Medical care for specific groups of patients

You are entitled to medical care for specific groups of patients. This care comprises general medical care for specific patient groups under or pursuant to the Healthcare Insurance Act (Zorgverzekeringswet).


The care can include diagnostics, consultations, targeted consultation with your attending physician and implementation of or management of the treatment plan. This concerns care for vulnerable groups living at home, for example vulnerable elderly people, people with chronically progressive degenerative diseases, people with non-congenital brain damage and people with a mental impairment aged eighteen and older. This care focuses on improving independent living, preventing the restrictions from worsening and learning to live with the (continuing) restrictions.

You are not eligible for this type of care if you have a Wlz indication or if you qualify for one.

Reimbursement medical care for specific groups of patients

The costs of medical care for specific groups of patients is fully reimbursed under the public healthcare insurance.This care does not include care that forms part of other types of care, such as first-line in-patient stays and geriatric rehabilitation care.

No statutory personal contribution

There is no statutory personal contribution for medical care for specific groups of patients.


The costs of medical care for specific groups of patients count towards the compulsory excess.

Who should you approach?

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

  • a specialist geriatrics doctor
  • a doctor for the mentally disabled
  • a healthcare psychologist
  • a clinical psychologist
  • a child and adolescent psychologist NIP (Dutch Association of Psychologists)
  • a remedial educationalist

You need a referral from a general practitioner or medical specialist.

Please note

The information on this page is a brief outline of the reimbursements only. No rights can be derived from this page. You can only derive rights from our insurance conditions.

Your health insurance

In MyHollandZorg you will find all information about your health insurance policy. 

Reimbursements, conditions and regulations 2022

Maximum rates for a non-contracted care provider

If, for care included in the public healthcare insurance, you choose a healthcare provider with whom we have not made any agreements, the rates in the Rate list for non-contracted care will apply. Do the rates charged by the non-contracted healthcare provider exceed our maximum rates? In that case, the difference will be payable by you. This will apply for reimbursement both under the public healthcare insurance, and the supplementary insurance.

Where to go for healthcare

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 happy to help you.