Nursing and care at home from 2015 in Insurance Act

Miscellaneous gman3968 July 25, 2016 0 15
As of January 1, 2015, the nursing care at home from the Zorgverzekeringwet be reimbursed. In 2014 this still is finances from the Exceptional Medical Expenses Act. The health insurer will cover the cost of personal care and nursing home now reimbursed from the basic insurance. At the closing of the new health insurance for 2015 is for people who receive nursing care at home is important to determine whether the health care provider does have a contract with the provider.


In 2015, some changes are made in the area of ​​concern. One of the changes is that the nursing care at home is transferred from the AWBZ to the ZVW. In 2014, someone entitled to AWBZ care if he has obtained an indication of the Care Assessment Centre. In determining whether someone gets the following are taken into consideration an AWBZ indication:
  • The general state of health
  • The limitations that are encountered
  • The property and / or environment
  • The psychological and social functioning
  • The nature and extent of the offered assistance and care and the opportunities for the continuation and extension thereof

  • Personal care and nursing home

    Under personal care at home is the care that is necessary to be able to carry out the purposes of general daily living. The following operations are personal care:
    • Help with bathing and dressing
    • Pinpointing and administering medications
    • Putting probes and catheters
    • Keep clean and stoma care

    Among nursing home means performing nursing procedures by a physician, nurse or acquiring these actions to the client or his caregiver. The following nursing procedures covered by nursing:
    • Give periodic injections
    • Daily wound care
    • Learning to give periodic injections

     Choose between care in kind and Personal Budget

    The extent of personal care products is determined by the direct care a person needs. This direct care is referred to as classes. The higher the class in which someone is shared, the more that person is entitled to immediate care. Each class includes a certain amount that can pay the care taker for concern. The care taker can choose a specific healthcare provider or opt for a personal budget. If the care taker chooses care in kind, does the financial settlement through the provider, such as a home care setting. If the care taker chooses a PGB, the care taker gets a certain amount to buy self-care in the care of his choice.

    Transitional regulations 2015

    For 2015 is that anyone who gets in 2014 AWBZ care, there is a transitional arrangement. For people whose AWBZ indication continues into 2015 is that they are covered by the Insurance Act 2015. This means that the health insurance now pays the personal care or nursing home.
    If the care taker care in kind fell under the Exceptional Medical Expenses Act, will continue this care in kind in existence under the Insurance Act. It must take into account the fact that care in kind can only be taken from care providers with which the health insurer has a contract. If the healthcare provider no contract with the health insurer has concluded, one can apply for a PGB, switch to another provider who has a contract with the insurer, or switch to another health care provider who has a contract with the provider. If the care taker a PGB fell under the Exceptional Medical Expenses Act, the PGB will continue to exist under the Insurance Act. When the AWBZ indication expires, the health care provider contact the care taker will to agree on the extension of the care in kind or the PGB.