I’ve been admitted to a mental health institution. Who will cover the costs?
If you are admitted to a mental health institution, your health insurance will in any case cover the first three years of your hospitalisation. This is laid down in the Healthcare Insurance Act.
Long-term residence in a mental health institution
Should your stay in a mental health institution exceed three years, the costs of your stay, including care and treatment, will be covered under the Chronic Care Act (WLZ), provided you have a WLZ care needs assessment. You can apply to the Care Needs Assessment Centre (Centrum indicatiestelling zorg, CIZ) for this assessment.
Chronic Care Act – transitional arrangement
If, on 31 December 2014, you had been residing at a mental health institution for more than one year on the basis of an AWBZ care needs assessment (GGZ-B package), your AWBZ care needs assessment will automatically be converted into a WLZ care needs assessment. This means you will continue to receive the same care and entitlements as before 1 January 2015.
If, on 31 December 2014, you had been hospitalised in a mental health institution for less than one year, your health insurer will pay for your stay, including care and treatment, for up to three years. After that, you will have to apply for a WLZ care needs assessment.
Chronic Care Act and co-payment
If you are staying in a mental health institution on the grounds of a WLZ care needs assessment, you will be charged a co-payment. The amount of the co-payment depends on your age, income and family situation. The Central Administrative Office (CAK) will bill you for the co-payment.
A co-payment will not be charged if your health insurer is covering the costs of your care and treatment. However, a compulsory excess (€375 in 2015) applies to all secondary care.
Chronic Care Act and patient fundholding
The Chronic Care Act does not provide for personal budgets for new patients. If you already had a personal budget on 31 December 2014, you will keep your entitlement.
Short stay (board and lodging) in a mental health institution
According to the Social Support Act 2015, your local authority is responsible for facilitating short stays, consisting only of board and lodging, in a mental health institution. These types of short stay may not exceed three days a week. Contact your local authority to find out how you can apply for a short stay in a mental health institution.
If you had a current AWBZ care needs assessment for short stays on 1 January 2015, you will be entitled to continue to receive the arrangement described in the assessment in 2015. This transitional arrangement is laid down in the Social Support Act 2015 and will apply until 1 January 2016 at the latest.
Some people with mental disorders or psychosocial problems live in supported accommodation (the GGZ-C package) to help them manage on a day-to-day basis. As of 1 January 2015, this form of care and support falls under the Social Support Act 2015. This means local authorities are responsible for arranging and funding it.
The medical treatment of people in supported accommodation is covered by health insurance. For more information, go to ‘ I live in supported accommodation. Who covers the costs of my care and treatment?’