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What types of health insurance are there?

In the Netherlands, having health insurance is mandatory. Everyone over the age of 18 must at least have basic health insurance. But did you know that there are different types of basic health insurance? For example, there is a restitution policy, naturapolis, combination policy, and budget policy. The content of the basic package is the same with every health insurer, but there is an important difference in the way you are reimbursed for care.

What is a refund policy?

Insurance with a restitution policy means that you must first pay for the care from the basic insurance yourself. However, you can later request a refund from the health insurance company. In practice, most health care providers do not require you to pay the bill first. This is simply settled directly with your insurer.

With a restitution policy you do not have to take contracts into account. You can choose which doctor, practitioner or hospital you go to, without having to pay extra. Be careful, do you go to a private clinic and do they charge unreasonably high care costs? Then you may still have to pay part of the bill.

What is an in-kind policy?

With a natura policy, healthcare costs are only reimbursed by the health insurer if they have contracts with the healthcare provider. If you visit a doctor or practitioner who does not have a contract with the health insurer, the insurer will only pay part of the bill. The other part will be for your own account. The insurer pays the practitioner directly, so you do not have to advance the costs.

What is a combination policy?

A combination policy is a combination between a natura policy and a restitution policy. In general, a combination policy allows you to choose your own health care providers. Always check the contracts that your health insurer has concluded with the care providers. In a combination policy, certain care providers are excluded from contracting for some types of care. In many cases, this concerns care providers who work in mental health care and district and nursing care.

If you go to a contracted healthcare provider, you will be reimbursed for your entire bill. If you go to a non-contracted care provider, then your bill will only be reimbursed up to the 'normal' amount. This is also called the average contracted rate.

In most cases, this amount is sufficient to cover the entire bill. However, it may happen that a non-contracted healthcare provider charges a higher rate than the "normal" rate. In that case, you pay the difference yourself.

What is a budget policy?

The budget policy is similar to the natura insurance, but in the cheap variety. You only get full reimbursement for care if you go to a contracted healthcare provider. While with a natura policy you can usually choose from a wide range of contracted healthcare providers, with some budget policies you have a more limited choice. The moment you go to a hospital or other care provider with whom the insurer has not made agreements, you will not be reimbursed for the full costs. You will then have to pay part of it yourself. Another characteristic of a budget policy is that the additional packages are often limited (and therefore cheaper). Moreover, with a budget policy you often have to take into account that you have to arrange certain medicines or aids online.

What is supplementary insurance?

The above insurances we have named are basic insurances. In the Netherlands you are obliged to take out at least basic insurance. The basic insurance includes the care that the government considers medically necessary, such as costs for a general practitioner, maternity care and emergency care. If you also want to be reimbursed for care costs that fall outside the basic insurance, you can take out supplementary health insurance. Dental costs and costs for the physical therapist, for example, are included in the supplementary insurance. The premium for this supplementary insurance comes on top of the costs of the basic insurance.

Have questions?

Then get in touch. Our healthcare experts are at your service from Monday to Friday from 08.30-17.00 at telephone number: 088 - 12 10 251.

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