Medical referral

If a medically necessary treatment is not available on your island, you are entitled to a medical referral to a healthcare institution that does offer this treatment. The following always applies: as close as possible, further if necessary. ZJCN currently has agreements with healthcare providers in Curaçao, Aruba, St. Maarten, Colombia and the Netherlands.

ZJCN refers to these healthcare providers abroad

Horacio Oduber Hospital

Oranjestad, Aruba

Curaçao Medical Center

Willemstad, Curaçao

Sint Maarten Medical Center

Philipsburg, Sint Maarten

Fundación Valle del Lili Hospital

Cali, Colombia

Hospital Pablo Tobón Uribe

Medellín, Colombia

Cardiovas

Medellín, Colombia

Inser

Medellín, Colombia

Imbanaco Medical Center

Cali, Colombia

Clínica Portoazul Auna

Barranquilla, Colombia

Fundación Santa Fe de Bogotá

Bogotá, Colombia

Amsterdam UMC

Amsterdam, Nederland

Travel and accommodation

ZJCN arranges your travel and accommodation if you are sent abroad for treatment. You are notified as soon as possible once the schedule for your treatment has been finalised.

Reimbursements

ZJCN reimburses the expenses of medically necessary examinations and treatments. In addition, you are entitled to the following reimbursements in the event of a medical referral:

· a daily reimbursement for yourself and any companion*;
* This reimbursement is not applicable to days you are hospitalised.

· the cost of your flight and, if applicable, the flight of your companion;

· airport taxes;

· the costs of transport to the airport of departure, from the airport of arrival to your destination and vice versa;

· hotel charges; or

· accommodation costs for staying with family or friends.

Companionship during medical referral

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Companionship Protocol

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Companionship during a medical referral?

Know your responsibilities!

When is a companion permitted?

If the insured person is unable to travel alone. Due to serious illness . Or due to a physical or mental disability.

Not everyone is entitled to a companion.

The referring doctor advises, and ZJCN checks if it’s in line with the regulations.

Is the insured person under 18? Or is the referral for a pregnancy?

Then a companion is always permitted.

Local medical staff may be assigned. For example, if someone can’t find a companion.

Or if a companion is only needed for a short time.

What are the arrangements for minors?

1 parent or guardian is always allowed to accompany a minor during a medical referral.

In exceptional circumstances 2 parents or guardians are permitted.

Who can be a companion?

A companion must be at least 18 years old. They must be able to read and write and be physically and mentally fit.

In other words, the companion must be able to carry out the requested tasks properly.

Women more than 28 weeks pregnant cannot be a companion. Someone who is on a medical referral themselves cannot also be a companion at the same time.

What are the tasks and responsibilities of a companion?

The companion supports the insured person in every way possible For example: by helping them to shower, dress and travel. By taking care of grocery shopping, meals and laundry. And by accompanying them to the hospital.

The companion also assists with medical documents, forms and translations. And the companion acts as the contact person. For ZJCN, for intermediaries and for the hospital.

What happens in the event of irresponsible or criminal behaviour?

Such behaviour is not tolerated. ZJCN will start an investigation after a complaint. If irresponsible or unlawful behaviour is proven, payment of allowances will be stopped.

The companion must return immediately. They will no longer be accepted by ZJCN for companionship. Damages and unnecessary expenses will be for their own cost.

How is the allowance arranged?

The insured person and the companion are both entitled to a daily allowance. ZJCN pays the insured person. The insured person pays the companion. The payment is a contribution. In other words, it does not always cover all costs.

The insured person and companion stay together in 1 hotel room. Those who want a private room have to pay for it themselves.

If any conflicts arise, ZJCN is not responsible. You must resolve this amongst yourselves.

How is the trip arranged?

The insured person and companion travel together if it’s medically required. If not, they are not obliged to travel together.

The companion may already be at the referral location, or may travel on a later flight.

How much luggage is permitted?

The amount of luggage is restricted. The maximum weight is 15 kilo’s per person for Curaçao, Bonaire, Sint Maarten and Aruba.

Beyond Caribbean Netherlands the maximum is 20 kilo’s per person. Excess luggage may be refused, or result in extra costs for the insured person or companion.

How long will the companion stay?

Should a medical referral last longer than 4 weeks? Then the companion may be replaced. Should the companion leave earlier? Then the cost of replacement will not be reimbursed by ZJCN.

Is your companion actually available for 4 weeks if needed? Discuss this well!

What happens in the event of illness or early departure?

Should a companion fall ill before departure or during a medical referral?

They may then be replaced. TAKE NOTE: a medical statement is required!

Should the companion suddenly have to leave? For example, due to serious private circumstances. This is possible after consultation with ZJCN. The costs will then be reimbursed.

What happens if long-term care is required?

The right to a companion may change during the referral period.

Like when an insured person is admitted to an institution for long-term care.

Is the admission for longer than 3 weeks? Then the companionship ends and the companion returns home.

Those who wish to stay at the referral location have to pay the costs themselves.

After discharge, a companion can again provide support.

They may accompany the insured person from the referral location back to their place of residence.

TAKE NOTE: this is only allowed on medical grounds.

ZJCN will then reimburse the travel expenses.

You may find more information in the Companionship Protocol booklet.

Accompaniment

If you are going on a medical referral, you are assigned a case manager from ZJCN who is your permanent point of contact for assistance and any questions you may have. In addition, you can be joined by a companion throughout the entire medical referral or a necessary part thereof. This companion must be able to support you physically and mentally during the referral.

You can obtain authorisation for accompaniment if the insured person:

· is under the age of 18;

· has an intellectual impairment;

· has limited mobility and uses a medical aid to move around;

· has a visual or hearing impairment;

· is so seriously ill that travelling without a companion is not possible;

· is referred for a delivery.

A minor insured person can be granted consent for two companions. This is permitted if the insured person:

· is terminally ill;

· is treated with chemotherapy;

· suffers from leukaemia;

· according to a statement from the attending physician, is in a life-threatening situation.

An adult insured person can be granted consent for a second companion if the insured person:

· is terminally ill and death is expected within a week;

· according to a statement from the attending physician, is in a life-threatening situation.