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In-patient care
Reimbursement HollandZorg healthcare insurance 2021
- What is in-patient care?
- When will you qualify for reimbursement?
- Referral required
- Maximum rates non-contracted provider
- Reimbursement in-patient care in 2021
- No statutory personal contribution
- Policy excess
- Who may provide this type of care?
- Request permission
Please note: the information provided on this page is a summary of the reimbursement applicable. You will only be able to derive rights from the HollandZorg Conditions of Insurance (pdf).
1. What is in-patient care?
In-patient care will involve an admission for an uninterrupted period of no more than 1095 days (three years). An interruption of admission for a maximum of 30 days will not count towards the uninterrupted period of 1095 days. Weekend and holiday leave will count towards the calculation of the 1095 days. The care does not include:
- stays you require in connection with a psychiatric disorder or impairment if you are younger than 18;
- stays in connection with the temporary takeover of care to release a family caregiver (respite care);
- first-line in-patient stay.
2. When will you qualify for reimbursement?
You will be eligible for a reimbursement if admission is medically necessary in connection with:
- Medical specialist care
- Plastic surgery
- Rehabilitation care
- Geriatric rehabilitation care
- Transplant care
- Artificial respiration
- Sensory disability care
- Obstetric care
- Specialist mental healthcare
- Genetic advice
- Special dental care
3. Referral required
For in-patient care, you will be required to have a referral from a general practitioner, a medical specialist, a dentist or an obstetrician. A referral will not be required in the event of an urgent situation.
4. Maximum rates non-contracted provider
If you are planning on seeing a care provider with whom we have not concluded an agreement, the rates of the rate list for non-contracted care apply. If the rates of the non-contracted care provider are higher than our maximum rates, the difference will be for your expense.
5. Reimbursement in-patient care in 2021
Under HollandZorg public healthcare insurance, you qualify for in-patient care:
Public Healthcare Insurance | Reimbursement |
---|---|
HollandZorg public healthcare insurance | 100% |
6. No statutory personal contribution
You will not be subject to a statutory personal contribution for in-patient care.
7. Policy excess
Are you 18 or older? The costs incurred for in-patient care will count towards your compulsory policy excess and any voluntary policy excess.
8. Who may provide this type of care?
Depending on the care you need, you will be able to approach the following care providers for in-patient care:
- hospitals;
- rehabilitation centres;
- a psychiatric hospital;
- respiratory centres;
- centres for genetic advice;
- an institution for geriatric rehabilitation care;
- an institution for sensory disability care.
Use our Care Guide to find a care provider near you. If you have any questions or would like more information, contact customer services on +31(0)570 687 123. We will be happy to answer your questions.
9. Permission required
You will require our prior permission where an admission for the following is concerned:
-
Treatmenst on the list ‘Vooraf aan te vragen verrichtingen’;
-
Treatments on the list ‘Limitatieve Lijst Machtigingen Kaakchirurgie’;
- Rehabilitation care by a non-contracted care provider;
- Sensory disability care
- Specialist mental healthcare by a non-contracted care provider
- Specialised medical mental care for the second year of continuous stay and for the third year of continuous stay. You must enclose a (copy of the) national checklist for prolonged medical mental care (LGZZ) with each application.
When applying for care you will need to send us a copy of a report from the attending physician with the medical diagnosis/diagnoses, a description of the current problem and the medical need for in-patient stay. You must enclose (a copy of) the treatment plan with your request Please send requests for permission to:
HollandZorg
Medical Advisor
Antwoordnummer 30
7400 VB Deventer
No stamp is necessary.
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