The Minister of Health, Welfare and Sport (In Dutch: minister van Volksgezondheid, Welzijn en Sport (VWS), changed the health care package for physiotherapy for 2013. These changes may indeed come into effect officially on January 1st , 2013, but the Minister of VWS has decided that a transitional arrangement will be introduced, which will end on June 30th , 2013. Until then, nothing changes regarding the rights of the insured for physiotherapy. As of July 1st , 2013, however, this will be the case.
We have put together a list with the most important changes, which will come into effect as of July 1st , 2013 for the insured:
1. for all insured the treatment of some chronic diseases of the so-called ‘lijst Borst’ has been removed. This is a list containing all physiotherapy and exercise therapy treatments. This list can be found at www.rijksdienstcn.com;
2. an insured adult of eighteen years or older will only receive reimbursement for physiotherapy treatment from the twenty-first treatment, if the disease is according to the on January 1st , 2013 revised ‘lijst Borst’. All treatments which took place per indication according to the old or new ‘lijst Borst’ before July 1st , 2013, will be considered when determining these first twenty treatments;
3. for patients with Chronic Obstructive Pulmonary Disease (COPD) physiotherapy will only be reimbursed at ‘stage II of the Gold Classification for COPD’.
What will still be reimbursed?
· insured children up to seventeen years get nine treatments reimbursed plus possibly nine additional treatments with a treatment plan;
· insured children up to seventeen years will get all treatments reimbursed, provided that their diseases fall within the ‘revised Lijst Borst’ of January 1st , 2013;
· insured adults aged eighteen or older receive reimbursement only from the twenty-first physiotherapy treatment if the disease is according to the new revised ‘Lijst Borst ‘. There is an exception for pelvic physiotherapy associated with urinary incontinence. This care include up to nine treatments for insured persons aged eighteen or older.
Examples of the transitional arrangementOngoing treatments not conform the ‘lijst Borst’ started in 2012
December last year you started a treatment for a broken arm. You already had 4 treatments. This means that until June 30th , 2013 you will receive reimbursement for 5 treatments in order to complete the 9 treatments which you are entitled to. If you need more treatments you will have to pay for them yourself.
Treatment not conform the ‘lijst Borst’ started in 2013
You start a treatment with a physiotherapist for a broken leg in March 2013. You will receive reimbursement for up to 9 treatments, provided that such treatments are carried out before July 1st , 2013. From July 1st , 2013, you can only claim physiotherapy if your illness is on the ‘lijst Borst’.
Ongoing treatment based on ‘lijst Borst’ started in 201If you started a treatment, for example, in December 2012 or earlier in the year 2012, these will be carried out and reimbursed until June 30th , 2013. These treatments are all taken into account for the determination of the first twenty treatments.
Treatment on the basis of ‘lijst Borst’ started in 2013
If you get a disease in February 2013 that is on the ‘lijst Borst, all your treatments will be reimbursed until June 30th , 2013. Suppose on June 30th you had a total of 16 treatments and you’re not quite finished with the treatment. In this case you will have to pay yourself for the 4 remaining treatments in order to be eligible for further reimbursement of the treatments. From the twenty-first treatment you entitled again to reimbursement of the treatments.
Insured persons with questions please contact the Health Insurance Office (Zorgverzekeringskantoor (ZVK) during office hours, telephone number 7158899, you may also visit us.
If you started a treatment, for example, in December 2012 or earlier in the year 2012, these will be carried out and reimbursed until June 30th , 2013. These treatments are all taken into account for the determination of the first twenty treatments.If you get a disease in February 2013 that is on the ‘lijst Borst, all your treatments will be reimbursed until June 30th , 2013. Suppose on June 30th you had a total of 16 treatments and you’re not quite finished with the treatment. In this case you will have to pay yourself for the 4 remaining treatments in order to be eligible for further reimbursement of the treatments. From the twenty-first treatment you entitled again to reimbursement of the treatments.Insured persons with questions please contact the Health Insurance Office (Zorgverzekeringskantoor (ZVK) during office hours, telephone number 7158899, you may also visit us.If you started a treatment, for example, in December 2012 or earlier in the year 2012, these will be carried out and reimbursed until June 30th , 2013. These treatments are all taken into account for the determination of the first twenty treatments.If you get a disease in February 2013 that is on the ‘lijst Borst, all your treatments will be reimbursed until June 30th , 2013. Suppose on June 30th you had a total of 16 treatments and you’re not quite finished with the treatment. In this case you will have to pay yourself for the 4 remaining treatments in order to be eligible for further reimbursement of the treatments. From the twenty-first treatment you entitled again to reimbursement of the treatments.Insured persons with questions please contact the Health Insurance Office (Zorgverzekeringskantoor (ZVK) during office hours, telephone number 7158899, you may also visit us.