Basic mental healthcare

Reimbursement of mental care costs

Your basic health insurance plan entitles you to reimbursement for mental healthcare.

The care is divided into the following care trajectories (the basic mental healthcare profiles):

• General Basic Mental Health Care Short
• General Basic Mental Health Care Medium
• General Basic Mental Health Care Intensive
• General Basic Mental Health Care Chronic

The care trajectories may consist of different components, such as: intake, diagnosis, treatment by means of individual interviews, group sessions or internet treatment, effects measurements, reporting and consultation.

Basic mental health care does not include:

• the treatment of adjustment disorders following a far-reaching event or change;
• help with work and relationship problems;
• indicated prevention in case of depression, panic disorders and anxiety disorders and problematic alcohol consumption;
• Care in the case of a psychiatric disorder or restriction if the insured is younger than 18.

In basic mental healthcare a psychiatrist cannot be a coordinating practitioner.

Field agreements

Nationally, field agreements for mental healthcare are established by representatives of the government, healthcare providers, health insurers and patients. The care provider must provide the care in accordance with nationally established field agreements. You can view and download the nationally determined field agreements at www.zorgprestatiemodel.nl.

Referral needed?

You need a referral from a general practitioner, medical specialist, coordinating practitioner (in case of a referral), an occupational physician or a doctor affiliated to Nederlandse Straatdokters Groep:

• at the start of the diagnosis and treatment
• after 365 days have expired after the start of care, except in the case of the care trajectory ‘Generalist Basic GGZ Chronic’
• in the event of a new need for care. This is determined by your referrer

The requirement for a referral does not apply:

• in the event of unforeseen care that cannot reasonably be postponed
• in the case of mandatory treatment under the Dutch Mandatory Mental Healthcare Act
• if the care is a direct continuation of:
  
  
  • care provided to you by order of a judicial procedure
  • care provided to you by the same healthcare provider after the indication under the Long-Term Care Act has ended
  • care provided to you under the Dutch Youth Act
  • specialist mental healthcare for the same care need
    
    
• in the case of a referral for the same care need between healthcare providers who are authorised to offer basic mental healthcare or specialist mental healthcare under these policy conditions.

The term of validity of the referral is 9 months (275 days), counting from the date on which you registered with a designated healthcare provider to provide the care.