Ergotherapy

Reimbursement ergotherapy 2021

  1. What is ergotherapy?
  2. A referral is required for a non-contracted care provider
  3. Reimbursement for ergotherapy in 2021
  4. Maximum reimbursement for a non-contracted care provider
  5. No statutory personal contribution
  6. Policy excess
  7. Who may provide this type of care?

Please note: the information provided on this page is a summary of the reimbursement applicable. You will only be able to derive rights from the HollandZorg Conditions of Insurance (pdf).

1. What is ergotherapy?

Occupational therapy includes care such as the care that occupational therapists generally provide. The object of ergotherapy is to promote or restore self-care and independence. Ergotherapy will be provided by an ergotherapist. The care includes conditional occupational therapy as referred to in the article on Conditional care.

2. Referral required for a non-contracted care provider

You need a referral from a general practitioner, medical specialist, a geriatrics specialist, youth doctor, doctor for the mentally disabled, company doctor, nursing specialist, physician assistant or a coordinating practitioner in the context of medical care for specific patient groups (GZSP). This does not apply to care provided by a contracted care provider who has successfully completed the Direct Access course.

 

If a referral is required, you must enclose a copy of the referral when submitting the invoice.

3. Reimbursement for ergotherapy in 2021

Under HollandZorg public healthcare insurance, you will qualify for the reimbursement of the costs of ergotherapy.

 

Public Healthcare Insurance                                       Reimbursement 
HollandZorg public healthcare insurance a maximum of 10 treatment hours per calendar year

4. Maximum rates for non-contracted care providers

Have you decided to receive ergotherapy from a care provider with whom we have not made any agreements? If so, the rates set out in the Rate List for Non-Contracted Care will apply. If the rates charged by the non-contracted care provider are higher than our maximum rates, the difference will be for your account.

5. No statutory personal contribution

You will not be subject to a statutory personal contribution for ergotherapy.

6. Policy excess

Are you 18 or older? The costs incurred for ergotherapy will count towards your compulsory policy excess and any voluntary policy excess.

7. Who may provide this type of care?

The following care providers are permitted to provide this type of care:

  • occupational therapy in the event of Parkinson's disease: an occupational therapist who is affiliated with the national ParkinsonNet network. Affiliation with the ParkinsonNet is not compulsory if the provision of care started before 1 January 2019;
  • other occupational therapy: an occupational therapist.

Use our Care Guide to find a contracted care provider near you. For more information, contact customer services on +31(0)570 687 123. Our expert employees will be pleased to help you.

 

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