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Geriatric rehabilitation care

Reimbursement HollandZorg healthcare insurance 2019

  1. What is geriatric rehabilitation care?
  2. When will you qualify for reimbursement?
  3. Referral required
  4. Reimbursement under public healthcare insurance in 2019
  5. Maximum rates for non-contracted care
  6. No statutory personal contribution
  7. Policy excess
  8. Who may provide this type of care?
  9. Request permission

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 geriatric rehabilitation care?

Geriatric rehabilitation consists of integral and multidisciplinary rehabilitation care, provided by specialists in geriatric medicine. The care provided relates to vulnerability, complex multi-morbidity and a decrease in learning and trainability.

 

The object of geriatric rehabilitation care is to reduce functional limitations in order to enable you to return to the home situation.

2. When will you qualify for reimbursement?

You will qualify for reimbursement for geriatric rehabilitation care if:

  • you are admitted (a stay is the case) when care starts.
  • the care is provided within one week of your hospitalisation in connection with specialist medical care and the admission to the hospital was not preceded by a stay at a nursing home; this does not apply if you suffer from an acute condition causing acute mobility disorders or impaired self-reliance and you received specialist medical care for that acute disorder prior to the geriatric rehabilitation care.

The duration of care does not exceed six months. You will require our written permission for the reimbursement of geriatric rehabilitation care for a period of more than six months. Request permission before the period of six months has expired.

3. Referral required

For geriatric rehabilitation care, you need a referral from a general practitioner, medical specialist, doctor for the mentally disabled or specialist geriatrics doctor.

4. Reimbursement under public healthcare insurance in 2019

Under the HollandZorg public healthcare insurance, you qualify for the reimbursement of geriatric rehabilitation care:

 

Public Healthcare Insurance                    Reimbursement 2019                          
HollandZorg public healthcare insurance 100% for contracted care

 

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

 

5. Maximum rates for non-contracted care

If you decide to use a care provider with which we have not made any agreements for geriatric rehabilitation care, we will apply a maximum reimbursement. In this situation, the rates 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.

6. No statutory personal contribution

There is no statutory personal contribution for geriatric rehabilitation care.

7. Policy excess

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

8. Who can you approach?

Hospitals, rehabilitation centres and institutions for geriatric rehabilitation care may provide geriatric rehabilitation care. Use our Care Guide to find care providers of geriatric rehabilitation care near you. The care must be provided under the final responsibility of a specialist geriatrics doctor (ultimately responsible).

If you have any questions or would like more information, contact customers services on +31(0)570 687 123. We will be happy to answer your questions.

9. Request permission

You will require our written permission for the reimbursement of geriatric rehabilitation care for a period of more than six months. Request permission before the period of six months has expired. When applying for this type of care, please include the following information:

  • the reason why your return to your home is not possible yet after rehabilitation for a period of six months;
  • the treatment plan for the further treatment, including the prognosis for recovery, a return to the home situation and the expected duration of the further treatment.

Send a request for permission to:

 

HollandZorg
Medical Advisor
Antwoordnummer 30
7400 VB Deventer

No stamp is necessary.

 

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