You still have a few days left to switch health insurer before the end of the change over period on January 1. Here’s a break down of some of the most important terminology to help you make your choice. And to make it even easier, find out how much you can save by using website ZorgWijzer.nl which offers a useful English comparison tool.
If you live or work in the Netherlands you are required by law to take out standard (basic) health insurance. This ‘basisverzekering’ covers the most essential medical expenses such as visits to and treatment by a general practitioner (GP), most medicine, hospital treatment, paramedical care and midwifery services. Children under 18 are covered for the basic policy and dentistry free of charge
2 Aanvullende verzekering
The ‘aanvullende verzekering’ is a supplementary insurance that you can opt for if you need extra coverage. You may want a supplementary policy because the standard health insurance package does not cover all medical expenses. Supplementary policies cover other types of healthcare, such as physiotherapy, dental care and alternative medicine and vary greatly in cover and cost.
Some supplementary insurances also cover additional emergency medical expenses when you are abroad (buitenlanddekking). This extra insurance will cover most or all the additional costs you may run up if you need treatment while in another country.
This could be useful if you travel because the basic Dutch health insurance only covers emergency medical care abroad up to the equivalent price in the Netherlands. This means that if you have emergency treatment in a country where healthcare is expensive, you may be liable for some of the bill yourself.
4 Eigen risico
‘Eigen risico’ is a mandatory deductible that everyone, except children, has to pay for healthcare before the insurance kicks in. The deductible is €385 in 2016.
Say you have a hospital bill of €500 and this is the first claim you have made on your insurance in the year. You have to pay the first €385 of the bill and your insurer picks up the rest. Next time you go to hospital, your insurance company will pay the full whack. The eigen risico does not apply to visits to a GP, midwifery or healthcare covered by supplementary insurance.
5 Eigen bijdrage
Your health insurance may not cover you for 100% of all treatment and medical expenses. The amount you have to pay yourself is known as the ‘eigen bijdrage’ and applies to some medicines, orthopedic shoes, dentures and maternity care, for example.
A ‘naturapolis’ is the most common health insurance policy and has average premiums. Policy holders may undergo treatment in hospitals and clinics with which the insurance company has a contract. If you decide to have treatment in a different hospital, your insurer may only pay between 70% and 80% of the bill.
The ‘restitutiepolis’ offers the widest choice of hospitals and clinics and covers 100% of the bill for healthcare providers that do not have an agreement with the insurance company. A ‘restitutiepolis’ is more expensive than a ‘naturapolis’ because it offers a wider choice of hospitals and clinics, and will pay for non-contract care. Be aware, you may have to pay the bill for non-contracted care first and reclaim it from your insurance company.
The ‘budgetpolis’ generally offers the lowest price and has several limitations. You will have a much more limited choice of hospitals and clinics, and if you opt to use a different care provider, you may have to foot between 25% and 50% of the bill yourself.
A ‘collectiviteitskorting’ is a group discount that the insurance company offers when an insurance agreement is made with a group of people or a company. It might be worth checking if any clubs you are a member of would entitle you to a discount.
‘Overstappen’ is what you do when you switch from one health insurance company to another during the December window. When you change your health insurance, your old policy is automatically terminated by the new insurance company.
If you are thinking about switching your health insurance, you may want to check ZorgWijzer.nl. This site offers several English guides and an English tool that will help you find a new, suitable and affordable health insurance for 2016.
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