Changes in BES Healthcare Insurance claims as of January 1st, 2019

Several elements of the BES Healthcare Insurance Claims Regulation (Regeling Aanspraken Zorgverzekering BES) will change as of January 1st, 2019. This will be effected in conjunction with changes in the basic package of the Healthcare Insurance Act (Zorgverzekeringswet) applicable in the Netherlands.

It regards the clarification of a several claims for the implementation of the BES Healthcare Insurance (Zorgverzekering BES) and further requirements for some provisions.

The changes are summarised below. They can also be found in the information leaflet ‘Who is insured with the ZVK? What is covered by the healthcare insurance?’ of the BES Healthcare Insurance Office (Zorgverzekeringskantoor BES, hereinafter ZVK).  

  1. No reimbursement of disability examination
    Medical examinations do not fall under general-practitioner care. A disability examination is deemed a medical examination and therefore is not reimbursed.
  2. Sterilisation
    Men and women are entitled to reimbursement of costs related to sterilisation.
  3. Remedial therapy for COPD
    Insured persons aged 18 and over are entitled to claim supervised remedial therapy for COPD. The practitioner determines who qualifies for this and how many treatments will be reimbursed. Reimbursement of remedial therapy for COPD requires the ZVK's prior consent. 
  4. Dietetic preparations on prescription 
    Insured persons are entitled to reimbursement of pharmaceutical care prescribed by a dietitian.
  5. Reduced personal contribution for orthopaedic shoes
    The personal contributions for orthopaedic and hypoallergenic shoes are reduced in relation to the financial capacity of insured persons. Insured persons aged 16 and older pay a personal contribution of $50.00 per calendar year; for insured persons under the age of 16 the personal contribution is $25.00 per calendar year.
  6. Extension of claim for non-emergency patient transport
    The reimbursement of transport, not by ambulance, for oncological and kidney patients includes transport for consultations, examinations and check-ups.
  7. Repatriation of deceased persons
    The entitlement of surviving relatives to reimbursement of the repatriation costs of a deceased insured person also applies to transportation between the islands of the Caribbean Netherlands.

Validity

The texts mentioned and presented above are intended as general information for the population in Bonaire, Saba and St. Eustatius. No rights can be derived from this information.