fysiotherapie-oefentherapie (2024)

Treatments of manual therapy E.S. (Egg Shell) / method Van der Bijl and orthomanual medicine are not covered under this coverage. These treatments may be covered under alternative therapies and medicines.

Reimbursements

Remedial therapy is provided by Cesar and Mensendieck remedial therapists. The object of physiotherapy or remedial therapy is to prevent, end or reduce limitations and focuses on pain control and the improvement of mobility, among other things.

When will you qualify for reimbursement?

If you are 18 or older, you are entitled to reimbursement from the public healthcare insurance:

  • reimbursement starting after the 21st treatment, for a disorder stipulated on the Appendix 1 to the Health Insurance Decree (Besluit zorgverzekering), This is the List of disorders for physiotherapy and remedial therapy.
  • pelvic physiotherapy in connection with incontinence, subject to a maximum of nine treatments (once-only);
  • supervised remedial therapy for peripheral arterial disease (PAD) in Fontaine stage 2. In that case you will be entitled to a maximum of 37 treatments during a maximum of 12 months. Also the first 20 treatments are reimbursed, which isn't the case with other cases;
  • patients aged 18 years or older with severe rheumatoid arthritis (chronic joint rheumatism) are entitled to exercise therapy from the first treatment as of Jan. 1, 2025. No maximum number of treatments is set;
  • supervised remedial therapy for arthrosis in your hip or knee joint. In that case you will be entitled to a maximum of the first 12 treatments during a maximum of 12 months;
  • supervised remedial therapy for COPD, if it concerns stage II or higher of the GOLD Classification for spirometry.Your healthcare provider must follow the KNGF Guideline COPD of the Royal Dutch Society for Physical Therapy and the Association of Cesar and Mensendieck Remedial Therapists to determine the number of treatments.
  • conditional physiotherapy and remedial therapy as referred to in the article on Conditional care.

Under our supplementary insurance, you will qualify for reimbursement of a number of treatments by a contracted provider, depending on your supplementary insurance.

Referral required for certain treatments

You need a referral from ageneral practitioner, medical specialist, paediatrician, psychiatrist, company doctor, dentist, geriatrician, nurse specialist, physician's assistant or a so-called 'regiebehandelaar' in the context of medical care for specific patient groups (GZSP):

  • for treatment of a complaint on the List of disorders for physiotherapy and remedial therapy;
  • for treatment by a pelvic physiotherapist in connection with urine incontinence;
  • for supervised remedial therapy for peripheral arterial disease (PAD) in Fontaine stage 2;
  • for supervised remedial therapy in the event of arthrosis in your hip or knee joint;
  • for supervised remedial therapy for COPD, if it concerns stage II or higher of the GOLD Classification for spirometry;
  • for care provided at home or in an institution by a non-contracted care provider.

If you go to a non-contracted care provider, you must include a copy of the referral when you submit the first invoice. You must also include a statement from your care provider when submitting the first invoice. This statement must list any historic physiotherapy or remedial therapy received for that same disorder. This does not apply if:

  • the insured is under the age of 18 or if
  • it concerns the costs of pelvic physiotherapy in connection with incontinence;
  • if it concerns supervised remedial therapy in connection with:
    • peripheral arterial disease (PAD) in Fontaine stage 2 (intermittent claudication);
    • arthrosis in your hip or knee joint;
    • COPD, if it concerns stage II or higher of the GOLD Classification for spirometry.

Reimbursement for physiotherapy and remedial therapy

If you are 18 years or older, you qualify for a reimbursement for physiotherapy and remedial therapy under the public healthcare insurance and our supplementary insurance.

Public Healthcare Insurance Reimbursement
HollandZorg public healthcare insurance
  • all treatments* metioned under 2: when will you qualify for reimbursement.

* Is there a maximum period for treatment of the disorder? If so, you will qualify for the reimbursement of care up to the end of the maximum period.

Supplementary Insurance Reimbursement
Compact 3 treatments* per calendar year
Start
6 treatments* per calendar year
Extra
9 treatments* per calendar year
Plus
15 sessions per calendar year, a maximum of 9 of which for the same disorder relate to manual therapy**
Top
25 sessions per calendar year, a maximum of 9 of which for the same disorder relate to manual therapy**
No Risk I
none
No Risk II
none

Note: Will you be receiving physiotherapy and remedial therapy from a care provider with whom we have not made any agreements? In this situation, the maximum rates for non-contracted care providerswill apply. With your first invoice, you must also include a statement that lists any historic physiotherapy or remedial therapy received for that same disorder.

New in 2025: If you do not use up all the physical therapy or remedial therapy treatments from your supplementary package in 2025, you may take a maximum of 3 with you to 2026. This only applies if you take out health insurance with supplementary insurance with HollandZorg again in 2026. The extra treatments remain valid for 1 year.

*Explanation of reimbursement under the supplementary insurance

A treatment is calculated as follows:

Type of treatment Counts as
Telephonical treatment 0,5 treatment
Screening
0,5 treatment
Intake and research after screening
0,5 treatment
Group treatment 3 up to 10 persons
0,5 treatment
Other
1 treatment

**Reimbursement of manual therapy
The reimbursement for manual therapy does not include manual therapy E.S. (Eggshell / Van der Bijl) and therapy by an orthomanual therapist or orthomanual doctor. In that case, the reimbursement for alternative medicine applies.

Maximum rates for a non-contracted care provider

If you will be receiving physiotherapy and remedial therapy from a care provider which whom we have not made any agreements, the rates in the Rate List for Non-contracted Carewill apply. Do the rates charged by the non-contracted healthcare provider exceed our maximum rates? In this situation, the difference will be payable by you. This will apply for reimbursement under the public healthcare insurance and the supplementary insurance.

No statutory personal contribution

There is no statutory personal contributionfor physiotherapy and remedial therapy.

Policy excess

Are you 18 or older? The costs incurred for physiotherapy and remedial therapy under the public healthcare insurance will count towards your compulsory policy excess.

Who may provide this type of care?

For physiotherapy and remedial therapy, you may use a:

  • physiotherapist for general physiotherapy;
  • pelvic physiotherapist for pelvic physiotherapy;
  • pelvic remedial therapist for pelvic remedial therapy;
  • geriatric physiotherapist for geriatric physiotherapy;
  • geriatric remedial therapist for geriatric remedial therapy;
  • physiotherapist or skin therapist for scar treatment;
  • manual therapist for manual therapy.
  • oedema therapist and skin therapist for oedema therapy and lymph drainage;
  • remedial therapist (Cesar or Mensendieck) for general remedial therapy;
  • psychosomatic remedial therapist for psychosomatic remedial therapy (this only apply to reimbursement under the supplementary insurance);
  • supervised remedial therapy in the event of peripheral arterial vascular disease (intermittent claudication): a physiotherapist or remedial therapist who is affiliated to the Chronisch ZorgNet national network. Affiliation with the Chronisch ZorgNet national network is not compulsory if the provision of care started before 1 January 2018;
  • physiotherapy and remedial therapy in the event of Parkinson's disease: a physiotherapist or remedial therapist who is affiliated with the national ParkinsonNet network. Affiliation with the ParkinsonNet network is not compulsory if the provision of care started before 1 January 2018.
fysiotherapie-oefentherapie (2024)
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