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Costs Therapy

As per January 2014, the mental healthcare that is covered by your insurance has been divided over 3 levels: entry level general practitioner’s care, general mental healthcare and specialized mental healthcare. Access to the insured mental healthcare requires a mandatory prescription of your general practitioner and will be limited to people of 18 years and older as of 2015. The Dutch Healthcare Authority (NZa) has decided that as of 2016 no prescription from a general practitioner is required in case the client decides upfront to pay him-/herself for the therapy. After having made such decision, costs cannot yet be claimed at your insurer.

The (health)care of children and youngsters under 18 is covered by a new law called ‘Jeugdwet’. This law stipulates that it is the municipality where the youngster has its registered residence will have to contract providers of care and will have to pay for this care. The general practitioner or pediatrician of the youngster are today the exclusive entrances to this care, but your municipality may appoint other prescribers as well.

In case the practitioner presumes that your or your child’s troubles are not caused by a more serious, profound cause, he/she will treat these troubles him-/herself, possibly helped by a dedicated assistant, or send you to e.g. the social work.

However, in case your practitioner is convinced of a serious, more profound cause, he/she will refer you in writing to a professional of ‘general mental healthcare’ (GBGGZ) or of ‘specialized mental healthcare’ (SGGZ) depending on the seriousness. The ‘specialized mental healthcare’ is defined by complex, risk bearing problems. Your practitioner will use a standardized classification system for a first diagnosis.

SYNTAGMA provides ‘general mental healthcare’ and has contracted nearly all Dutch insurance companies. Given that the situation around youth aid hasn’t crystallized sufficiently, SYNTAGMA has decided not signing contracts with municipalities. The costs of this specific category of therapy are therefore to be borne by the parents. Municipalities exist which are open to parents’ requests for reimbursement afterwards.

The Dutch government has defined 3 distinct ‘treatment products’ relative to the expected ‘care burden’, i.e. ‘Short’, ‘Medium’ and ‘Intensive’; the ‘care burden’ of each ‘treatment product’ may be expressed in e.g. the expected required treatment duration.

Your psychologist will confirm the initial diagnosis of your practitioner, or will diagnose once more, selects the most appropriate ‘product’ and claims payment at your insurer or municipality. In case it appears, in the course of the treatment, that a lighter ‘product’ is possible or a heavier required, the treatment will be adapted with your agreement. In case the first 1 or 2 sessions prove that the cause of your complaints doesn’t meet the criteria of the ‘general mental health care’, your will be referred back to you general practitioner and SYNTAGMA claims according to the regulation an ‘incomplete treatment’ at your insurer.

Specific aspects of mental healthcare are excluded from your insurance policy and are at your own cost. SYNTAGMA will specify this upfront to you and come to an agreement on content and duration of the treatment. This also applies in case your municipality hasn’t contracted SYNTAGMA four youth care. The price of €97,50 that is charged per single session is restricted by the maximum tariff allowed by the Dutch Healthcare Authority (NZa).

Appointments that are not lived up to or have not been cancelled (at least two full working days in advance) will be invoiced to you.