Medical specialist care
Medical specialist care is care provided by a medical specialist, a psychiatrist, a hospital, an audiological centre, a dialysis centre, a respiration centre or a thrombosis service. For this care, a referral is needed from a general practitioner or a specialist. An obstetrician may also refer you to a gynaecologist. Medical specialist care also includes:
A transplant is the replacement of a poorly or non-functioning organ or tissue. The healthcare insurance reimburses various forms of transplants. These transplants are only performed with generally accepted medical indications.
Plastic surgery modifies the exterior from a functional or aesthetic point of view. This a medical specialist in is only included in the healthcare insurance if it concerns medically required corrections.
Light therapy is a medical treatment that uses visible or invisible light. Medically necessary UVB light therapy is a reimbursed with skin conditions or babies with jaundice.
You can go to an audiological centre for hearing and language examinations. For example, you can receive advice from a multidisciplinary team regarding hearing aids. Upon referral from a ENT specialist, you are entitled to a maximum of 6 weeks of audiological assistance in an audiological centre. For audiological assistance for longer than 6 weeks, your referring care provider must request permission from ZJCN.
Assistance heredity issues
The healthcare insurance reimburses certain tests for genetic issues, heredity issues and any related psychosocial counselling.
Haemodialysis, also known as dialysis, is a treatment for kidney patients, where a machine takes over the function of the kidney. On medical indication, you have a right to haemodialysis, examination, treatment and pharmaceutical assistance, inclusief epo. If dialysis does not take place in a dialysis centre, the healthcare insurance reimburses the expense of accompanying the patient as well as the people who assist with the dialysis.
With home dialysis, the immediate expenses of the dialysis are reimbursed. Any expenses for modifying the residence and restoring it to its original state could be reimbursed as well.
Chronic intermittent respiration
Chronic intermittent respiration entails that a patient depends on artificial support of for breathing. The healthcare insurance reimburses regular stays in a centre for mechanical respiration. The use of artificial respiration equipment at home or at a location set up for this, including assistance, is also reimbursed. For chronic intermittent respiration, the care provider must request prior permission from ZJCN.
Thrombosis is when a blood vessel is closed off by a blood clot, so that the blood can no longer flow properly. Assistance by a thrombosis service with a prescription from a physician is reimbursed. The assistance also includes the use of equipment to measure coagulation time of your blood and advice on the use of medicines.
You are entitled to a second opinion by a qualified healthcare provider in the region in the event of a life-threatening condition, doubts as to a treatment or treatment method and an operation with irreversible results. For a second opinion outside your island of residence, prior permission from ZJCN is required and must be requested by the specialist. Click here to download the Conditions and approval second opinion leaflet.