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Diabetes medical aids

Reimbursement health insurance 2019

  1. What are diabetes medical aids?
  2. When do you qualify for reimbursement?
  3. Prescription required for diabetes medical aids
  4. On loan or owner?
  5. Reimbursement diabetes medical aids in 2019
  6. Maximum rates non-contracted provider
  7. No statutory personal contribution
  8. Excess
  9. Who can you go to?
  10. Apply for consent

Note: the information on this page is a brief outline of the reimbursement. You can only derive rights from our insurance conditions (pdf) and the Medical Aids Regulations (pdf).

1. What are diabetes medical aids?

Diabetes medical aids within the meaning of the public healthcare insurance are lancets, test strips and insulin pens. A lancet and test strip allow you to measure the blood sugar levels in your blood. An insulin pen allows you to administer insulin.

A lancet is a type of needle. You insert the lancet in a device (the equipment used to take blood). You can lance yourself with this device. The blood droplet that appears must be placed on a test strip. This test strip can then be 'read' by the blood glucose test meter. This is a very simply method to determine the blood sugar levels in your blood.

2. When do you qualify for reimbursement?

You qualify for lancets and test strips when you suffer from diabetes mellitus that is treated with insulin. If you also take pills against excessive sugar levels, but your physician is considering treating you with insulin, you may also (temporarily) use test strips and lancets.

When you need insulin for the treatment of diabetes, you are entitled to insulin pens.

3. Prescription required for diabetes medical aids

For lancets and test strips, you need a prescription from a physician or diabetes nurse. The prescription must show the indication and a description of the medical aid required.

4. On loan or owner?

You will be the owner of the lancets and test strips.

5. Reimbursement diabetes medical aids in 2019

By virtue of the public healthcare insurance, you are entitled to diabetes medical aids:

 

Public Healthcare Insurance           Reimbursement 2019
HollandZorg public healthcare insurance 100% in the case of contracted care*

 

Supplementary Insurance                   Reimbursement 2019                  
Start none
Extra none
Plus none
Top none

 

*) The number of diabetes medical aids you receive depend on your diabetes:

 

                                                                Number of medical aids
You have completed your diabetes treatment with pills to lower your blood sugar and now your physician is considering insulin treatment. a maximum of 100 test strips/lancets (once)
You apply one to two insulin injections per day to treat your diabetes a maximum of 100 test strips/lancets every three months**
You apply three or more insulin injections per day or you use an insulin pump to treat your diabetes. a maximum of 400 test strips/lancets every three months**
In all cases a maximum of two insulin pens every three years

 

**) In the case of diabetes that is difficult to control, we may decide to give more test strips and lancets. You can request this consent in writing. When you send in your request, you must enclose the prescription from a physician or diabetes nurse.

For more information, see appendix 2 of the Medical Aids Regulations.

6. Maximum rates non-contracted provider

If the medical aids are available from a contracted care provider in time, but you prefer to go to a non-contracted care provider,  we will apply a maximum reimbursement. The non-contracted provider has to comply with the conditions set out in the Medical Aids Regulations.

A medical aid that we sell to you is reimbursed up to a maximum of 75% of the costs we would incur if you would have received the care from a contracted care provider. In that case, we also reimburse a maximum of 75% of any repair costs in connection with the medical aid.

7. No statutory personal contribution

There is no statutory personal contribution for lancets and test strips.

8. Excess

Are you 18 or older? The costs of lancets and test strips count towards your compulsory and, if applicable voluntary excess.

9. Who can you go to?

You can take the prescription from a physician or diabetes nurse to a contracted provider or dispensing chemists. The provider or chemist will determine, on behalf of HollandZorg, if you qualify for test strips and/or lancets.

Our Care Guide helps you find a contracted provider near you. For more information, please call our Care Advice Line on +31(0)570 687 123. Our expert staff will be pleased to answer your questions.

Do you want to use a provider with whom we have not concluded an agreement?  In that case, you need our prior consent. You can only go to a chemist or S.E.M.H.-recognised provider of medical aids.

10. Apply for consent

Do you want to use a provider with whom we have not concluded an agreement?  Or do you want to apply for a higher number of test strips or lancets? In that case, you need our prior consent. Please send your prescription and offer to:


HollandZorg
Medisch adviseur
Antwoordnummer 30
7400 VB Deventer

No stamp required.

 

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