Reimbursement HollandZorg healthcare insurance 2021
- What is transplant care?
- When will you qualify for reimbursement?
- Referral required
- Reimbursement transplant care in 2021
- Maximum rates non-contracted provider
- No statutory personal contribution
- Policy excess
- Who may provide this type of care?
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).
A transplant is the (partial) replacement of a patient's organ that is functioning poorly or not at all. Transplant care consists of all of the care necessary in relation to a transplant. Care will be provided to the giver (donor) and receiver of the transplant material.
Under the public healthcare insurance, you are entitled for reimbursement for transplant care if the care consists of:
- Transplants of tissue and organs, if the transplant is carried out in an EU or EEA country. If the transplant is carried out in a country other than an EU or EEA country, the donor must reside in that country and be your spouse, registered partner or a blood relation of the first, second or third degree.
- Specialist medical care in relation to selection of the donor.
- Specialist medical care in relation to the operative removal of the transplant material from the donor.
- Treatment of the transplant material if the donor has died.
- Care during the hospital admission of the donor for selection or an operation. Care will be provided for up to a maximum of 13 weeks after the end of admission. Care for liver donors will be up to a maximum of six months after the end of admission.
- Transport of the donor in the Netherlands that is connected to the selection of, admission to and discharge from a hospital and for care up to a period of 13 weeks (or six months) after admission has ended. This does not apply if the donor has health insurance. In that instance, the transport is at the expense of the donor's health insurance.
- Transport from and to the Netherlands if the donor lives abroad. In this situation, the transplant must be of a kidney, liver or bone marrow for an insured party in the Netherlands. The transport must take place in the lowest class of public transport, or by car if this is medically necessary. This does not apply if the donor has health insurance. In that instance, the transport is at the expense of the donor's health insurance.
- Other costs that a donor will be required to incur if he lives abroad. For example, travel expenses for a screening in the country where the donor lives.
You will require a referral from a medical specialist or a clinical technologist for transplant care. You will not require a referral where an urgent situation is the case. For example, if the transplant cannot be postponed.
Under the HollandZorg healthcare insurance, you quality for the reimbursement of the costs of transplant care.
|Public Healthcare Insurance||Reimbursement|
|HollandZorg public healthcare insurance||100%|
Are you a donor? The receiver of the transplant material will cover the costs of transplant care that you receive. These costs will be reimbursed under the public healthcare insurance of the receiver.
If the period referred to under heading 2, part 5, has expired, the cost of your care in relation to the transplant will be covered by your public healthcare insurance. These costs will not count towards your compulsory policy excess or any voluntary policy excess.
If you are planning on seeing a care provider with whom we have not concluded an agreement for transplant care, 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.
You will not be subject to a statutory personal contribution for transplant care.
Are you 18 or older? The costs incurred for transplant care will count towards your compulsory policy excess and any voluntary policy excess. Please read our extensive terms and conditions (PDF) for the exceptions.
You may receive transplant care from a transplantation centre. Use our Care Guide to find a hospital 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.
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