Frequently Asked Questions

Everyone who lives or works in the Netherlands must take out basic insurance. With this you insure yourself for care from the basic package. Think of the family doctor, the hospital, the psychiatrist and the pharmacy. The government determines what is included in the basic health insurance package. Are you curious about the Dutch health insurance, take a look at this movie.

Supplemental insurance allows you to get additional insurance for expenses that the basic insurance does not cover. This is not mandatory.

You can review the most important changes for the new policy year here.

The main difference between the natura and restitution policies is about choosing your own healthcare providers. With a restitution policy, you have free choice of care and will receive full reimbursement from any healthcare provider as stated in your healthcare policy.

With a natura policy, the insurer makes agreements with a number of care providers. Only with these care providers will you receive full reimbursement as stated in your policy. Are you going to another hospital or doctor? You can, but the insurer will often only reimburse 50 to 80 percent. Because of the limitations in free choice of care, a naturopathic policy is always cheaper than a restitution policy with the same insurer. Also take a look at this movie.

Please note that most insurers no longer offer unlimited (aka pure) restitution policies. Certain restrictions may still apply to some reimbursements. Check with your insurer or call the Alpina Care Advice Line on 088 - 12 10 222.

A natura policy allows you to choose from contracted healthcare providers. Do you want to go to a care provider with whom your health insurer has no contract? You can, but you will have to pay part of the costs yourself. Your policy will tell you how high the reimbursement is.

If you go to a health care provider that your health insurance company has not contracted with, there is a chance that you may have to pay part of the bill yourself.

Physical therapy is partly included in the basic package. What is reimbursed depends on your age and the reason why the physical therapy is necessary.
In outline, it is arranged as follows:

- Young people up to 18 years of age are reimbursed for the first 9 treatments for physical and remedial therapy. if these treatments do not have the desired result, the health insurer may reimburse for more treatments (maximum 9).

- For patients aged 18 and older with a chronic condition, physical and remedial therapy is reimbursed from the 21st treatment. So you pay for the first 20 treatments yourself. These 20 treatments apply per disorder and not per calendar year. Do you have supplementary insurance with a physiotherapy reimbursement (not yet used)? Then you can use this to help pay for (part of) the first 20 treatments. Your practitioner will know whether your disorder is covered by this reimbursement.

A denture is reimbursed once every 5 years for 75% from the basic insurance. This means that, in addition to the deductible, you have to pay 25% of the costs yourself.

If an artificial or click denture needs to be repaired or refitted (rebasing), 90% of this is covered by the basic insurance. The remaining 10% is your own contribution.

It is possible to be reimbursed for the co-payment for dentures through supplementary or dental insurance.

Note: If you have a natura basic insurance, to get reimbursement you must go to a contracted health care provider. Not every dentist or prosthodontist is contracted.

When a new hip has been recommended by the specialist and the insurer has agreed, the operation will be reimbursed from the basic insurance. However, you will pay the deductible for this.

Assistive devices needed for treatment, nursing, rehabilitation or care are reimbursed from the basic package. This no longer applies to simple walking aids, such as crutches or a walker. If you need permanent aids, for example because of a disability, you usually get them from your municipality.

You will be reimbursed for patient transportation from the basic health insurance package. It must be medically necessary transportation. Sometimes you pay a personal contribution depending on the type of transportation. Check your policy conditions to see if you can choose your own transporter.

Visit your insurer's online care finder or call the Alpina Care Advice Line at 088-12 10 222.

If you need immediate specialist medical assistance (for example, because you are being transported by an ambulance) then any restrictions on contracted healthcare providers do not apply. The deductible does apply to that ambulance, by the way.

Alternative medicine and remedies are reimbursed from some supplementary insurance policies up to a maximum per year and a maximum per day or session.

Normally, this is not reimbursed from the basic package. This only applies to special lenses or special optical aids such as telescope glasses, ptosis glasses or binocular magnifying glasses. And then only with a medical indication.
For ordinary glasses or lenses, the costs are for your own account unless you have taken out supplementary coverage that includes a reimbursement for glasses.

Hearing aids are reimbursed from basic insurance under certain conditions. For example, there must be a minimum hearing loss of 35 decibels (dB).

There is no full reimbursement from basic insurance. This is a maximum of 75%. The remaining 25% is co-payment.
There are supplementary insurances that reimburse all or part of this co-payment.

Don't confuse this co-payment with the deductible. You pay your deductible first. And for the amount reimbursed, you pay your deductible first.

Example:
- You buy a €900 hearing aid on the advice of the audiologist.
- You then send the bill to your insurance company
- You first pay a co-payment of 25%, which comes down to € 900 x 25% = € 225. There is now € 675 left.
- Suppose you have not yet used your deductible. In this example, we assume that you have only opted for the obligatory deductible excess of € 385.
- Of the remaining € 675, the € 385 will first be deducted. There now remains € 675 - € 385 = € 290

Ultimately, you will then pay €225 co-payment and €385 out of pocket. The remaining € 290 is paid by the insurer.

If you cancelled your current insurance before January 1, you can still take out a new health insurance policy until January 31. Your new policy will then take effect January 1.

Switching during the year is possible in some situations. For example, if you change employers. When you were collectively insured through your previous employer and your new employer also offers collective health insurance. You will then immediately benefit from the collective offer. When you reach the age of 18, switching is also possible. And in case of divorce, the co-insured partner can take out his own policy elsewhere.

Every health insurance company is required by law to accept you for basic insurance. So you may never be refused, regardless of your age or health status.
However, the insurer may refuse you for supplementary insurance. However, most insurers do not have acceptance questions for most of their supplementary insurance policies.

Switching to another insurer is not possible if you are in premium arrears with your current insurer. It is not allowed to cancel a health insurance when you have not (yet) paid the due premiums. Your current health insurance will continue as usual, and you will retain the right to medical care.

Insurers do not charge an additional fee when you leave or sign up as a new customer.

Outstanding deductible payments will still have to be paid to the old insurer, of course, but this does not prevent a switch.

It is possible to change health insurance during ongoing treatment at the hospital or the mental health center. For that treatment, the policy conditions of the insurer where you were insured at the start of the treatment apply.
Are you planning to switch and are you undergoing treatment? Always inform your advisor in advance. They can tell you more about this.

For medications, health insurers use a preference policy. Preference policy means that for each drug, the health insurer chooses a preferred drug within a group of drugs with the same active ingredient. Each health insurer has its own policy.

Switching to a different health insurance company may result in you being supplied with a different medication. And that you won't just get your old medicine delivered.

Inform in advance about the other health insurer's preference policy. Don't let the premium alone guide your choice.

Budget Day: On Budget Day, the calculation premium of the basic health insurance for the coming year is announced. It is also announced, among other things, what the deductible will be in the new year. The deductible is set by the government and not by health insurers.

Deadline for announcing premiums for the new year.
Insurers are required to announce the premium for the new year no later than November 12. That is therefore the deadline by which policyholders must be informed of their new premium.

Because most insurers wait until Nov. 12 to announce the new premium(s) and terms, it may take several days for a health care comparator such as the one we use to process and test all this information.

Therefore, please allow several days after Nov. 12 before all premiums and terms of all insurers are available in the comparator.

Canceling health insurance
You can cancel your current health insurance until December 31. You can switch to another health insurance from November 12, 2022 to January 2023.

Changing health insurance
You are no longer allowed to cancel your health insurance in January. And you may no longer change your basic insurance and deductible. But some insurers allow you to change your supplementary and/or dental insurance until February 1. The change must be received by the insurer by January 31 at the latest.

Copayment and deductible are different things. The mandatory deductible applies to most care in the basic package. Some care requires a co-payment. This can be a fixed amount or a percentage of the cost.

For example, for orthopedic shoes, hearing aids and patient transportation. Here is another explanation of the difference.

In 2023, the mandatory deductible remains € 385,-. The deductible can be increased (usually in increments of € 100,-) to € 885,-. This is called voluntary deductible excess. This reduces the monthly premium to be paid.

It is not possible to buy off the deductible.

You do not pay any deductible for a visit to the general practitioner or a medical procedure performed by a general practitioner. Medication and, for example, (blood) tests prescribed by the general practitioner do fall under the deductible.

No deductible is also payable for a visit to the doctor's office. However, you do when they prescribe medication or a (blood) test, for example.

You pay a deductible for medications included in the basic insurance. You pay this deductible in addition to a possible co-payment for medications.

At Medicijnkosten.nl you can find information on drug reimbursement.

You can check here, among other things:
- whether your medicine is included in the basic health insurance package;
- Which costs count towards your deductible;
- What, if any, is your personal contribution;
- whether there is a cheaper medicine that is fully reimbursed.

A visit to the emergency room is subject to the deductible.

You do not have to pay any deductible or co-payment for district nursing. This is fully reimbursed by the basic insurance. Pay attention to whether the district nursing you want is contracted by your insurer.

With (almost) all insurers it is possible to pay the deductible in installments. Most insurers also allow you to pay in advance, even before you visit a care provider. If it turns out that you needed little or no care, the unused portion of the deductible will be refunded.

Prepaying the deductible must be requested before Feb. 1, 2023. The deductible will then be deducted from your account in 10 monthly installments.

Of course this is possible, this can often be arranged as of the first day of the following month. Alpina can easily arrange this for you if the collective goes through our mediation.

This depends, among other things, on the current coverage of your policy; does it match your needs or not. Collective health insurance through your employer may cover a certain treatment, but your current health insurance does not. So it often makes sense to check your policy. It can also save premiums.

Yes. Contact Alpina for more information when the collective is through our intermediary.

This is also possible. If you contact us by phone 088 - 12 10 222 or via e-mail, we can take care of this for you.

Depending on, among other things, your income, it is determined whether you are entitled to care allowance. The amount of the (maximum) allowance is determined every year. Do you want to know if you are eligible for care allowance? On the website of the tax authorities you can read more about this.

Under certain conditions, it is possible to deduct certain healthcare expenses from your taxes. Sometimes you may also deduct expenses you incur for others. Look for more information on this page.

It is not possible to stop basic insurance. Not even if you cannot pay the premium. The basic insurance is mandatory by law. However, taking out supplementary health insurance is voluntary and therefore not mandatory.

The premium for basic insurance is independent of your health status. The insurer may not charge an extra premium for this. This is laid down by law.

It is certainly possible to save on your health insurance. This can be done, for example, by scrutinizing your supplemental insurance.

Many insurers offer modular packages and it pays to look carefully at what you really think you need. Also look here for some tips.

These questions have been answered with great care by Alpina on the basis of information from the national government and others. Nevertheless, no rights can be derived from them.

Always check the policy conditions for exact reimbursements and discuss matters with your specialist. You can also call the Alpina Care Advice Line: 088 - 12 10 222.