Medical referral

If a medically required treatment is not available on your island, you are entitled to a medical referral. This is a referral to a care provider in the region designated by ZJCN with whom the ZJCN has a contract. At this time, ZJCN has contracts with care providers on Bonaire, Curaçao, Aruba, St. Maarten, Saint Martin, Guadeloupe and in Colombia. For a medical referral, prior permission from ZJCN is required unless it is an emergency. Your attending physician will request this permission from ZJCN and will receive a decision from ZJCN as well as possible reasons for denial.

Companionship Protocol


Companionship during a medical referral?

Know your responsibilities!


When is a companion permitted?

If the insured person is unable to travel alone. Due to serious illness . Or due to a physical or mental disability.

Not everyone is entitled to a companion.

The referring doctor advises, and ZJCN checks if it’s  in line with the regulations.

Is the insured person under 18? Or is the referral for a pregnancy?

Then a companion is always permitted.

Local medical staff may be assigned. For example, if someone can’t find a companion.  

Or if  a companion is only needed for a short time.

What are the arrangements for minors?

1 parent or guardian is always allowed to accompany a minor during a medical referral.

In exceptional circumstances 2 parents or guardians are permitted.


Who can be a companion?

A companion must be at least 18 years old. They must be able to read and write and be physically and mentally fit.

In other words, the companion must be able to carry out the requested tasks properly.

Women more than 28 weeks pregnant cannot be a companion. Someone who is on a medical referral themselves cannot also be a companion at the same time.


What are the tasks and responsibilities of a companion?

The companion supports the insured person in every way possible  For example: by helping them to shower, dress and travel. By taking care of grocery shopping, meals and laundry.  And by accompanying them to the hospital.

The companion also assists with medical documents, forms and translations. And the companion acts as the contact person. For ZJCN, for intermediaries and for the hospital.


What happens in the event of irresponsible or criminal behaviour?

Such behaviour is not tolerated. ZJCN will start an investigation after a complaint. If irresponsible or unlawful behaviour is proven, payment of allowances will be stopped.

The companion must return immediately. They will no longer be accepted by ZJCN for companionship. Damages and unnecessary expenses will be for their own cost.


How is the allowance arranged?

The insured person and the companion are both entitled to a daily allowance. ZJCN pays the insured person.  The insured person pays the companion. The payment is a contribution. In other words, it does not always cover all costs.

The insured person and companion stay together in 1 hotel room. Those who want a private room have to pay for it themselves.

If any conflicts arise, ZJCN is not responsible.  You must resolve this amongst yourselves.


How is the trip arranged?

The insured person and companion travel together if it’s medically required.  If not, they are not obliged to travel together.

The companion may already be at the referral location, or may travel on a later flight.


How much luggage is permitted?

The amount of luggage is restricted. The maximum weight is 15 kilo’s per person for Curaçao, Bonaire, Sint Maarten and Aruba.

Beyond  Caribbean Netherlands the maximum is 20 kilo’s per person. Excess luggage may be refused, or result in extra costs for the insured person or companion.


How long will the companion stay?

Should a medical referral last longer than 4 weeks? Then the companion may  be replaced. Should the companion leave earlier? Then the cost of replacement will not be reimbursed by ZJCN.

Is your companion actually available for 4 weeks if needed? Discuss this well!


What happens in the event of illness or early departure?

Should a companion fall ill before departure or during a medical referral?

They may then be replaced. TAKE NOTE: a medical statement is required!

Should the companion suddenly have to leave?  For example, due to serious private circumstances. This is possible after consultation with ZJCN.  The costs will then be reimbursed.


What happens if long-term care is required?

The right to a companion may change during the referral period.

Like when an insured person is admitted to an institution for long-term care.

Is the admission  for longer than 3 weeks? Then the companionship ends and the companion returns home.

Those who wish to stay at the referral location have to pay the costs themselves.

After discharge, a companion can again provide support.

They may accompany the insured person from the referral location back to their place of residence.

TAKE NOTE: this is only allowed on medical grounds.

ZJCN will then reimburse the travel expenses.


You may find more information in the Companionship Protocol booklet.


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Travel and accommodations

With medical referrals the ZJCN office on your island arranges the travel and accommodations and the necessary guarantee statements for treatment and examination.


ZJCN reimburses the expenses of medically necessary examinations and treatments. For a medical referral, the following reimbursements also apply:

  • a daily reimbursement for yourself and for your companion, if any;
  • the expenses of your flight and the flight of your companion, if any;
  • airport taxes;
  • transport expenses to the airport of departure, from the airport of arrival to your destination and vice versa;
  • hotel expenses; or
  • accommodation expenses for staying with family or friends.


Upon advice by your physician, it is possible that you will be provided with a companion for the duration of the entire medical referral or a required part of it. After prior permission from ZJCN, there is entitlement to companionship if an insured person:

  • is younger than 18 years of age;
  • has a mental limitation;
  • has reduced mobility and uses a medical device to move;
  • has a visual or auditory limitation;
  • is so seriously ill that travel without a companion is not possible;
  • is being referred for a child-birth.

After prior permission from ZJCN, an insured minor may be accompanied by two companions. This is permitted if the insured minor:

  • is terminally ill;
  • is being treated with chemotherapy;
  • suffers from leukaemia.
  • is in a life-threatening situation according to a statement from the attending physician.