Reimbursement of healthcare in country of residence

Reimbursement of medical care abroad

With your Dutch health insurance, you are entitled to medical care abroad. In your country of residence for instance, or during an international business trip or holiday.  The reimbursement for that healthcare depends on the country you are staying in and the type of care received. Please find below more information about the reimbursement of healthcare abroad.

Reimbursement of healthcare in EU/EEA and treaty countries

Are you temporarily staying or residing in an EU/EEA or treaty country other than the Netherlands? In that case you are, at your discretion, entitled to the following in that country or another EU/EEA or treaty country:

  1. A reimbursement of the costs of the care you would have received from us if this care was provided by a non-contracted care provider in the Netherlands, namely:
     
    1. if we apply a maximum rate for that care, subject to a maximum of the rate we have stipulated. The insurance conditions state whether or not we apply a maximum reimbursement for non-contracted care, per type of care.
       
    2. if we do not apply a maximum rate for that care, subject to a maximum of the competitive rate that applies to that care in the Netherlands. The competitive Dutch rate in any case includes the costs of care that corresponding with the maximum rate applicable to that care at that time, stipulated by virtue of the Healthcare (Market Regulation) Act (Wet marktordening gezondheidszorg);
       
  2. Care or reimbursement of the costs of care in accordance with the statutory regulations of the social healthcare insurance of that country.

The reimbursement referred to under 1a) does not apply if the contracted care provider cannot provide the care, cannot provide it in time or only at a great distance from your place of residence or your temporary place of residence abroad. In that case, you are entitled to the reimbursement referred to under 1b) or 2.

Care from a contracted care provider

If you reside or are temporarily staying in an EU, EEA or treaty country other than the Netherlands, you are, at your discretion, entitled to the following with regard to care provided by a contracted care provider in that other EU/EEA or treaty country:

  • a reimbursement of the costs of care provided by a contracted care provider, subject to a maximum of the rate we have agreed with that care provider. Sometimes, the agreement between us and the care provider ends the moment you receive care from that care provider. In that case, you are entitled to reimbursement of the costs of the remaining care to be provided by this care provider, subject to a maximum of the competitive rate that applies for that care in the Netherlands. The competitive Dutch rate in any case includes the costs of care that corresponding with the maximum rate applicable to that care at that time, stipulated by virtue of the Healthcare (Market Regulation) Act (Wet marktordening gezondheidszorg);
     
  • to care or reimbursement of the costs of care in accordance with the statutory regulations of the social healthcare insurance of that country.

Use our Care Finder to find a contracted care provider near you. You can also contact our Customer Services on +31 (0)570 687 123.

Reimbursement of costs in other countries

Are you temporarily staying or residing in a country that is not an EU/EEA or treaty country? In that case, you are entitled to a reimbursement of the costs:

  1. if we apply a maximum rate for that care, subject to a maximum of the rate we have stipulated. The insurance conditions state whether or not we apply a maximum reimbursement for non-contracted care, per type of care.
     
  2. if we do not apply a maximum rate for that care, subject to a maximum of the competitive rate that applies to that care in the Netherlands.

The competitive Dutch rate in any case includes the costs of care that correspond with the maximum rate applicable to that care at that time, stipulated by virtue of the Healthcare (Market Regulation) Act (Wet marktordening gezondheidszorg).
 

The reimbursement referred to under 1) does not apply if the contracted care provider cannot provide the care, cannot provide it in time or only at a great distance from your place of residence or your temporary place of residence abroad. In that case, you are entitled to the reimbursement referred to under 2).
 

We reimburse the costs of care in Euros. We use the exchange rate applicable on the date on which the care was provided, where possible.

Claiming foreign invoices

The submission process for invoices for care abroad is subject to the same conditions as those for claiming invoices for care in the Netherlands. The invoices must be drawn up in Dutch, English, French, German, Spanish or Turkish and contain a description of the care provided. Is the invoice drawn up in a different language? Please enclose a certified translation of the invoice.

 

Do you have any questions? Call our Customer Services on +31 (0)570 687 123 or read the insurance conditions for more information.