeys make it possible. This has no effect on your coverage, and we only do it on condition that your own timings are respected.

Timings set once, kept all year round

When we take on a dialysis patient, we do not note down an appointment: we record a rhythm. The session days, the arrival time at the centre, the pick-up address, the floor, whether or not there is a lift, the usual arrangements for the journey home.

From then on, it is simple for you.

1. We set off early. The pick-up time is worked out from real traffic conditions across the Nantes area, not from an optimistic estimate. Better to wait five minutes at the centre than to arrive late.
2. We take you door to door. The driver collects you from your home, helps you into the vehicle if needed, and drops you as close as possible to the entrance of the department, not at the far end of the car park.
3. We agree on a time for the journey home. For a long session, we leave and come back for you at the agreed time. If the session runs on, a call from the centre or from you is all it takes to put the time back.

This applies to evening and weekend sessions too: we are on the road 7 days a week, by reservation.

The journey home, the trickiest moment

Patients all say the same thing: the journey there is fine, it is the journey home that is hard. Blood pressure drops, tiredness hits, and the trip feels twice as long as it did on the way out.

Here is what that changes in the way we work:

• the driver collects you from the exit of the department, not from a car park you would have to walk to;
• the driving is gentler, without jolts, with the cabin temperature set the way you want it;
• the help does not stop at the car door: we walk you to your front door, and inside your home if you would like us to;
• personal belongings, your bag, your blanket, can stay in the vehicle from one session to the next if that suits you.

None of this appears on a prescription. Yet these are the things that make the difference over a hundred and fifty journeys a year.

Why a dedicated driver makes a difference

For regular treatments, we build our schedules so that, as far as possible, it is the same driver who takes you. This is not a sales pitch, it is a practical gain.

A driver who knows your case knows where to park at your address, which entrance to the centre is the shortest, whether a prescription needs collecting on the way, whether you prefer silence on the journey home. They also notice what changes: unusual tiredness, new difficulty getting into the vehicle. Where it is useful, they pass those signs on to your family or to the centre’s medical secretary.

Discretion is part of the job. What is said in the vehicle stays in the vehicle.

The dialysis centres we serve around Nantes

We take patients to every dialysis facility in the Nantes metropolitan area and across Loire-Atlantique, including:

• the Centre de dialyse et d’hémodialyse ECHO in Nantes;
• the Centre d’hémodialyse ECHO in Rezé;
• the Unité de dialyse médicalisée ECHO in Saint-Herblain;
• the haemodialysis centre at the Polyclinique de l’Atlantique in Saint-Herblain;
• the Cap Santé dialysis centre in Saint-Nazaire;
• the nephrology departments of the CHU de Nantes.

The full list of the facilities we serve, town by town, with their addresses and phone numbers, is published in our directory: healthcare facilities served, and in particular the healthcare facilities in Nantes page.

If your centre is not on that list, it does not mean we do not serve it: call us and we will check together.

A change of time, an extra session, holidays

A regular treatment does not rule out the unexpected, and the unexpected can be planned for.

• A change of time: let us know as soon as the centre tells you, and we will shift the series without rebuilding the whole arrangement.
• An extra session or a follow-up appointment: that counts as a one-off journey, to be booked like any other, ideally the day before.
• A hospital stay: admission and discharge are prescribed and arranged like the rest, and we pick up the usual rhythm afterwards.
• Going away on holiday: back-up sessions at a host centre are arranged with your nephrologist. Tell us the dates, we will suspend your journeys and start them again when you get back.
• A cancellation: one call is enough. We would far rather take a late call than send a driver to a closed door.

For centres, medical secretaries and families

Teams that arrange transport for several patients need a person to talk to, not a switchboard. We work with medical secretaries and care departments on that principle: a shared schedule, times fixed in advance, and someone who picks up the phone when a session runs on.

How these partnerships work is set out on our healthcare professionals page. For families, the arrangement is the same: a single number, and the option of sending us a photo of the prescription on WhatsApp rather than dropping it off.

Arranging your dialysis transport with Ma Centrale 44

1. Ask your nephrologist for the prescription covering the series of sessions.
2. Call us on +33 6 37 36 48 20 or fill in the booking form, choosing “Dialysis”: session days, arrival time, pick-up address and destination centre.
3. A driver confirms the arrangement with you by phone, and your journeys are then carried over automatically, with no need to call back every week.

For a fuller picture of how approved seated medical transport works, from the prescription to coverage, our reference page sets out every step: medical transport and approved medical taxi in Nantes.