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The AVBZ coverage is a national insurance implemented in 1997 to cover the care of persons suffering from a prolonged chronic illness, where they are dependent on others to care for them. It is an insurance based on the solidarity principle that covers the whole population.
If you are suffering from a chronic illness/impairment that makes you incapable of caring for yourself or functioning optimally and/or are a person physically and/or mentally handicapped, or suffer from psychiatric disorders, you might be able to qualify and benefit from the care products AVBZ offers.
You cannot independently apply for AVBZ insurance. Applications are processed through the treating physician via a request form which includes supporting documents indicating that AVBZ care is necessary. The requesting physician will receive a confirmation if the request is approved or denied.
Is the AVBZ insurance an insurance package I can purchase?
No, it is not an insurance which can be purchased. Everyone who is employed pays a monthly contribution towards the AVBZ fund along with your employer and the Government of Sint Maarten.
If I'm suffering from Diabetes for a long time, do I get AVBZ coverage?
Diabetes is not covered under the AVBZ insurance. AVBZ coverage is mainly for long-term care in our assigned care products, institutions and to cover the costs of medical aids. Medication, doctors’ visits, and certain medical aids are covered under your primary insurance (ZV, OZR, FZOG, PP).
Why do I have to pay premiums and not get AVBZ coverage?
Everyone who is employed pays a monthly contribution monthly towards the AVBZ fund along with your employer and the Government of Sint Maarten. This is to ensure that when the care, admission to an institution, medical aids or home adjustments are needed this can be provided to insured without requesting any additional payments of the insured.
I require changes in my home due to my illness, is this covered?
The AVBZ insurance covers changes inside your home to make it possible for you to be mobile within your home. For example; installing of grab bars, removal of the tub and adding a shower chair, raised toilet seats. Widening of your inside doors to be able to access the bathroom. This is all done in agreement with your rehabilitation physician, occupational therapist, AVBZ officers, and an indication from the Indication Committee, approval from SZV and by an appointed SZV contractor.
What can AVBZ assist me or my family member with whom is diagnosed with Alzheimer’s?
AVBZ insurance covers care offered by the White and Yellow Cross Foundation to patients with Alzheimer’s for example: District nursing can assist with the personal care, we also offer a Psycho-geriatric daycare from the White and Yellow Cross Foundation on weekdays. If an insured becomes ill and is a danger to him/herself or others, he/she can, after going through the application process, be admitted to the nursing home where there is 24-hour nursing assistance and supervision."
How can I get my family member admitted to a home?
Admittance to a home must be done in consultation with the patient’s GP. The GP’s request including a report on the diagnosis and status of the patient goes to the White/Yellow Cross. They complete the request by having a social worker visit the patient at home for an evaluation. Once the request is complete (family doctor plus White/Yellow Cross evaluation, reports, and additional forms) it has to be send in to the AZVB department. The department will then conduct a house visit prior to sending the request in for evaluation with the Indication Committee. The final decision will be taken within 2 weeks and will be communicated to the White/Yellow Cross who will then update the patient. The patient can be proposed to be admitted immediately or the use of other products/services that can be of assistance to the family can be proposed. Please bear in mind that there are waiting lists and that it is not always possible to have your family member placed asap.
I had my leg amputated, what happens next?
The specialist or GP in charge will prescribe district nursing for you to take care of the wound, making sure it’s healing correctly and no infection is contracted. You will also immediately start with physical therapy. Once the specialist or GP in charge deems you fit enough, he/she will refer you to the rehab physician for an assessment. Based on the advice of this rehab physician he/she will provide a referral for you to be measured for a prosthetic leg.
Social & Health Insurances SZV © 2021