Obstetric care
Reimbursement
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.
Referral required
For obstetric care in a hospital, you need a referral from a general practitioner, medical specialist, nursing specialist, obstetrician or physician assistant.
Reimbursement under public healthcare insurance
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% |
| Supplementary Insurance | Reimbursement |
| Start | none |
| Extra |
none |
| Plus |
statutory personal contribution: 60% |
| Top |
statutory personal contribution: 60% |
| No Risk I |
none |
| No Risk II | none |
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.
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 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.
Excess
The costs of obstetric care do not count towards the compulsory excess. The compulsory excess does 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.
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).
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.
Coverage of an interpreter
Pregnant women who do not speak sufficient Dutch are eligible for coverage of the costs of an interpreter. It's important for the mother-to-be to fully understand the information given by the obstetrician and the maternity care provider, and that she has the opportunity to ask questions. An interpreter can help out. The obstetrician or maternity care provider will determine whether there is a need for an interpreter. If so, they will organise a professional interpreter. For this, they will be reimbursed.
Please note:
The information on this page is a brief outline of the reimbursements. No rights can be derived from this page. You can only derive rights from our insurance conditions.
Your health insurance
In My HollandZorg you will find all information about your health insurance policy.
Maximum rates for a non-contracted care provider
Have you chosen a healthcare provider with whom we have no contract? Then, we will reimburse according to our maximum rates. If the rate invoiced by the non-contracted care provider is higher than our maximum rates, you will have to pay the difference yourself. You will be able to find contracted care providers with our Care finder.
Reimbursements, conditions and regulations 2023
