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Basic mental healthcare

Reimbursement basic mental health care 2019

  1. What is basic mental health care?
  2. Referral required for psychological care
  3. Reimbursement from your healthcare insurance in 2019
  4. Maximum rates for non-contracted care providers
  5. Statutory personal contribution
  6. Policy excess
  7. Where can you go?

Note: the information on this page gives an abbreviated outline of the reimbursement provided. You can only derive any rights from our insurance conditions (pdf).

1. What is basic mental health care?

Basic mental healthcare includes diagnosis and treatment of mild to moderate non-complex psychological disorders or stable chronic disorders such as clinical psychologists generally provide. In basic mental healthcare a psychiatrist cannot be a coordinating practitioner.The basic mental health care is divided into the following care products:

  • General Basic Mental Health Care Short
  • General Basic Mental Health Care Medium
  • General Basic Mental Health Care Intensive
  • General Basic Mental Health Care Chronic
  • Incomplete treatment process

The care products may consist of different components, such as: intake, diagnosis, treatment by means of individual interviews, group sessions or internet treatment, effects measurements, reporting and consultation.

 

Basic mental health care does not include:

  • the treatment of adjustment disorders following a far-reaching event or change;
  • help with work and relationship problems;
  • indicated prevention in case of depression, panic disorders and anxiety disorders and problematic alcohol consumption;
  • Care in the case of a psychiatric disorder or restriction if the insured is younger than 18.

More information on which treatments meet the state of the art and practice can be viewed at our website. We can also send you an overview on request.

2. For basic mental health care a referral is required

You will need a referral from a general practitioner, medical specialist, doctor for the mentally disabled,  specialist geriatrics doctor, company doctor or youth healthcare doctor. This condition will not apply where any if the following is the case:

  • unforeseen care that cannot reasonably be postponed;
  • follow-up treatment required further to unforeseen care that could not reasonably be postponed;
  • treatment required further to the provision of care pursuant to judicial proceedings;
  • referral for the same problem from specialist mental healthcare to basic mental healthcare;
  • follow-up treatment for the same problem, by means of generalist basic mental-healthcare (chronic) (Generalistische Basis GGZ Chronisch) with the same healthcare provider;
  • if you have reached the age of 18, continued treatment by the same healthcare provider;
  • if you have reached the age of 18, continued treatment by a practitioner in charge of the care process for adults, after having been transferred by a special education expert or NIP child and adolescent psychologist;
  • treatment for a period of more than one year.

3. Reimbursement healthcare insurance in 2019

Your public healthcare insurance entitles you to reimbursement for basic mental healthcare.

 

Public Healthcare Insurance Reimbursement 2019
HollandZorg public healthcare insurance 100% from contracted health care providers

 

Supplementary Insurance Reimbursement 2019
Start none
Extra none
Plus none
Top none

4. Maximum rates for non-contracted care providers

Do you see a care provider we have not made any arrangements with? In that case, the reimbursement is limited to the rates in accordance with the rates list for non-contracted care. If the rates of the non-contracted care provider are higher than our listed maximum rates, then the difference will be for your account.

5. No statutory personal contribution

There is no statutory personal contribution for basic mental health care.

6. Excess

If you are aged 18 or older, the costs count towards compulsory and, if applicable, voluntary excess.

7. Where can you go?

The following care providers can provide specialist mental health care as the practitioner in charge:

  • healthcare psychologists;
  • clinical psychologists;
  • a clinical neuropsychologist;
  • psychotherapists;
  • a specialist geriatrics doctor who works at an institution for the provision of basic mental healthcare;
  • an addiction specialist who works at an institution for the provision of basic mental healthcare;
  • a clinical geriatrics doctor who works at an institution for the provision of basic mental healthcare;
  • a specialist mental healthcare nurse who works at an institution for the provision of basic mental healthcare.

This is subject to the condition that the care provider has a quality status that is listed in the National Health Care Institute's Quality Standards Register.

 

Transitional arrangement

If you will reach the age of 18 in 2017 and are then receiving care from a remedial educationalist or a care provider registered as a child and adolescent psychologist in the register of the Netherlands Institute of Psychologists (NIP), then these care providers may continue to provide the care as coordinating practitioners for a maximum period of 365 days, commencing on the day that you reach the age of 18.

 

Use our care guide to find a contracted care provider in your neighbourhood. You can also call the Healthcare advice line: +31(0)570 687 123. Our expertly trained staff will be pleased to help you on your way.

 

Healthcare insurance reimbursement overview