In-patient care

Reimbursement HollandZorg healthcare insurance 2020

  1. What is in-patient care?
  2. When will you qualify for reimbursement?
  3. Referral required
  4. Maximum rates non-contracted provider
  5. Reimbursement in-patient care in 2020
  6. No statutory personal contribution
  7. Policy excess
  8. Who may provide this type of care?
  9. 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:

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 2020

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

 

Public Healthcare Insurance Reimbursement      
HollandZorg public healthcare insurance 100%

 

Supplementary Insurance  Reimbursement 
Start none
Extra none
Plus none
Top none
No Risk I none
No Risk II none

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:

  • 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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