Preventive foot care
Reimbursements
Preventive foot care encompasses the full package of activities within care profiles 1 to 4, as described in the ‘2019 Prevention of Diabetic Foot Ulcers Care Module’. An individual treatment plan determines the actual amount of treatment you will receive.
Preventive foot care includes:
- annual foot check (screening),
- specific foot examinations and any treatment of skin and nail problems, deviations in the foot shape and position and the treatment of risk factors. To qualify, you must have a moderately increased (Simm's Classification 1) or increased risk (Simm's Classification 2 or 3) of inflammation, artery problems and loss of sensation in your feet;
- information and encouragement to modify your lifestyle as part of the treatment;
- advice on suitable footwear.
Non-therapeutic actions, such as the removal of calluses for cosmetic or therapeutic reasons and the cutting of toenails, do not fall under preventive foot care.
Preventive foot care can also be part of integrated care or medical specialist care. When this is the case, you will receive reimbursement on the grounds of the article on integrated care or (general) medical specialised care.
Overview of profiles and reimbursements for chiropody
| Reason for pedicure/podology treatment | Reimbursement |
| Diabetes mellitus type I or II Care Profile 0 | You do not qualify for a reimbursement under the public healthcare insurance. |
| Diabetes mellitus type I or II Care Profile 1 | You qualify for one foot examination once a year under the public healthcare insurance. |
| Diabetes mellitus type I or II Care Profile 2 to 4 | You qualify for a reimbursement under the public healthcare insurance. |
|
Podiatry, podology;
|
You do not qualify for a reimbursement under the public healthcare insurance. Right, if any, to a reimbursement for chiropody under the Plus and Top supplementary insurance contracts. |
Maximum rates non-contracted care provider
We apply a maximum reimbursement for preventive foot care provided by a non-contracted podiatrist. In that case, the reimbursement is limited to the rates in accordance with the rates list for non-contracted care.
When you go to a non-contracted care provider, then you should send a copy of the referral in the presentation of the first note. The note should make clear what care you received.
Reimbursement from the supplementary insurance
From our supplementary insurances Plus and Top you are entitled to reimbursement of pedicure treatments if you have rheumatism (rheumatoid arthritis), where the feet are affected, or if you suffer from a reduced feeling in the feet (peripheral neuropathy ), which is not caused by diabetes.
No statutory personal contribution
There is no statutory personal contribution for preventive foot care.
Excess
The costs of preventative foot care do not count towards compulsory excess.
Who can you go to?
The following care providers are permitted to provide this type of care:
For Sims classification 1 (care profile 1):
- a general practitioner;
- a podiatrist;
- a pedicure provider.
For Sims classifications 2 and 3 (care profiles 2, 3 and 4):
- a general practitioner;
- a podiatrist.
And:
- you can visit the chiropodist for a pedicure treatment under the supplementary insurance. The chiropodist must be listed in the Chiropodists Quality Register, specialising as a diabetic foot chiropodist or medical chiropodist or in foot care for rheumatics. If the care is provided by a contracted provider, he will claim the care as well. In that case, you do not have to pay the care provider yourself.
A chiropodist may perform the annual foot check for Sims classification 1 (care profile 1) independently. A chiropodist may provide care for Sims classification 2 and 3 (care profile 2 and higher) on behalf of the podiatrist. In that case, the podiatrist is the main practitioner and the podotherapist charges the care.
Referral for preventive foot care required
You need a referral from a general practitioner, nursing specialist, physician assistant or medical specialist in order to receive foot care from a chiropodist or a podiatrist. The referral must state the type of diabetes and the care profile.
You need a referral from a general practitioner or medical specialist for foot care in virtue of the supplementary insurance. You must include a copy of the referral when you submit the first invoice.
Please note:
The information on this page is a brief outline of the reimbursements. No rights can be derived from this page. You can only derive rights from our insurance conditions.
Your health insurance
In My HollandZorg you will find all information about your health insurance policy.
Maximum rates for a non-contracted care provider
Have you chosen a healthcare provider with whom we have no contract? Then, we will reimburse according to our maximum rates. If the rate invoiced by the non-contracted care provider is higher than our maximum rates, you will have to pay the difference yourself. You will be able to find contracted care providers with our Care finder.
Reimbursements, conditions and regulations 2023
