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Obstetric care

Reimbursement HollandZorg healthcare insurance 2019

  1. What is obstetric care?
  2. A referral is required for obstetric care
  3. Reimbursement for obstetric care in 2019
  4. Maximum rates non-contracted care
  5. No statutory personal contribution
  6. No policy excess
  7. Who can you approach?

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 obstetric care?

Obstetric care is care that obstetricians generally provide. You and your baby may receive this care before, during and after childbirth. Obstetric care includes:

  • Information and advice about prenatal screening during pregnancy (counselling). The object of prenatal screening is to identify congenital anomalies.
  • Echoscopy (echo) in the 20th week of pregnancy.
  • Neck fold measurement and serum test (combination test) if there is a medical indication.
    Note: if there is no medical indication for the combination test, you may, depending on your package and subject to certain conditions, qualify for reimbursement under the supplementary insurance

  • A NIPT if there is a medical indication. It also concerns a medical indication if a combination test reveals a significant risk of the baby having Down syndrome, Edwards syndrome or Patau syndrome;

  • invasive diagnostics (villus testing or amniocentesis), if there are medical grounds to do so. It also concerns a medical indication if a combination test or NIPT reveals a significant risk of the baby having Down syndrome, Edwards syndrome or Patau syndrome.

2. Referral required

For obstetric care in a hospital, you will require a referral from a general practitioner, a medical specialist or an obstetrician.

3. Reimbursement under public healthcare insurance in 2019

Under HollandZorg public healthcare insurance, you qualify for the reimbursement of the costs of obstetric care. Under our supplementary insurances Plus and Top you are entitled to reimbursement of a part of the statutory personal contribution in case of a childbirth without medical indication in a hospital or in a contracted birth centre.

 

Public Healthcare Insurance Reimbursement 2019                  
HollandZorg public healthcare insurance 100%

 

Supplementary Insurance                   Reimbursement 2019 
Start none
Extra none
Plus statutory personal contribution: 60%
Top statutory personal contribution: 60%

4. Maximum rates non-contracted care

Are you going for obstetric care to a health care provider with whom we have made no agreements? In that case we reimburse the rates of the price list for non-contracted care. Are the rates of the non-contracted care provider higher than our maximum rates, then the difference is for your own account.

5. No statutory personal contribution

Do you have a medical indication for childbirth in a hospital? If so, you will not pay a statutory personal contribution for the use of the delivery room in a hospital.

 

If you give birth in a hospital without a medical indication, the personal contribution will apply. The calculation of the personal contribution will fall under the costs and reimbursement of maternity care.

6. Excess

The costs of obstetric care do not count towards the compulsory and, if applicable, voluntary excess. The
compulsory and, if applicable, voluntary excess do include:

  • the cost of laboratory testing in a hospital or independent laboratory at the request of an obstetric care provider;
  • the cost of the NIPT;
  • indirect costs, such as medicine and transport costs.

7. Who can you approach?

You will be able to use the following care providers for obstetric care:

  • obstetricians;
  • general practitioners;
  • hospitals;
  • a birth centre;
  • a birth care organisation which has been contracted for this purpose by us;
  • an echoscopic centre (only for an echoscopic examinations).

Prenatal screening may only be provided if the care provider referred to above:

  • is a licensee by virtue of the Population Screening Act; or
  • has a cooperation agreement with a regional centre that is a licensee under the Population Screening Act.

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. Or visit our Care Guide to find a contracted birth centre.


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