KRALENDIJK – As of January 1, 2025, the healthcare insurance package in the Caribbean Netherlands will undergo changes, as announced by Zorg en Jeugd Caribisch Nederland (ZJCN). These updates are outlined in the Healthcare Insurance Claims Regulation BES (RazBES) and aim to make healthcare more accessible and better aligned with the needs of the residents of Bonaire, Sint Eustatius, and Saba.

One key update is the reimbursement for COPD physical therapy, which will no longer have a limit on the number of sessions. Coverage will start immediately from the first session. However, prior approval from ZJCN is required for this care. Additionally, individuals with severe rheumatoid arthritis will receive full coverage for physical therapy starting in 2025, provided they obtain prior authorization.

Geriatric rehabilitation care will also be explicitly included in the package. A geriatric specialist will determine if this is the most appropriate form of care for the individual. For medical referrals, insured persons aged 18 and older who are terminally or acutely critically ill will now be entitled to a second companion, subject to ZJCN’s approval. A suitability assessment will be introduced to ensure companions are prepared to assist with daily tasks and provide emotional support during important decision-making processes.

Another significant change is the elimination of the “better ear” criterion for hearing loss reimbursement. Until the end of 2024, reimbursement depends on the hearing ability of the better ear; from 2025 onward, this limitation will no longer apply.

Premium Reduction

ZJCN has also announced a reduction in the employer premium rate from 11.7% to 9.3% to offset the increased minimum wage in 2024. This measure is part of the Regulation Establishing Employee and Employer Premium Rates BES and aims to provide financial relief for employers.