Tariffs and insurers

Since 2014 primary psychological care in the Netherlands has fallen under ‘general basic mental health’ (generalistische basis geestelijke gezondheidszorg: GB GGZ). Psychotherapy or second-line treatment is now called ‘specialist mental health’ (specialistische geestelijke gezondheidszorg: S GGZ) or specialized mental health ( gespecialiseerde geestelijke gezondheidszorg: G GGZ ).

General basic mental health (GB GGZ) insured products

Under the GB GGZ four types of treatments, or ‘products’, can be declared under the basic insurance. The layout of the different products and corresponding tariffs, established by the Dutch Healthcare Authority (Nederlandse Zorgautoriteit : NZA ), is as follows:

Basic psychological healthcare products Description Maximum number of minutes NZa Tarrif Average numer of appointments
Basic Short Mild DSM disorders 294 457,43 Euro 2 to 5 appointments
Basic Medium Moderate DSM disorders 495 779,40 Euro 5 to 8 appointments
Basic Intensive Severe DSM disorders 750 1222,15 Euro 8 to 13 appointments
Incomplete treatment trajectory*   120 182,22 Euro 1 to 2 appointments

Own risk in 2016 is € 385,-

The product ‘Uninsured treatment trajectory’ (Onverzekerd behandeltraject) will still be charged if, during the first two calls, it turns out that the client does not belong in the GB GGZ. This may be either because there is no DSM diagnosis or because the symptoms are too complex to be dealt with in the GB GGZ. You should be aware that an incomplete treatment process under this product is also covered by your statutory own risk.

You can obtain further information regarding tariffs and compensation from the therapist that will treat you.

Read more about Registration and treatment >>

Psyche and Pregnancy therapists

Competent practitioners within the GB GGZ are health care psychologists with a **BIG (Beroepen Individuele Gezondheidszorg) ** registration and/or primary health care psychologists registered with the **NIP (Nederlands Instituut voor Psychologen)** We thereby fulfil the requirements of all health insurance companies for reimbursement .

Insured product

In order to qualify for reimbursement under health care insurance you will need a referral letter from your GP and or from your company doctor, which must include the following information:

  • Doctor’s full name and AGB code
  • The date on the referral letter must be earlier than the date of the first appointment
  • The presumed diagnose
  • A brief description of the symptoms

Read more at Registration and treatment >>

Compensation for contracted care : contracted care means that your practitioner has a contract with the health insurance company. Your psychologist will be able to inform you with which health insurance company they have a contract. In the case of contracted care your will be reimbursed in 2016 for one of the four care products in the basic package .

Compensation for non-contracted care: not all therapists have an agreement with one or more health insurance companies. You will receive the invoice for the health product after your treatment with the practitioner. You can then submit the invoice yourself to the health insurance company. Depending on the refund conditions you will be reimbursed between sixty and one hundred percent. Check this with your insurer. Or visit the website www.contractvrijepsycholoog.nl , which has a good overview.

General basic healthcare’ (Generalistische Basis GGZ:GB) ’uninsured product(onverzekerd product: OVP)

Relationship therapy, bereavement issues, work problems and adjustment disorders, among others, are not covered by uninsured care. In some cases the insurer may reimburse these in supplemental packages. You can check this in the overview of compensations provided by your health insurance company.

If you want to receive treatment for such issues then you must pay the costs yourself. The tariff for uninsured care is maximum € 95 per 60 minute session. VAT is not charged for this and no referral from a GP is required. Healthcare psychologists each have different rates for this, which may be adjusted according to your income. You can check this with your practitioner.

Terms of payment

You will receive the terms of payment before or during the first appointment and these apply to all aspects of the treatment and appointments. If you do not attend the first appointment and do not cancel more than 24 hours in advance you will still be charged This will apply also to all future appointments. You will be solely responsible for the payment of these costs .

Statutory own risk

Treatment by a healthcare psychologist falls under your own risk. This was fixed in 2016 at 385 euro. That means that you must pay the first 385 euro yourself, with the exception of care from a general practitioner care or midwife. The own risk portion of your bill is deducted from your compensation by your health insurance company.

Basic insurance(basisverzekering)

For the basic insurance you can choose from two variants: an ‘in-kind policy’ (naturapolis) or a ‘refund policy’ (restitutiepolis).

‘Compensation basic insurance’ (Restitutie basisverzekering):

You will receive full compensation from both contracted and non-contracted healthcare providers so you are free to choose the one you prefer.

‘Combination basic insurance’ (Combi basisverzekering):

A combination policy means that for some forms of healthcare only contracted healthcare providers are fully compensated, while, for other forms, non-contracted healthcare providers are also eligible for full compensation. It can also be the case that healthcare providers actually maintain an in-kind policy. Healthcare providers are not always clear about this, so take care![ The meaning of this paragraph is not clear. ]

‘In kind basic insurance’ (Natura basisverzekering):

With an in kind basic insurance you will receive full compensation only from contracted healthcare providers, who will send the bill directly to your insurance company. If you choose a non contracted healthcare provider then you must pay part of the cost yourself. The amount you must pay yourself varies between healthcare providers but is on average sixty to eighty percent of the total.

It is a good idea to read your policy carefully and to request the information from your insurance company by email. Our experience, unfortunately, is that they do not always provide correct information over the phone.

For more information see: ‘Healthcare insurers compensation 2016’ (Zorgverzekeraars Vergoedingen 2016)

Disclaimer:

This information has been compiled with the utmost care and attention; Psyche and Pregnancy is however liable neither for any errors nor any ambiguities.