Where can I apply for a personal budget?

Depending on the type of care you need, you can apply for a personal budget (PGB) from your regional care administration office, your health insurance company or your municipality.

Heavy, long-term care needs: personal budget under the Chronic Care Act (WLZ)

If you have chronic heavy care needs, you are eligible for care under the Chronic Care Act (WLZ). This care may be provided at home, but only if it is practicable and if the costs do not exceed the costs of residential care. When you apply for a personal budget the care administration office will invite you for an interview to see what would be best for you: a personal budget, care services in kind or a combination of the two.

You can use a personal budget to finance care arrangements that you make yourself. You can apply for a personal budget with the care administration office. The main requirements for a personal budget are:

You must draw up a budget plan stating what care you intend to buy and from which care provider(s).

You must sign a contract with each care provider, which must include a description of the care they will provide. The Social Insurance Bank (SVB) will pay the care provider out of your allocated budget.

You may appoint a representative to administer your personal budget. In some cases, you will be obliged to do so.

You may not use your personal budget to pay for medical treatment.

The addresses of care administration offices can be found on the Zorgverzekeraars Nederland website (in Dutch).

Support at home: personal budget under the Social Support Act

If you receive social support at home under the WMO 2015 you may be able to choose between care services in kind or a personal budget. You can apply for this personal budget from your municipality. Payments from the budget will be made by the SVB.

The main requirements are:

  • You must clearly explain why you want a personal budget. The municipality will assess whether it is appropriate for you.
  • The municipality will assess the quality of the services and equipment you buy.
  • Some personal budget holders now use their PGB to pay for support from their social network – the help they receive from relatives, friends and neighbours. Your municipality may have introduced special rules on this.

Youth care services: personal budget under the Youth Act

Since 1 January 2015 municipalities have been responsible for all youth services. If you need care for your child, you may be able to choose between a personal budget or care services in kind. You can apply for a personal budget from your municipality. The SVB will administer the budget, and pay your care provider(s) from your allocated budget.

The main requirements are:

  • You must clearly explain why you want a personal budget for your child and why care services in kind are not appropriate in your child’s situation. The municipality will assess whether a PGB is appropriate for your child.
  • The municipality will assess the quality of the services and equipment that you buy for your child.
  • Some personal budget holders now use their PGB to pay for support from their social network – the help they receive from relatives, friends and neighbours. Your municipality may have introduced special rules on this.

Nursing and personal care at home: personal budget under the Healthcare Insurance Act (ZVW)

Nursing and personal care at home are covered by your basic health insurance, under the Healthcare Insurance Act (ZVW). You can opt for care services in kind or, under certain conditions, you can apply to your health insurer for a personal budget.

The main requirements are:

  • You must draw up a budget plan stating what care you intend to buy using your PGB.
  • You must clearly explain why you want a personal budget. The insurance company will assess whether it is appropriate for you.
  • The insurance company will assess the quality of the services you buy.
  • The rules for a PGB under the Healthcare Insurance Act may differ from one insurer to another. You will find the rules in the terms and conditions of your health insurance policy.

More than one personal budget

You may have more than one personal budget at the same time. For example, if after a care needs assessment you or your child are eligible for coaching/companionship, personal care and nursing. In this case, you will receive a PGB for coaching/companionship from your municipality (under the WMO or Youth Act) and from your health insurer for nursing and personal care. You can only use your PGB from the municipality to pay for care and support for which the municipality is responsible. Similarly, your PGB from your health insurance company may only be used to pay for care for which the health insurer is responsible.

Client support

It may be wise to ask your municipality to put you in touch with a client support worker. The client support worker can help you decide whether a personal budget is the right thing for you. This service is free of charge.