Reimbursement HollandZorg healthcare insurance 2021
- What is obstetric care?
- A referral is required for obstetric care
- Reimbursement for obstetric care in 2021
- Maximum rates non-contracted care
- No statutory personal contribution
- No policy excess
- 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).
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.
- Non-invasive prenatal test (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 (chorionic 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.
* From 1 October 2021, the combination test will no longer be carried out. Therefore, the reimbursement will end on 1 October 2021. The reason is that the NIPT is much more reliable than the combined test, as a result of which fewer and fewer pregnant women opt for the combined test. Due to the low participation, the quality of the test can no longer be guaranteed, because the laboratory and ultrasound operators cannot perform the test often enough.
For obstetric care in a hospital, you will require a referral from a general practitioner, a medical specialist or an obstetrician.
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|
|HollandZorg public healthcare insurance||100%|
|Plus||statutory personal contribution: 60%|
|Top||statutory personal contribution: 60%|
|No Risk I||none|
|No Risk II||none|
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.
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 or birth centre without a medical indication, the personal contribution will apply. The calculation of the personal contribution is in accordance with maternity care in an institution as described under the costs and reimbursement of maternity care.
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.
You will be able to use the following care providers for obstetric care:
- general practitioners;
- a birth centre;
- a birth care organisation which has been contracted for this purpose by us;
- an echoscopic centre (only for an echoscopic examinations).
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.