Basic mental healthcare

Reimbursement basic mental health care 2021

  1. What is basic mental health care?
  2. Referral required for psychological care
  3. Reimbursement from your healthcare insurance in 2021
  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 treatment programmes:

  • 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 treatment programmes 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.

 

Treatment programmes

In principle, you are entitled to one treatment programme per year (365 days). If you have different care needs, your healthcare provider will deal with them in one and the same programme. You are not entitled to two (or more) treatment programmes simultaneously or consecutively within the same year. Your healthcare provider can adjust the treatment programme in the interim, in line with your care needs.

 

After closing a treatment programme, you will only be entitled to a new treatment programme within the same year (365 days) if your treatment programme has ended and you unexpectedly (unexpectedly for both you and your healthcare provider):

  • return with the same symptoms (relapse); or
  • are developing other symptoms .

2. For basic mental health care a referral is required

You need a referral from a general practitioner, medical specialist, coordinating practitioner (in case of a referral), an occupational physician or a doctor affiliated to Nederlandse Straatdokters Groep:

  • at the start of the diagnosis and treatment;
  • after 365 days have expired after the start of care, except in the case of the care product ‘Generalist Basic GGZ Chronic’;
  • in the event of a new need for care. This is determined by your referrer.

 

The requirement for a referral does not apply:

  • in the event of unforeseen care that cannot reasonably be postponed.
  • in the case of mandatory treatment under the Dutch Mandatory Mental Healthcare Act;
  • if the care is a direct continuation of;
    • care provided to you by order of a judicial procedure;
    • care provided to you by the same healthcare provider after the indication under the Long-Term Care Act has ended;
    • care provided to you under the Dutch Youth Act;
    • specialist mental healthcare for the same care need;
  • in the case of a referral for the same care need between healthcare providers who are authorised to offer basic mental healthcare or specialist mental healthcare under these policy conditions.

 

The term of validity of the referral is nine months (275 days), counting from the date on which you registered with a designated healthcare provider to provide the care.

3. Reimbursement healthcare insurance in 2021

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

 

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

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 2021 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