Changes basic insurance
Remedial therapy for hip or knee osteoarthritis
From 1 January 2018 on, patients with osteoarthritis involving their hip or knee joints will have their first 12 remedial therapy treatments reimbursed. Reimbursement is subject to the basic healthcare insurance excess, so treatment may have to be paid initially. Until now such treatment was covered by supplemental insurance.
(Jeugdwet) will now fall under Healthcare Insurance Act (Zorgverzekeringswet)
If your child requires care related to medical care (such as assistance washing and taking medication), beginning in 2018 there will be entitlement to compensation under basic healthcare insurance. In 2017 this reimbursement fell under the Youth Act (Jeugdwet). The care minors receive involving general activities of daily living (such as assistance eating and dressing) will remain under the Youth Act.
Medication in case of stomach cancer
Some medication is temporarily allowed in 2018.
Extension of seated non-emergency patient transport for oncological treatments
Oncology patients who are receiving immune therapy will receive reimbursement for seated non-emergency patient transport to and from treatments. This reimbursement was not available previously.
Non-contracted care Zorg Zeker Polis
In 2018 there is 80% reimbursement for non-contracted care in the Zorg Zeker Polis instead of 75% (except district nursing: this remains 75%).
Non-contracted care involving community nursing and primary in-patient care (ELV: eerstelijnsverblijf)
In 2018, if you choose a care provider with whom we do not have a contract, you will receive reimbursement of 75% of the prevailing market rate with the Zorg Gemak Policy and Zorg Zeker Policy. This reimbursement was 75% of the Health Care (Market Regulation) Act rate (WMG: Wet marktordening gezondheidszorg). Due to this adjustment, the reimbursement for non-contracted care in 2018 is lower than it was in 2017. Stricter conditions for reimbursement will apply. This entails that a qualified nurse must establish the indication and also provide the care.
Required advance authorisation for long-term mental health care (GGZ)
Beginning in 2018, prior permission (advance authorisation) from Zorg en Zekerheid is required for admission to a mental healthcare institution for a second or third year. Your care provider will arrange this authorisation for you.
Zorg en Zekerheid encourages pharmacists to dispense medication which is not unnecessarily expensive. Beginning in 2018, you are entitled to the medication with the lowest price, or no more than 3% higher than this, within a group of medication which is identical with regard to active ingredient, strength and with a comparable form of administration. In some cases this may mean that you will receive other medication from your pharmacist than exactly prescribed. Of course this medication will have the exact same active ingredient as the one prescribed by your doctor.