Applying for a medical ‘indication’ (e.g. asking the municipality for support)

When you or someone within your social circle is ill for a long period of time, or has a disability, you could use a helping hand. In order to receive this kind of support, you must apply for a (medical) ‘indication’ (eligibility for support on official medical grounds) at the municipality. Applying for an indication can be complicated. Therefore it is a good idea to think carefully about the practical matters before you start the conversation with the city council. In this article we provide you with nine practical tips. They come in handy when you’re applying for an indication at the municipality.

How do I apply for an indication in a well-prepared manner?

1. Look through the eyes of a professional

Take a step back and look at your situation from a different point of view. How does an outsider view/ perceive your situation? Stay away from emotions. Try to define what your needs are as clearly as possible. Think of a few key points that you definitely want to discuss.

2. Looking ahead

Don’t just think about the present, think about your future. What are you, or your loved one, capable of doing now that might change over time? Where are you now and where will you be in a few years? What do you think you will need by then?

3. Strengths and weaknesses

During your meeting with the local government people, describe your current situation and explain what the difficulties are. Clearly point out what goes wrong, and why. Perhaps you’ve already come up with a solution for certain problems yourself? You should definitely mention that during the meeting. That way you show the municipality that you contribute to the thinking process and that you, yourself, are actively trying to come up with solutions as well.

Care tasks
Support during every day life
Medical issues, primary doctor and hospital visits
Hobbies and social interaction

4. Set your limits – as a caregiver as well

Try to clearly explain what is currently available within your social network in terms of care, and point out what the consequences will be if the municipality decides not to issue the indication. Be open and honest during the conversation. What can you still cope with yourself? How much can you morally demand from your social network? One has to draw a limit somewhere. Is that limit reached yet?

5. Pen and paper

It is a good idea to grab a pen and a piece of paper when thinking about these themes. That way you draw a clear picture of the situation right away. You should definitely bring those notes to the meeting with the local government, so you can use it as a handy cheat sheet in case you’re asked about those subjects.

6. The more the merrier

Don’t enter the meeting by yourself, make sure somebody else is present. You can bring a relative or your caregiver. They can support you in getting your point across, but they can makes notes as well, to help you remember all the information. Ahead of the meeting you should go over the notes together. Make sure all persons present know what kind of support you need.

7. Ask about the co-payment

Ask about your co-payment beforehand, so there will be no surprises. Help from the local government is nice, but if you have to pay an awful lot for it, it isn’t that nice anymore. Sometimes your co-payment is so high that it is much cheaper to arrange the requested assistance independently.

8. To arrange independently?

When applying for a medical indication, the municipality will most likely offer you ‘care in kind’. Care in kind means that the local government arranges everything for you, but at the same time it stipulates who provides you with care.

However, you always have the right to present your own care plan and to indicate what kind of care is necessary. You do this by applying for a personal budget (pgb). Inform the local government about your intention to make use of this during the meeting.

9. Why a pgb?

It is important to clearly explain why you opt for a pgb. The reason might be because you would like to hire someone you know. Or because you found a facility that you would like to go to for help, but said facility only works with pgb’s.

The local government would also want to know how you will be taking care of the accounting when it comes to your pgb. You will have to sign various contracts and do the bookkeeping. That is how the local government makes sure that you’re able to handle all that.

Important to know

The municipality can assist you in preparing for the indication discussion. You are entitled to the help of an independent client support worker.

You may ask the municipality for a report of the meeting that you had. That way you can verify that the local government has formed the correct picture of your situation.

The municipality may ask for personal information of caregivers. If you feel this is an invasion of privacy, you may refuse.

On the ‘Iederin’ website you can find lots of information about a pgb – together with some useful, sample letters you can send after your request has been denied.

Source: Reuma Amsterdam

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