In-patient care

Reimbursement HollandZorg healthcare insurance 2019

1. What is in-patient care?
2. When will you qualify for reimbursement?
3. Referral required
4. Reimbursement in-patient care in 2019
5. No statutory personal contribution
6. Policy excess
7. Who may provide this type of care?
8. 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.

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

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.

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. Reimbursement in-patient care in 2019

Under HollandZorg public healthcare insurance, you qualify for in-patient care:

5. No statutory personal contribution

You will not be subject to a statutory personal contribution for in-patient care.

6. 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.

7. 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, if you are receiving medical specialist care, rehabilitation care, geriatric rehabilitation care, transplantation care, artificial respiration, obstetric care, specialist medical mental care or surgical dental
  care of a specialist nature;
• rehabilitation centres, if you are receiving rehabilitation care or geriatric rehabilitation care;
• a psychiatric hospital, if you are receiving specialist medical mental care;
• respiratory centres, if you are receiving artificial respiration;
• centres for genetic advice, if you are receiving 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.

8. Permission required

You will require our prior permission where an admission for the following is concerned:

• Plastic surgery
• Surgical dental care of a specialist nature
• 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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