Both organisations have given you an answer, but you still have no support. Here is how to turn referrals into clear, written next steps.
You need care or support. The municipality says it belongs under health insurance. The health insurer tells you to contact the municipality.
This can happen because help at home is divided across several Dutch laws. The name of a service is not always enough to determine who is responsible. Personal care, guidance or equipment may fall under a different scheme depending on why it is needed and who assesses it.
This page helps you understand the main routes and turn separate phone calls into a record that can be checked. It provides general information about the Dutch care system, not individual legal advice.
This is a starting point, not a decision about your individual case. Regelhulp provides an official Dutch overview of the differences between the Wmo, Zvw and Wlz.
The municipality arranges social support that helps people live independently and take part in society. This can include guidance, household support, social transport or a home adaptation. What is considered appropriate depends on the person's circumstances and the municipality's assessment.
Health insurance covers insured medical care. Nursing and personal care at home may fall under district nursing when there is a medical need. A district nurse assesses what district nursing is needed; the health insurer pays for care covered by the policy and the Dutch statutory package.
The Long-term Care Act is intended for people who permanently need supervision or care available around the clock. The CIZ decides whether a person qualifies for Wlz care. After an indication, the regional care office helps organise that care.
If the main issue concerns household tasks, guidance, daytime activities, social transport or adapting the home, the route often starts with the municipality. Ask for an assessment of your support needs and, if you apply, request the final decision in writing.
If you need care at home that is normally provided by a nurse, district nursing under health insurance may be appropriate. The assessment is made by a district nurse, rather than a general customer-service employee at the insurer.
If permanent care nearby or constant supervision is necessary to prevent serious harm, a Wlz application to the CIZ may be relevant. A client support adviser can help you explore the route without deciding the application.
You should not have to settle the legal classification yourself. Describe what help is needed, why it is needed and what happens when it is missing. Then ask each organisation to explain its assessment and referral in writing.
Move from verbal referrals towards specific answers, named contacts and written next steps.
Do not only name the service you want. Note what you cannot manage, what support is needed, how often the problem occurs and what the consequences are if nobody helps. This makes the actual question clearer.
Ask which support question was assessed, what the conclusion was and why the organisation does not consider itself responsible. For a Wmo application, request the municipality's formal decision. Ask the insurer to confirm its response and reasoning in writing.
Do not stop at "not us". Ask for the name of the responsible organisation, the route you should use and the information that should be included. Also ask whether your request or records can be forwarded.
An adviser can help organise your question, attend meetings and compare the different answers. Read how independent client support works and where to request it.
Het Juiste Loket is the Dutch national service for questions at the boundary between the Youth Act, Wmo, Zvw and Wlz. It provides information and independent guidance about the organisations that may be involved.
If you disagree with a decision, use the objection or dispute route that belongs to it. If the problem is a lack of response or how you were treated, use the complaint procedure. For an insurance dispute, you normally complain to the insurer before SKGZ can consider the matter.
For every contact, note the date, organisation, name, question, answer and any stated deadline. Keep letters, emails and reference numbers together. This makes it easier to show where the two answers contradict each other.
A notification, assessment, application and formal decision are different stages. Ask which stage your request has reached and when you will receive the formal decision. That decision should explain how and within what period you can object.
Ask when you will receive a substantive response and which internal complaint procedure applies. If the issue remains unresolved, SKGZ can explain whether mediation or a formal dispute procedure may be available. Always verify current time limits with the relevant organisation.
If you repeatedly have to explain why the other organisation sent you back, this is more than an isolated administrative problem. Zorgfuik collects these experiences so recurring gaps in the Dutch system become visible.
