Reimbursement

Basic Insurance and Reimbursements
Mental health care (GGZ) costs are covered under your basic health insurance (not supplementary insurance).

Every insured person aged 18 and older pays a mandatory deductible (eigen risico) of €385 per calendar year. This amount is settled by your health insurer. Costs above the deductible are reimbursed according to the terms of your basic insurance and any contract between the care provider and your insurer.

No contract with your health insurer
If there is no contract between CITB and your health insurer:

• treatment is partially reimbursed (usually 55–75%);
• the exact reimbursement percentage depends on your policy and policy terms;
• you pay the invoice to Infomedics;
• you submit the invoice to your health insurer yourself;
• your insurer pays the reimbursement to you, not to CITB (except for insurers with whom we have a contract).

The portion of costs not reimbursed by your insurer is at your own expense.

Please note: health insurers often state they reimburse, for example, 75%. This percentage is usually calculated based on the insurer’s own “market rate”, which is lower than the NZa rate. This may mean the actual reimbursement is lower than expected.

Contracts with Health Insurers
CITB has contracts with DSW, Stad Holland and Menzis.

NZa rates
NZa rates are based on the average cost of mental health care. CITB applies these rates as they accurately reflect the costs required to deliver quality care.

Current rates can be found 👉 here .

Waiting times and mediation
At CITB we aim to see you quickly for an intake and treatment. Dutch national standards (Treeknormen) apply within mental health care: intake within 4 weeks and start of treatment within 10–14 weeks.

If you cannot be seen on time at your contracted care provider, you can request waiting list mediation (wachtlijstbemiddeling) from your health insurer. Insurers have a legal duty of care to help you or refer you to a provider where you can be seen sooner. Always keep proof of your request, such as an email or form.

CITB is a largely non-contracted provider, which means you usually pay the invoice yourself first. If you are referred to us through waiting list mediation and your treatment qualifies for reimbursement, your health insurer must reimburse the costs in full.

Practical tip
The Dutch health insurance system and differences between policies can be complex. We advise you to check with your health insurer in advance:

• what percentage is reimbursed for non-contracted mental health care;
• whether this percentage is calculated based on NZa rates or a lower market rate;
• how your deductible is settled.

For independent information you can also visit www.zorgwijzer.nl

Specialist mental health care is partially or fully reimbursed by basic insurance.

Do you have a refund policy? Then the treatment will be 100% reimbursed.