What will you be reimbursed next year?
Edith Schippers, Minister of Health, Welfare and Sport, announced in a letter to the House of Representatives what will change in the basic insurance for 2014. No treatments or medical aids will disappear from the basic health insurance package next year. What will change then?
The basic package reimburses frequently used medical care, medicines and medical aids. Physiotherapy, psychological care, patient transport and dental care are partially reimbursed under the basic insurance.
The basic health insurance package reimburses:
- medical care by general practitioners, medical specialists and obstetricians
- hospital stay
- dyslexia care
- medicines
- medical mental health care (GGZ)
- maternity care
- aids intended for treatment, nursing, rehabilitation, care or a specific disability (i.e. not walkers and other simple walking aids)
- (limited) physiotherapy and remedial therapy from the 21st treatment for certain chronic conditions
- Pelvic physiotherapy for urinary incontinence up to and including the 9th treatment
- speech therapy and occupational therapy
- dental care (check-up and treatment) for children up to the age of 18
- dental surgical care (oral surgeon) and dentures
- fluoride treatment for children under 6 who have ‘permanent’ teeth
- patient transport
- quit smoking programs
- up to three hours of dietary advice
- three ivf treatments
Special treatments
In 2014, Schippers decided special treatments for patients with infected pancreatic necrosis (inflammation of tissue of the pancreas) and to conditionally admit people with a severe variant of Crohn’s disease to the basic package.
primary care psychologist
The reimbursement for consultations with primary psychologists will change in 2014. You will now be reimbursed for a maximum of five consultations from the basic package. As of 2014, this restriction will be abolished, but patients will be classified into four care categories that together form the ‘Generalist Basic Mental Health Care’.
People who have serious psychological problems and who need more than five consultations no longer need to be referred to specialized psychological care. From now on they can be treated within the basic GGZ. As a result of this change in 2014, patients with stable chronic problems can also be treated within basic mental health care.
home dialysis
From 2014, home dialysis equipment will be reimbursed as specialist medical care and no longer as a medical aid. This also includes the necessary accessories and consumables, training/instruction, support and guidance, maintenance and repairs. This means that the hospital becomes formally responsible for the performance to be delivered, but in practice this was already the case. As an insured you will not notice this.
vacuum pump
The vacuum pump that is part of vacuum therapy will be reimbursed from 2014 as part of the therapy and no longer as an aid. This makes the hospital formally responsible for the entire vacuum therapy, including the pump. This also has no financial consequences for insured persons.
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