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Home nursing and care

Reimbursement health insurance 2019

  1. What is home nursing and care?
  2. Care plan required
  3. Reimbursement home nursing and care in 2019
  4. Personal contribution
  5. No excess
  6. Maximum rates non-contracted care
  7. Who can you go to?

Note: the information on this page is a brief outline of the reimbursement. You can only derive rights from our insurance conditions (pdf).

1. What is home nursing and care?

Home nursing and care is the care provided by nurses at home. You are entitled to home nursing and care if the care is in connection with your need for medical specialist care (general), plastic surgery, surgical dental care of a specialist nature, rehabilitation care, geriatric rehabilitation, transplantation care, artificial
respiration or specialist medical mental care, general practitioner care, basic medical mental care, obstetric care, sensory disability care or paramedical care, or if you have an increased risk in relation to that care.


The care does not include:

  • nursing and care during your stay at a hospital or other institution;
  • maternity care.

2. Care plan required

You or your legal representative must have signed a care plan. The same applies in the event of adjustments made in the care plan. The care plan must at least state the type, scope, frequency and intended duration of the required home nursing and care, the performances and include a motivation. The care plan must also involve the contribution of your social network.

 

A district nurse and nursing specialist are permitted to define the indication for your care and draw up a care plan.

3. Reimbursement home nursing and care in 2019

By virtue of the public healthcare insurance, you are entitled to home nursing and care.

 

Public Healthcare Insurance Reimbursement 2019                   
HollandZorg public healthcare insurance 100% in the case of contracted care

 

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

4. Personal contribution

There is no statutory personal contribution for home nursing and care.

5. No excess

The costs of home nursing and care do not count towards the compulsory and, if applicable, voluntary excess.

6. Maximum rates non-contracted care

We apply a maximum reimbursement for home nursing and care provided by a non-contracted care provider. 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, the difference will be at your expense.

7. Who can you go to?

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

  • a nursing specialist;
  • a district nurse;
  • institutions that provide nursing or care at home.

Receiving the care is subject to our written consent in the following cases:

  • For reimbursement for nursing without in-patient care provided by a non-contracted care provider. You must enclose a copy of the care plan with your request.
  • For reimbursement for nursing without in-patient care provided abroad. You must enclose a copy of the care plan with your request. You also need to send an offer for the care, setting out what kind of care it concerns, the costs involved and the period it applies to.
  • For reimbursement of palliative terminal home care required for longer than three months. The same applies to care received abroad. You must enclose a copy of the care plan with your request.

If the care plan changes, you need to obtain our written consent again prior to you receiving the care.

 

Contracted care providers are listed at our care fuide. You may also call our Care Advice Line: +31 (0)570 68 74 70.

 

Personal budget

Instead of the right to care, you may qualify for a personal budget. In that case, you will receive funds to purchase the care and nursing yourself. The right to a personal budget is subject to special conditions. They are defined in the Personal District Nursing and Home Care Regulations (pdf).

 

If the costs you incur for nursing and care are higher than the reimbursement in the form of a personal budget, the difference between the costs and the personal budget will be payable by you.

 

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