Paramedical care focuses on helping you to function better with a certain illness or condition. Chiropractic treatment and electric depilation are not included in paramedical care.
Physiotherapy and Cesar and Mensendieck remedial therapy
Physiotherapy and Cesar and Mensendieck remedial therapy focus on healing, reducing pain or maintaining a physical condition that is as good as possible. For physiotherapy and remedial therapy, a referral from a general practitioner or a specialist is required.
For children up to and including 17 years of age, the first 9 treatments per calendar year are reimbursed. If this does not suffice, the referring physician can submit a subsequent application for yet another 9 treatments in the same year. The total per year is therefore a maximum of 18 treatments.
For insured person 18 years of age or older, physiotherapy is reimbursed for conditions that are on 'chronic list'. The first 20 treatments are not eligible for reimbursement. The list can be found in the BES Healthcare Insurance Claims Regulation (Regeling aanspraken zorgverzekering BES), section 4, article 1.4.2. For a number of conditions, a maximum period has been set. Your practitioner can inform you about this.
For reimbursement of physiotherapy and remedial therapy, your care provider must request prior permission from ZJCN.
Insured Persons are entitled to speech therapy that is meant to restore or improve speech function or the power of speech. This requires a referral by a general practitioner, specialist or dentist. Speech therapy for non-medical purposes (for example, dyslexia, public speaking or singing training) is not reimbursed. For compensation, prior permission from ZJCN is required.
Occupational therapy promotes or restores self-care and self-reliance by teaching people how to improve the execution of daily activities. The occupational therapist gives advice, instructions, training or treatment in his treatment room or at your home. For occupational therapy, a prescription from a general practitioner, specialist or nursing home physician is required. You are entitled to a maximum of 10 treatment hours per year.
Information and advice about diet and eating habits with a medical objective is provided by a dietician. A prescription from a physician or dentist are required for this. You are then entitled to a maximum of 3 treatment hours per year.
Podotherapy and podo-soles are meant to reduce or stop foot complaints. This does require a prescription from a general practitioner or medical specialist.
A medical pedicure involves (specialist) care of the foot and treatment of skin and nail conditions. All insured persons with diabetes are entitled to claim medical pedicures. Your care provider must request prior permission from ZJCN.
Insured persons may participate in a stop-smoking programme prescribed by a general practitioner or specialist. This concerns medical and, if necessary, pharmaceutical assistance that is included in the Stop Smoking Quality Register. A stop-smoking programme can be followed for a maximum of 1 time per calendar year. Prior permission from ZJCN is required for this.
Combined lifestyle intervention
For insured persons 18 years of age and older, care for combined lifestyle intervention (CLI) is reimbursed if prescribed by a general practitioner or specialist. CLI is a two-year programme that focuses on healthy eating (less energy intake), more exercise and psychological support for behavioural change. A CLI programme can be followed for a maximum of 1 time per 24 months. If the programme is not completed, only a part is reimbursed.
For reimbursement of participation in a CLI programme, prior permission from the ZJCN is required.