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op 05-08-2015 17:27 - laatst bewerkt op 10-01-2017 18:26 door Raoul
I have a few questions regarding treatments, this comes from a discussion via MP, posting it here so everyone looking for this info can access it
Assuming that allergy immunotherapy is not covered, what happens if my gp thinks it could help me? Would I get a huge bill for the full cost or what? How does the billing work?
I was checking the different plans on the ZK website, and eg. I dont get what could make the 'Basis Zeker' or 'Basis Exclusief' worth it over the 'Basis Budget' one. reimbursement of the average contracted rate at care providers with whom we don't have a contract seems to be the only difference. Does that apply for emergency? I'm not sure what that means, but considering that 20% could still be a whole lot, why would someone go to a care provider with which you guys dont have a contract? And why does it say in the basis budget description that its for if "When you don't need much health care"? I dont see a real difference tbh
, and anyway while I'm young and generally healthy, that statement doesnt make me feel really safe
The supplementary ones have a certain amount per year for 'alternative therapies', what does that mean? contraception and physiotherapy?
And, what happens if you have a condition before registering to the insurance? And since most treatments, surgeries etc seem to be covered, how could I find a comprehensive list of what is not ?
Thank you very much!
op 06-08-2015 17:45 - laatst bewerkt op 01-12-2015 15:26 door Jeppe
concerning the allergy shots you would get the bill for the shots. It would be very costly when done in a hospital, but nowhere near American prices when done by GP or "alternative practitioner". Since I don't know what shots you are gonna get, I can't tell you what the price would be. I understand your concern, but since there is no way to determine what shots you will get, there is also no way to know what the price would be. Just go to the GP, see what is prescribed, go to the pharmacy with the prescription and see if it is covered. Otherwise they will ask you the full amount for the prescription right then and there.
Basis Zeker and Basis exclusief have a small difference where the exclusief policy focusses on people who are in need of a lot of help and cannot take care of stuff on their own (basically elders). They pay extra for service of our "zorgcoach" that takes work out of their hands that isnt really involved with the health insurance but is involved with a persons health.
the budget policy contracts a smaller amount of hospitals. Currently the zeker and exclusief policy contract all dutch hospitals. Off course, with emergency care you can always go to all hospitals without you paying that extra amount. The thing is you might have to travel further with a basis budget policy for regular hospital care then you would with a zeker policy. So thats why we dont tell people who go to hospitals often to take this policy as it contradicts their freedom to go to the nearest hospital in a lot of cases.
The "alternative health care" is for things like accupuncture, chiropractor and things like that. fysiotherapy and contraception have their individual reimbursements, if you are interested in those you can check the coverage based on your policy of choice.
op 06-08-2015 21:26 - laatst bewerkt op 01-12-2015 15:27 door Jeppe
Oke, thank you very much Michiel for the insight.
It wouldnt feel right to pay the shot costs and also the insurance, but I heard its mandatory
Whats the policy on preexisting conditions?
07-08-2015 10:29 - bewerkt 01-12-2015 15:27
I understand that it can feel that way. It's just that there are things considered not effective enough to be in the health insurance. The government looks at what is effective enough to put into the basic insurance. We don't undermine that as a health insurance company.
Concerning pre existing conditions, there is no issue there. any care concerning pre existing conditions are covered. We work with a solidarity principal. Everybody who lives and works here has to take a health insurance. In addition, health insurance company's can not refuse anyone that applies for a health insurance. there are also no exclusion's to be made to care from the basic insurance. Only the additional insurances can be refused. When applying for our insurance, we only have restrictions for the highest dental policies.
We do not have a list with care that isn't covered. If you want to know if something is covered, you can contact us for information.
I hope this answers all your questions. Let us know if anything is unclear or if you have further questions.