The following benefits are subsequently discussed:

• the Health Care Provisions Act (WVG);

• the General Disablement Act (AAW);

• the health care insurance (Health Insurance Fund and privately insured patients);

• the General Social Security Act (ABW).

In the following module the main points of the different regulations are discussed. A separate module discusses the tax-deductible unusual charge

Threshold figure, personal contribution and income limit

In most cases a threshold figure, a personal contribution or an income limit count when applying for an provision. In the following modules this is described for each regulation.

Important!

The legislation and regulations dealt with in this chapter are extensive and complicated. Here, only the main points can be discussed. More information can be obtained from the authorities involved.

It is important to be aware that the information described and the amounts mentioned change regularly. The information has been updated up to the 1st of December 1997.

WVG (Health Care Provisions Act)

Since April 1st the Health Care Provisions Act (WVG) has become effective. It is a law that sees to it that the council supplies housing allowances (up to f 45.000), transport allowances and wheelchairs to people who are chronically ill or handicapped. These allowances are also reserved for people older than 65 years of age. Civil servants and serviceman/ women may also apply for these allowances at their local council. The council may help in kind (for example, lend a wheelchair or give one), or grant a financial contribution (for example, transport allowances).

Housing allowances

If people are restricted in the house because of a handicap or chronic illness they may apply to the council for an allowance under the terms of the WVG (Health Care Provisions Act) to have their home altered. This may concern a small alteration, for example, a handrail in the toilet. But, radical alterations may also be necessary, such as building an extension onto the house or the alteration of a kitchen, toilet or bathroom. Housing allowances should be applied for at the council beforehand. The alteration of the house may start as soon as written permission has been obtained. Alterations that have been performed or added before the application and permission, will not be reimbursed.

Housing adaptation

For every application for a housing adaptation the council will bring in an expert. He/she evaluates what housing adaptation is required and/or whether or not they may be implemented at a reasonable price. In some cases, the expert will recommend the council to advise the applicant to move, for example, to a house that is more suitable for adaptation or a house that has already been adapted. If such a house is not available, or if a removal is not the cheapest solution, the house will be altered.

Housing adaptations over f 45.000

If the costs of the housing adaptation exceed f 45.000 the council refers the application to the Medical Insurance Board. Here, it is considered whether it would be better (cheaper) to let the person involved stay at home, with all sorts of provisions, or to have the person admitted to a nursing home.

Such an expensive adaptation to the house is therefore only granted if there is an indication for the person involved to be admitted to a nursing home and this admission can be prevented or delayed for a longer period of time by an

alteration. The housing adaptation should not exceed f 100.000

Removal

Applicants may apply for moving or refurbishment expenses if they have been advised by the council to move to an already existing adapted house.

Transport allowances

Under the terms of the WVG (Health Care Provisions Act)

people may apply for transport allowances if they are not able to use public transport or a bicycle but rely on transport by car due to a handicap or chronic illness.

When an application is submitted, the council will call in an expert. He/she will evaluate whether the housing adaptation that has been applied for is necessary for the applicant. The aim is to select the least expensive provision for the specific situation.

Transport from and to the work place may be reimbursed by the Industrial Insurance Board under the terms of the General Disablement Act (AAW). In the WVG, it is arranged that if transport to work and home coincides, the Industrial Insurance Board is in principle the supplier.

Collective or individual transport

If the council involved operates a collective transporting system such as: wheelchair-taxi, call-up bus service, etcetera, this option will be considered first. Only when it has been determined that the applicant is not able to use these or when there is no such collective transport system present, an individual arrangement can be made, such as individual transport by taxi or the use of a car on loan. Combinations of collective and individual transport are also possible.

Loan or financial allowance

The council may grant specific individual transport allowances as a loan. This mainly concerns a vehicle that meets the transport need of the person involved on short distance and in the direct living environment. Examples of such vehicles are: a wheelchair moved by hand or electromotion, scooter mobile and other means of transport. Another possibility is the loan of an adapted car or van. Additional transport allowances include financial reimbursement, for example, a mileage allowance for the use of a private or loan-car or a contribution to the costs of a (wheelchair)taxi. Reimbursements are also supplied for the purchase of a tricycle, a sports wheelchair or for the adaptation of an ordinary (motor)cycle or adaptation of a private car.

Personal contribution

The councils have a right to ask for a personal contribution from everyone who has received a provision. When a financial contribution is granted for a provision, the extent of this contribution may be matched to the applicant's income. Councils may ask for a personal contribution from everyone who has received a WVG-provision help in kind. When the council grants a financial contribution for a provision, the extent of the contribution may also be matched with the applicant's income. From the 1st of April 1996, the WVG's personal contribution regulation has been made considerably more flexible. Roughly this regulation entails the following:

• For a wheelchair that is given in kind, the council is not allowed to ask for a personal contribution. If a handicapped person is granted a financial contribution for a wheelchair (for example, for a sports wheelchair) this amount should be sufficient and the council is not allowed to ask the handicapped person for a personal contribution for the costs.

• The personal contribution that is granted in kind is limited to f 100.

• For the private payments (the amount that the handicapped person must pay him/herself for provisions such as housing adaptations for which no financial reimbursements are given) the following norms apply:

- with an income of below one and a half times the norm income (supplementary benefit level), no personal contribution or payment is required;

- with an income of above one and a half time the norm income (supplementary benefit level), a personal contribution may be demanded up to a maximum of a quarter of the percentage of the ability to pay that is used under the terms of the General Disablement Act. In the calculation of the personal contribution, the councils are obliged to take the other costs that have been made because of the handicap into account, as long as these have not been covered elsewhere.

If a personal home needs to be adapted, the client is forced to take out a second mortgage or a loan for the personal contribution. If this is not possible or the extra costs of interest and repayments exceed the ability to pay, the council may consider granting a higher allowance.

In the case of a rented house, the council may charge the proprietor part of the costs. The proprietor may subsequently pass on the costs in the rent. If the rent becomes too high in relationship to the income, rent rebate may be applied for.

Procedure of objection