Cover for Primary and Secondary Mental Healthcare

Treatment of mental health issues by the GP and Mental Health Nurse Practitioner is generally covered by the Basic Health Insurance.

Basic Health Insurance also covers most of the costs of Primary and Secondary Mental Healthcare. Coverage depends on the diagnosis. In the Netherlands this is based on the DSM-V  (Diagnostic and Statistical Manual of Mental Disorders).

DSM defined disorders

Only Psychological Disorders that are identified as such in the DSM-V, and that can be treated by the Primary or Secondary Mental Healthcare are covered.  Complaints or problems that are not defined as a Disorder in the DSM-V are treated –and usually covered by the Basic Insurance- by the GP and the Mental Health Nurse Practitioner.

Not all disorders defined by DSM-5 are covered, notably the treatment of Adaptation Disorders, though treatment of any resulting depression or anxiety will be covered.

Cost of treatment

Cost of treatment by Basic (Primary) Mental Healthcare is based on so-called Patient Profiles, and four Care Packages: Short, Intermediate, Intensive and Chronic. These packages have different rates that depend on the number of consultations and contract with the health insurer.

Cost of treatment by Specialized Mental Healthcare is defined by so-called DBC’s. DBC stands for ‘Diagnose Behandel Combinatie’ (‘Diagnosis Treatment Combination‘). The rates for DBC’s are negotiated between health care providers and insurance companies. You need to check with your health insurance provider which rates apply to your case.

If you are admitted to a Mental Health Institution, your insurance will cover the first three years of your hospitalization in any case.

Costs of treatment by Primary and Secondary Mental Healthcare providers counts towards your excess (eigenrisico).

Treatment of some Mental Problems not covered by Basic Health Insurance may be covered by Supplementary Health Insurance.

Support of children under 18 years is not covered by Basic Health Insurance but by provisions of the Youth Act.