Special regulations
The offer and quality of care in the BES is still developing. It is not always possible to offer the desired care immediately. This is why a number of special regulations have been laid down in the BES Healthcare Insurance Claims Regulation, such as:
Entitlement to care or transport
Your entitlement to care or transportation depends on your need and appropriate provision of care. You are only entitled to care and transportation that could reasonably be provided.
Article 10, paragraph 4 – non-contracted care providers
You can ask for permission if you wish to consult a care provider who does not have a contract with the ZJCN. In that case, you may appeal to Article 10, paragraph 4 of the BES Healthcare Insurance Decree.
If the needed care is provided by a contracted care provider, you will be referred to this care provider by default. However, if you explicitly wish to consult a non-contracted care provider, you can appeal to Article 10, paragraph 4, of the Decree. You need prior permission from ZJCN if you wish to do so. The date on which the permission is granted must be before the treatment date. Your treatment is not a medical referral.
You must pay the medical expenses in advance and submit an expense claim afterwards through the appropriate form. The reimbursement for medical care is capped at the price level of equal treatment in the region or, if the treatment is not possible in the region, in the Netherlands. Any costs for your travel and accommodation is for your own account. You can download the Article 10, paragraph 4 conditions and agreement here.