Valid from 1 January 2026
All information about your health insurance can be found in these policy conditions. However, you may still have questions. You can find many answers to your questions online, at www.hollandzorg.com. If this still does not answer your questions, please contact us using one of the methods below:
Online: You can ask us your question using the contact form on our website (www.hollandzorg.com/contact).
Customer Service: +31 (0)570 687 123 (lines are open Monday to Friday, from 8 am to 6 pm, also for waiting list mediation and care advice)
Emergency centre: +31 570 687 112 (standard rate/for emergency care abroad only) The emergency centre is reachable 7 days a week and 24 hours a day.
Postal address: HollandZorg, Postbus 166, 7400 AD Deventer
Our Care Finder is an easy tool to help you find a care provider near you. In addition, you can instantly see whether and for which treatments we have made agreements with this care provider. Visit: hollandzorg.z-zoeker.nl.
HollandZorg has concluded contracts with many care providers. These care providers can submit the invoice directly to us. You do not need to do anything. You can always view all invoices in My HollandZorg at mijn.hollandzorg.com.
Have you received an invoice from a care provider directed at you? You can claim the invoice online via My HollandZorg (mijn.hollandzorg.com). For this you need to log in using your DigiD. You fill in the online claim form and take a clear photo of the original invoice(s). You can upload the photo(s) and send them together with the online claim form. You will receive an e-mail to confirm we received your claim. You can view your claims via My HollandZorg.
The HollandZorg Claims app now makes claiming your healthcare expenses even easier. You enter your details, take a picture of the invoice and submit it with a single mouse-click. The app is available for both Android and iPhone. You can download the claims app from the App Store (iOS) and the Play Store (Android). In most cases, we will pay the claim within 5 working days.
In our policy conditions, we refer to regulations and lists that can be found on our website (www.hollandzorg.com/conditions). Such as the List of alternative care providers or the Medical Devices Regulations. All documents available online can also be sent, on request.
Each public healthcare insurance has an excess. This is the amount for care that you need to pay yourself before the healthcare expenses are reimbursed to you. Every insured party aged 18 or older has an excess.
Each year, the government determines the amount of the compulsory excess. In 2026, the amount is € 385. This means that, in the year 2026, you will never pay more than this amount as compulsory excess.
Not all care provided through public healthcare insurance is subject to compulsory excess.
The exceptions can be found on our website and in Articles 5 and 6 of the Specific provisions for the public healthcare insurance. As a health insurer, we too can decide whether to exclude certain care from excess. These exclusions can be found in the 'Designated care not subject to excess' scheme on our website.
In 2026, you spend € 400 on hospital care. The compulsory excess is € 385.
This is the amount you pay yourself. We will reimburse the payable amount that remains. So the reimbursement is € 15 (€ 400 - € 385).
You have now paid the full amount of the compulsory excess for 2026. We will no longer deduct compulsory excess on new healthcare expenses for the year 2026.
In 2026, you spend € 85 on medicines via the chemist. The full amount of € 85 is subject to compulsory excess. These costs are payable by you. You will not be reimbursed under the public healthcare insurance. For the year 2026, your remaining compulsory excess is € 300 (€ 385 - € 85).
In 2026, you spend € 200 on patient transport. The statutory personal contribution for transport is € 113 per calendar year. These costs are payable by you. The amount that remains after that is € 87 (€ 200 - € 113). This amount is subject to the compulsory excess of € 385.
These costs are payable by you too. For the year 2026, your remaining compulsory excess is € 298 (€ 385 - € 87).
In the general provisions you will find rules that apply to your insurance. For example, about cancellations, premium payments and the way in which you can submit a complaint.
The costs of care are allocated to the calendar year in which you received the care. If you received the care in 2 successive calendar years but the care has been charged as a single sum, the care is allocated to the calendar year in which the care started. The date on which you were treated, a medicine was issued or a medical aid supplied determines the reimbursement and excess. The invoice date or the date on which payment was made is not relevant in this respect.
Example: you are operated on in November of year A, but you receive the invoice for this in January of year B. In that case, the excess and reimbursement apply to year A and not year B.
The costs of a dbc care product (diagnosis treatment combination) apply to the calendar year in which the dbc product was opened. Therefore, in the event of a dbc care product that was opened in year A and closed in year B, you will be reimbursed in accordance with Year A. The excess also applies to Year A.
We often pay the care provider directly. Sometimes you may receive an invoice directed to you. For example, if you use the services of a non-contracted care provider.
Submitting the invoice online:
Submitting the invoice by post:
An invoice must meet the following conditions:
Care-related invoices must be submitted within 12 months of the end of the calendar year in which you received the care. This means the treatment or delivery date and not the date on which the invoice was issued. If the care is described as dbc or a dbc care product, you must submit the invoice within 12 months of the moment the dbc or the dbc care product is terminated. If you submit an invoice after 12 months, we may decide to reimburse the invoice partially or not at all. In that case, the additional costs for administrative processing will be payable by you. Invoices submitted 3 years after the treatment or delivery or the date on which the dbc or dbc care product is terminated are never eligible for reimbursement.
You are not permitted to transfer any (future) claims against us to any third party (i.e. another natural person or legal entity). The transfer of a claim is called assignment. This ban on assignment of a claim must be interpreted as a stipulation with property-law effect as referred to in Article 3:83, paragraph 2, of the Netherlands Civil Code.
You are not permitted to assign any third party (another natural person or legal entity) to collect any claim against us (by mandate, for example). If you do, we are not obliged to pay. Payment of the claim to you will in that case also constitute a valid discharge (the invoice has been duly paid).
We will pay an invoice submitted to us within 3 working days of receipt. This is based on the assumption that all conditions for (partial) reimbursement have been met. The processing time will be longer if the invoice is incomplete or if more time is needed to check whether the care meets the policy conditions.
We may request additional information from you to verify whether the care claimed complies with the policy conditions. You can view your claims via My HollandZorg. Alternatively, we are entitled to pay the costs of care directly to the care provider who provided the care. Your entitlement to reimbursement is nullified by that payment.
If we reimburse more to a care provider than we are obliged to under the insurance, we may charge you (insured party/policyholder) for the excess paid. In that case, you (insured party/policyholder) must pay us the amount paid in excess.
We pay the costs of care and other amounts payable to you (insured party/policyholder) by transferring the money into the policyholder's IBAN which we have in our records. Your entitlement to reimbursement is nullified by the payment to the policyholder.
We can set off the reimbursement of costs for care and other amounts payable to you (insured party/policyholder) against premiums, interest, costs or other amounts owed to us.
We deduct the statutory personal contribution from the reimbursement for the costs of care which falls under the public healthcare insurance, unless the statutory personal contribution has already been settled with the care provider. If an excess applies, we will also deduct the excess from the reimbursement. Finally, we will deduct any other amounts that remain payable by you from the reimbursement.
We reimburse the costs of care in Euros. We use the exchange rate applicable on the date on which the care was provided, where possible.
You (insured party/policyholder) can pay our invoices via:
If you (insured party/policyholder) pay an invoice via Internet banking or a transfer form from your bank, you (insured party/policyholder) must always state the payment reference given on the invoice. We will then process the payment on the relevant outstanding account.
If you (insured party/policyholder) fail to state a payment reference, or the payment reference is not or no longer known to us as an outstanding claim, we will process your payment at our discretion for any other outstanding claims. If there are no outstanding claims, we will refund the amount to you (insured party/policyholder).
If you (insured party/policyholder) fail to pay the premium or other amounts owed to us in time, we may charge statutory interest and collection costs. You will first receive written notice from us in which we inform you that you have not paid in time. The letter also states that you (insured party/policyholder) will be given the opportunity to pay the amount due, without additional costs (interest and collection costs), within 14 days from the day after the notice was delivered to you. Only if you have not paid everything after these 14 days will we charge statutory interest and collection costs on the unpaid amount. We will state the amount of the collection costs in the message to you and this is in accordance with the Extrajudicial Collection Costs (Fees) (Besluit vergoeding voor buitengerechtelijke incassokosten.).
You (policyholder) can apply for insurance online at aanvraag.hollandzorg.com. You can also submit a request via an agent with whom we have made arrangements about brokering our insurances.
The public healthcare insurance commences on the day on which we receive the application. We will send the policyholder and the person to be insured confirmation of receipt of the request, stating the date of receipt.
If we are unable to establish whether or not the person to be insured is obliged to take out public healthcare insurance, we will ask you (policyholder) for additional information. In that case, the public healthcare insurance commences on the day that we receive the additional information and that information demonstrates the obligation to take out insurance. We will send you (policyholder) and the person to be insured a confirmation of receipt for the additional information, stating the date on which we received it.
If the public healthcare insurance commences within 4 months of the obligation to take out healthcare insurance coming into force, the public healthcare insurance will be backdated to the date on which the obligation to take out healthcare insurance arose.
If, on the day of the request, the person to be insured already has a health insurance contract, the public healthcare insurance will commence on the later date on which you (policyholder) wish the public healthcare insurance to commence.
If the public healthcare insurance commences within a month of an earlier health insurance contract being terminated through cancellation as of 1 January of a calendar year or due to changes to the conditions subject to application of Article 7:940, paragraph 4 of the Netherlands Civil Code, the public healthcare insurance will be backdated to the day on which the earlier health insurance contract was terminated.
You (insured party/policyholder) will be issued policy documents as soon as possible after the insurance is taken out and subsequently at the start of each new calendar year. If you (insured party/policyholder) believe the policy is incorrect, you must report this to us within 1 month of receiving the policy. If we do not receive any notification from you within a month, we assume the details are correct.
The insurance is taken out for 1 calendar year. If the insurance commences during the course of a calendar year, it is concluded for the remaining part of that calendar year.
The public healthcare insurance is tacitly renewed for 1 calendar year on 1 January of each calendar year, unless it is terminated prematurely in accordance with these policy conditions.
If the public healthcare insurance will end or has ended, we will notify you (insured party/policyholder) of that fact as soon as possible, stating the reason and the date on which the insurance will end or has ended.
You (policyholder) can change your mind after having taken out the insurance. You can cancel within 14 days of receipt of the first policy documents. The insurance is then deemed not to have commenced. We will refund any premium paid. And you (insured party/policyholder) are obliged to repay any healthcare expenses paid by us.
You (policyholder) can cancel in one of the following ways:
NOTE: verbal cancellations or cancellations via social media is not accepted.
The insurance terminates automatically on the day following that on which:
The public healthcare insurance also terminates on the day following that on which you, as a result of changes to our territory, reside outside our territory.
The stated cancellation options do not apply to the public healthcare insurance if the premium and collection costs owed have not been paid and we have demanded payment from you (the policyholder) for the premium owed. This does not apply if we have suspended (temporarily discontinued) the cover of the public healthcare insurance or if we have confirmed the cancellation to you (the policyholder) within 2 weeks.
You (policyholder) can cancel in one of the following ways:
NOTE: verbal cancellations or cancelling via social media is not accepted.
If you (policyholder) ask us to provide insurance, we at the same time deem that request as a notice of termination of any other live, similar insurance contracts held with us.
If you (insured party/policyholder) ask another health insurer to provide insurance for you, we at the same time deem that request from that other health insurer as a notice of termination of any other live, similar insurance contracts held with us, from the moment that we receive a copy of that request. We call this the cancellation service.
If you are insured through the Central Administrative Office for Exceptional Medical Insurance (CAK) within the framework of measures against the uninsured, you can still cancel (terminate) the public healthcare insurance. This must be done within 2 weeks of the date on which the CAK has notified you that you are insured with us. In addition, you must demonstrate that you have been given another health insurance in the 3-month period from the date of dispatch by the CAK of the second administrative penalty on account of being uninsured and the instruction to take out insurance (or arrange for insurance to be taken out on your behalf) under the public health insurance scheme.
If you are insured through the Central Administrative Office for Exceptional Medical Insurance (CAK) within the framework of measures against the uninsured, you cannot cancel the public healthcare insurance during the first 12 months. During that period, the cancellation options under article 3.5 of these general provisions do not apply.
If you are insured through the Central Administrative Office for Exceptional Medical Insurance (CAK) within the framework of measures against the uninsured, we can cancel the public healthcare insurance on account of an error if, in retrospect, it transpires that you were not obliged to take out insurance. In that case, the public healthcare insurance is deemed not to have commenced.
We can cancel or dissolve the insurance, or suspend (temporarily discontinue) cover of the insurance:
In all cases, we will provide you (insured party/policyholder) with proof of termination of the insurance. Upon termination of the public healthcare insurance, we will send you proof of termination stating the details which we are required to provide under the Healthcare Insurance Act.
The cover and obligation to pay premiums under the public healthcare insurance are suspended (temporarily discontinued) during the time you are detained. We cannot cancel or dissolve your public healthcare insurance as long as you are in detention. Do not forget to state the starting and end dates of your detention. The starting date must be reported within 1 month of the detention commencing. The end date must be reported within 1 month of the detention ending. The report can be submitted by presenting a statement of detention from your penitentiary:
If you are detained abroad, you must send us a statement from the Minister of Foreign Affairs or a statement from the Dutch probation service in evidence of your incarceration.
The premium that you (the policyholder) must pay is the premium base minus any discount.
The premium base, any discount and the premium due that you (the policyholder) must pay can be found on the policy.
The premium calculation basis is shown in the Premium Appendix to these policy conditions.
If the insurance does not come into force on the first day of a month, the premium will be calculated in proportion to the number of insured days in that month.
It is possible that, pursuant to a law or treaty, we are obliged to pay a tax or other levy, in the Netherlands or abroad, in connection with your insurance. In any such case we may charge this amount in the form of a surcharge in addition to your premium. You (policyholder) must then pay the surcharge to us. If a surcharge applies, this will be specified in the policy.
You (the policyholder) must pay the premium in advance. Your payment must be made before the first day of the period to which the premium relates. We decide whether you can pay per month, per six months or per year, and which form of payment is possible.
You (insured party/policyholder) are not entitled to set off the premium or other amounts payable to us against any amounts that you (insured party/policyholder) are yet to receive from us. Nor are you (insured party/policyholder) permitted to suspend payments if you (insured party/policyholder) feel that we owe you (insured party/policyholder) an amount of money.
In the event of the death of the insured party, any premium paid relating to the period after the date of death will be refunded.
The insurances are intended for all persons living in the Netherlands or abroad and who are obliged to take out health insurance.
The insurance is governed by the laws of the Netherlands.
You (insured party/policyholder) are obliged:
NOTE: if you (insured party/policyholder) fail to meet the information requirements set out in this
article and the other policy conditions, you are not entitled to (reimbursement of the costs of) the care if this is detrimental to our interests.
Our notifications to you (insured party/policyholder) apply only if we have confirmed them in writing or, with your permission, by e-mail. When using the most recent residential address or e-mail address we hold on record, we assume that the notification will have reached you.
If you (insured party/policyholder) send us an e-mail, we may assume you authorise us to respond to that by e-mail.
If you (insured party/policyholder) have given us your authorisation to send notifications electronically, you (insured party/policyholder) are entitled to withdraw that authorisation. You can do so as follows:
You may at times require care due to the actions of someone else, e.g. as a result of an accident. That person may be liable to pay the costs of the care you consequently need.
If someone else may be liable to pay the costs of care provided to you, you are obliged to notify us of that fact. You can do so as follows:
You are obliged to provide us with the information we need to recover the costs of the care given to you from that other person.
You are not permitted to make arrangements with another person or the liability insurer of that other person which prejudice or may prejudice our chances of recovering the healthcare expenses. This does not apply if you have received our prior written authorisation. If our chances of recovering the healthcare expenses are prejudiced as a result of your actions or omissions, we may hold you liable for the damage incurred by us and corresponding costs.
We are not liable for damage or losses you (insured party/policyholder) suffer as a result of the actions or omissions of a care provider who has or should have provided you with care.
Any liability on our part for damage or losses suffered as the result of our own shortcomings in the execution of the public healthcare insurance is limited to the amount of the costs that would have been borne by us in the event of the correct execution of the public healthcare insurance.
We record the personal data and execution data we receive from you (insured party/policyholder) in our administration.
We use this data for the following purposes:
The processing of personal data is governed by our privacy statement. You (insured party/policyholder) can view and download this at www.hollandzorg.com/nl/privacy.
In connection with a responsible acceptance, risk and fraud policy, we may check your data with Stichting CIS. The objective of processing personal data at Stichting CIS is to manage risks for insurers and prevent fraud. More information about this and the Stichting CIS privacy statement is available at www.stichtingcis.nl.
If relevant arrangements have been made with your care provider, the latter can consult your address details and policy details we have registered through the national Internet portal VECOZO (Veilige Communicatie in de Zorg). This is necessary for the care provider in order to claim the costs of the care provided to you directly from us.
In some cases, your personal data may need additional protection, for instance because you are staying at a shelter. If you believe that you need this additional protection, you can ask your municipality for additional protection of your personal data in the Key Register of Persons (BRP). After processing by the municipality, your personal data will receive additional protection. We will automatically take over this modified registration. This way, we can take that into account.
If we suspect fraud, we will conduct an investigation to determine whether fraud has occurred. In the event of confirmed fraud:
If you (insured party/policyholder) have taken out an insurance policy or are insured by virtue of an insurance policy, your request will also count as a request to become a member of Coöperatie Salland U.A. This does not apply if you (insured party/policyholder) have told us of your wish to opt out of this provision. The members' council of Coöperatie Salland UA talks directly with the board of Salland Zorgverzekeraar, it contributes ideas about a variety of subjects and makes decisions on important matters. The member's council is elected from among the members. Membership ceases upon death, cancellation or member disqualification. Membership is deemed to have been cancelled at the moment that you (insured party/policyholder) have ended your last remaining insurance with us.
You are not entitled to (reimbursement of the costs of) care in the event of fraud, abuse or improper use of your insurance. This also applies if you attempt to mislead us by submitting false statements or withholding facts or circumstances from us that could be important for assessing the costs or the entitlement to reimbursement.
You are not entitled to reimbursement of the costs of care which is provided by yourself or by your partner or first- or second-degree blood relative. In exceptional cases, we may deviate from this:
You are not entitled to (reimbursement of the costs of) care if the injury is caused by, occurred during or ensues from armed conflict, civil war, uprising, domestic riots, revolt and mutiny as referred to in Article 3:38 of the Financial Supervision Act (Wet op het financieel toezicht). For the definitions of these terms, please refer to the text filed by the Netherlands Association of Insurers (Verbond van Verzekeraars in Nederland) on 2 November 1981 at the Registry of the District Court in The Hague.
If the Minister of Finance makes use of the authority set out in Article 18b, paragraph 1 of the Emergency Act on Financial Transactions (Noodwet financieel verkeer) and the need for care has come about due to any of the terrorist acts referred to in that act, you are entitled only to one or more services as long as the costs thereof are no higher than determined by the Minister of Finance. If the injury is caused by terrorism, the cover is limited to the amount of payment we receive, subject to the claim to compensation from the Dutch Terrorism Risk Reinsurance Company (Nederlandse Herverzekeringsmaatschappij voor Terrorismeschade). A description of the definitions and the Terrorism Cover Clause Sheet can be viewed at www.hollandzorg.com/conditions. If we receive an additional contribution by virtue of Article 33 of the Healthcare Insurance Act (Zorgverzekeringswet) or Article 3.23 of the Healthcare Insurance Decree (Besluit zorgverzekering), you are also entitled to the additional reimbursement by virtue of these regulations.
We can change the policy conditions with effect from a date to be set by us. A change to the premium calculation basis for the public healthcare insurance will come into force no earlier than 7 weeks after the date on which we have informed you (policyholder) of that change.
In some cases you need authorisation from us for the right to care or the reimbursement thereof. In that case, receiving the care is subject to our written authorisation. This is to prevent problems afterwards. The policy conditions specify, per type of care, whether or not you need written authorisation from us.
When assessing the request for authorisation we will gauge whether the care complies with the policy conditions, whether the care is the most appropriate in your situation and whether the care provider meets our quality requirements. In that case, you will know in advance if and how much reimbursement you will receive for the care. If we grant our authorisation, it is valid for 1 year, counting from the date on which the written authorisation is granted. This authorisation may be valid for a shorter or longer period of time, if we explicitly mentioned that fact when we granted the authorisation.
The request for authorisation must always state your name and address as well as the name, address and profession of the care provider. Any additional information the request must state is set out per care form in the specific conditions for the public healthcare insurance and supplementary insurance.
You can e-mail a request for authorisation to our medical advisor at: toestemming@hollandzorg.nl. Alternatively, send your request for authorisation to: HollandZorg, Medisch adviseur, Antwoordnummer 30, 7400 VB Deventer (no stamp required).
If your care provider submits the application on your behalf, your care provider may only provide us with personal data about your health, provided you have given the care provider explicit permission to do so.
We may invite you to explain your request in person during office hours.
It is possible that you need care under the public healthcare insurance that requires authorisation and that you have already received the authorisation for that care or the reimbursement thereof from your previous health insurer. In that case, the authorisation applicable to the period issued by your previous health insurer is continued. This authorisation will entitle you to the care or to the reimbursement of the costs of the care in accordance with the rules in our policy conditions. Sending us that authorisation at toestemming@hollandzorg.nl or to the address above suffices. If your previous health insurer did not specify a period, the authorisation remains valid for a maximum of 1 year of the date the authorisation was granted by your previous health insurer.
You are not entitled to care which was authorised by your previous health insurer if the care or the costs of the care the authorisation relates to is or are no longer insured.
The right to care or the reimbursement thereof will often be subject to a referral or prescription. The policy conditions state, per type of care, whether or not you need a referral or prescription. These conditions also state which care provider may be the referrer or prescriber. The referral or prescription will remain valid for a period of 9 months from the day the referral or prescription was issued. The validity may be longer or shorter, provided this is expressly stated in the policy conditions in relation to the type of care concerned. If the care did not commence within the validity period, then the right to care or the reimbursement thereof will be subject to a new referral or prescription.
The referrer or prescriber must be an expert in the discipline to which the referral or prescription relates.
If you received a referral or prescription in the period during which you were still insured with another health insurer, you do not have to ask for the referral or prescription again, unless the term of validity has expired.
If you (insured party/policyholder) disagree with a decision made by us within the framework of the public healthcare insurance, you (insured party/policyholder) can ask us to reconsider such a decision. You (insured party/policyholder) must submit your request within 6 weeks of receiving our decision. You can do so as follows:
If we do not respond to your request within 4 weeks or if you are not happy with our response, you can lodge the dispute with the Healthcare Insurance Complaints and Disputes Foundation (Stichting Klachten en Geschillen Zorgverzekeringen) (SKGZ). This does not apply if you already presented the dispute to a civil court. The SKGZ acts in accordance with its own regulations. The SKGZ ombudsman acts as the mediator in the dispute. If mediation is impossible or yields no satisfactory result, the SKGZ Disputes Committee can issue a binding recommendation. For more information, visit www.skgz.nl.
You (insured party/policyholder) are entitled to submit a dispute with us to the civil court at any time.
If you (policyholder) took out the insurance online, you (policyholder) can also send your complaint to the European ODR platform. The ODR platform can be reached at ec.europa.eu/consumers/odr. The platform must then forward your complaint to the SKGZ.
If you (insured party/policyholder) feel that a form we use is too complicated or unnecessary, you (insured party/policyholder) may ask us to review that form. You can do so as follows:
You (insured party/policyholder) can also submit complaints about the form we use to the Dutch Healthcare Authority (Nederlandse Zorgautoriteit). The Dutch Healthcare Authority will issue a binding recommendation. For more information, visit www.nza.nl.
The public healthcare insurance is subject to the following conditions:
The public healthcare insurance is based on the Healthcare Insurance Act (Zorgverzekeringswet), the Healthcare Insurance Decree (Besluit zorgverzekering) and the Healthcare Insurance Regulations (Regeling zorgverzekering). The public healthcare insurance is further based on the information provided by you (policyholder) during the application and on agreements in connection with any group scheme you participate in.
The public healthcare insurance should be interpreted and applied in accordance with the Healthcare Insurance Act (Zorgverzekeringswet), the Healthcare Insurance Decree (Besluit zorgverzekering) and the Healthcare Insurance Regulations (Regeling zorgverzekering) and the corresponding explanation.
If a provision in the policy conditions fully or partly contradicts a provision of the Healthcare Insurance Act, the Healthcare Insurance Decree or the Healthcare Insurance Regulations or the explanation, that provision or that part of the provision in the policy conditions does not apply. The provision in the Healthcare Insurance Act, the Healthcare Insurance Decree or the Healthcare Insurance Regulations applies instead.
The same applies if the Healthcare Insurance Decree or the Healthcare Insurance Regulations are amended in the course of the year. Should any such amendment change cause there to be a difference with the policy conditions of the public healthcare insurance, then the provisions of the amended Healthcare Insurance Decree or the Healthcare Insurance Regulations will apply.
All ministerial regulations or other appendices referred to in these policy conditions form part of the public healthcare insurance.
As a health insurer, we have an acceptance obligation if you (the policyholder) want to take out public healthcare insurance. We do not take into account a person's age, gender or health situation. In certain situations we are not obliged to offer the public healthcare insurance:
You (policyholder) must pay us premiums for the public healthcare insurance, except in the following cases:
Example: The insured party turns 18 on 10 September. In that case, you (the policyholder) start paying premiums for the health insurance from 1 October of that year.
No later than 10 working days after our records indicate payment arrears of 2 monthly premiums for public healthcare insurance, we will contact you (the policyholder) to agree on a payment arrangement. The payment arrangement consists of:
Our payment arrangement proposal further includes the following option. If you (policyholder) took out the public healthcare insurance for another party, you can cancel the public healthcare insurance of that other party with effect from the date on which the repayment arrangement commences. The conditions for this are:
With the payment arrangement proposal, we will send you (policyholder) a letter stating that you (policyholder) have 4 weeks to accept the proposal. It will further state the consequences if you (policyholder) were to reject the proposed payment arrangement and the premium arrears (excluding interest and collection costs) have risen to 6 or more monthly premium payments. We will also remind you (policyholder) of the option of debt counselling.
Do you (the policyholder) have premium arrears, excluding interest and collection costs, of at least 4 monthly premiums? In that case, we will notify you (the policyholder) as soon as possible about our intention to report to the CAK if the debt (excluding interest and collection costs) has risen to an amount of at least 6 monthly premiums. We will refrain from making the report if you (insured party/policyholder) have objected to the payments arrears within 4 weeks of having received the notification.
If you (insured party/policyholder) have objected to the premium arrears in time, but we maintain our position, we will report you to the CAK as soon as your arrears, excluding interest and collection costs, have increased to an amount of 6 monthly premiums or more. We will refrain from making the notification if you (insured party/policyholder), within 4 weeks of having been notified by us, have submitted a dispute in respect of the premium arrears to SKGZ, Postbus 291, 3700 AG Zeist, or to the civil court.
If the payment arrangement takes effect when the premium arrears, excluding interest and collection costs, have increased to an amount of 4 monthly premiums, we will not report to the CAK as long as future premiums are paid.
Once the premium debt, exclusive of interest and collection costs, has risen to an amount of 6 monthly premiums or more, we will notify the Central Administrative Office for Exceptional Medical Insurance (CAK) and you (insured party/policyholder) accordingly. As part of that notification, we will include the personal details required by the CAK for the execution of Article 34a of the Health Insurance Act (Zorgverzekeringswet). We will further state that we have acted in accordance with the procedure referred to in 4.6 to 4.9. We do not report to the CAK:
We will immediately notify the Central Administrative Office for Exceptional Medical Insurance (CAK) and you (insured party/policyholder) of the date on which:
PLEASE NOTE! As long as your premium payments are in arrears, you cannot change insurer. That is stipulated by law. As part of the implementation of this law, health insurers exchange data about people with premium arrears.
If you are eighteen or older, you are subject to a compulsory excess. The extent of this compulsory excess is included in the Premium Appendix to these policy conditions.
The following are excluded from the compulsory excess:
Per calendar year, the costs of care remain payable by you until the extent of the compulsory excess in that calendar year is reached.
Statutory personal contributions and other costs of care that remain payable by you (e.g. maternity care and certain medicines) do not count when establishing whether the limit of the excess has been reached, unless the Minister has stipulated otherwise.
If we have paid the costs of care to a care provider directly, without deducting the compulsory excess from that payment, you (insured party/policyholder) must pay us this excess yourself.
Does your public healthcare insurance come into force after 1 January? Does your public healthcare insurance end in the course of the calendar year? In that case, we will calculate your compulsory excess on the basis of how many days you will be insured in that calendar year. The calculated amount is rounded off to whole Euros.
You are entitled to:
In principle, you need to use the care provided by contracted care providers. Contracted care providers are listed at hollandzorg.z-zoeker.nl. You can also contact our Customer Service on +31 (0)570 687 123.
If the care provided by a contracted care provider is not available, not available in time or only at a great distance from your place of residence or temporary place of residence abroad, you are still entitled to reimbursement of the costs of care from a non-contracted care provider. The same applies if you opt for care provided by a non-contracted care provider for another reason. The extent of the reimbursement is described further down in the policy conditions.
The content and scope of the care are partially determined by the state of the art and practice. In the absence of such a benchmark, it is determined by what is regarded as responsible and adequate care in the relevant discipline.
You are only entitled to care, if you may reasonably be regarded as being dependent on that care in terms of content and scope. The care to be provided should be effective and not unnecessarily expensive or unnecessarily complicated.
Your care provider must provide care in accordance with the professional standard and the quality standards as referred to in the Healthcare Quality, Complaints and Disputes Act (Wet kwaliteit, klachten en geschillen zorg (WKKGZ). Has a guideline, care standard or quality standard been established for the care? Then you are entitled to (reimbursement of costs of) the care, if the care was provided in accordance with that standard. The current quality standards can be viewed and downloaded at www.zorginzicht.nl/kwaliteitsinstrumenten. Does your care provider deviate from the guideline, care standard or quality standard? You are still entitled to (reimbursement of costs of) the care if your care provider demonstrates that a deviation from this is medically necessary in your case and your care provider motivates this in your medical file.
The policy conditions state per type of care whether a statutory personal contribution applies. The statutory personal contribution exists in addition to the compulsory excess.
You are not entitled to the care if you are entitled to that care or reimbursement of the cost thereof by law or pursuant to other legal provisions. The law and other legal provisions include the Youth Act, Social Support Act 2015, municipal provisions in relation to these acts and the Long-Term Care Act.
The same applies if you do not want to exercise the right to care or the reimbursement of costs of the care by virtue of that act or the legal provision.
You are entitled to care in the Netherlands if:
You are entitled to care provided by a contracted care provider in the Netherlands, subject to a maximum of the rate we have agreed with that care provider. In some cases, the agreement between us and the care provider ends the moment you receive care from that care provider. In that case, you are entitled to reimbursement of the costs of the remaining care to be provided by this care provider subject to a maximum of the competitive rate which applies for that care in the Netherlands (the competitive Dutch rate).
Contracted care providers are listed at hollandzorg.z-zoeker.nl. You can also contact our Customer Service on +31 (0)570 687 123.
You are entitled to reimbursement of the costs of care provided by a non-contracted care provider in the Netherlands:
if we apply a maximum rate for that care, up to the maximum of the rate set by us. The policy conditions state, per type of care, whether or not we apply a maximum reimbursement for non- contracted care. The rates lists can be viewed and downloaded at www.hollandzorg.com/insured/customer-services/rate-lists2026.
if we do not apply a maximum rate for that care, subject to a maximum of the competitive rate which applies to that care in the Netherlands (the competitive Dutch rate).
The reimbursement referred to under (a) does not apply if the contracted care provider cannot provide the care, cannot provide it in time or only at a great distance from your place of residence. In that case, you are entitled to the reimbursement referred to under (b).
You are entitled to care abroad if:
Are you staying abroad and do you need medical care? Please contact our emergency centre if you require emergency care. Our emergency centre will help you find care. They can also give you information about the reimbursement of the care. You can reach the emergency centre by telephone: +31 570 687 112. The emergency centre can be contacted 24 hours a day, 7 days a week.
If you reside or are temporarily staying in an EU, EEA or Treaty country other than the Netherlands (including temporary stays for planned care), you are entitled, for care provided by a non-contracted care provider in that country or another EU, EEA or Treaty country, at your discretion:
to reimbursement of the costs of the care you would have received from us if this care was provided by a non-contracted care provider in the Netherlands. In practice, this means:
to care or reimbursement of the costs of care in accordance with the statutory regulations of the social healthcare insurance of that country, if that applies to you by virtue of the provisions of the applicable European social security regulations or the relevant treaty.
The reimbursement referred to under i) does not apply if the contracted care provider cannot provide the care, cannot provide it in time or only at a great distance from your place of residence or your temporary place of residence abroad. In that case, you are entitled to the reimbursement referred to under ii) or (b).
If you reside or are temporarily staying in an EU, EEA or Treaty country other than the Netherlands (including temporary stays for planned care), you are entitled, for care provided by a contracted care provider in that country or another EU, EEA or Treaty country, at your discretion:
PLEASE NOTE! Contracted care providers are listed at hollandzorg.z-zoeker.nl. You can also contact our Customer Service on +31 (0)570 687 123.
If you reside or are temporarily staying in a country that is not an EU, EEA or Treaty country, including a temporary stay for planned care, you are entitled to reimbursement of the costs of care in that country:
The reimbursement referred to under (a) does not apply if the contracted care provider cannot provide the care, cannot provide it in time or only at a great distance from your place of residence or your temporary place of residence abroad. In that case, you are entitled to the reimbursement referred to under (b).
We reimburse the costs of care in Euros. We use the exchange rate applicable on the date on which the care was provided, where possible.
The submission of invoices for care provided abroad is subject to the conditions contained in article 2 of the General Provisions. The invoice must be drawn up in Latin script, the alphabet used for almost all Western languages. The invoice must also contain a description of the care provided. If the invoice is drawn up in a different language, you must include a sworn translation of the invoice. We do not reimburse the costs of the translation. If you do not provide a sworn translation, we may refuse to process the invoice.
An invoice for care provided abroad must be accompanied by a fully completed and signed Foreign Claim Form. The claim form can be downloaded at www.hollandzorg.com/forms.
PLEASE NOTE! As regards healthcare abroad, the conditions and exclusions are the same as those that apply to healthcare in the Netherlands. For example, is a referral needed? You will need one abroad as well.
We make agreements with care providers about the costs and quality of the care. We often make agreements about the maximum reimbursement per year (turnover limit). In principle, we do not enter into agreements about the volume of care a care provider has to provide (volume agreement).
We do our best to ensure that you are not affected by agreements about a turnover limit. You can still use the care providers, even if the turnover limit is reached.
Unfortunately, it cannot be ruled out that there will never be any consequences. If a care provider no longer wants to treat you (for the rest of the year) after the turnover limit has been reached, we will help you find an alternative care provider who can provide the care to you.
In the exceptional case of possible consequences, we will state in our care finder which care providers it concerns, as well as the possible consequences. You can find this information at HollandZorg Care finder (hollandzorg.z-zoeker.nl).
Do you feel that the amount of the maximum reimbursement of the non-contracted care makes impossible for you to benefit from that care? We call that an obstacle. In that case, you may request us to grant you higher reimbursement for that non-contracted care. You can submit your request using the contact form at www.hollandzorg.com. In addition, you must state what non-contracted care is involved, when the care starts and why you feel that an obstacle criterion prevents you from using the care. We will contact you within 5 working days of submitting the contact form.
You are entitled to maternity care. Maternity care is care such as maternity carers generally provide to mother and child in connection with childbirth. The right to maternity care applies for a maximum of 6 weeks, counting from the day of delivery. the maternity carer assists during the delivery (partum assistance), takes care of you and the baby during the maternity period and gives advice.
The number of hours of maternity care are established by your care provider in consultation with and under ultimate responsibility of the obstetrician. The 'National Maternity Care Indication Protocol' is leading in this. The number of hours and days partly depend on the family composition and the presence of informal care (family and friends). The protocol can be viewed and downloaded at www.hollandzorg.com/conditions.
Provided there are medical grounds to do so during your delivery, you are, in addition to maternity care, entitled to admission and obstetric and medical specialist care in a hospital from the day of the delivery. In that case, maternity care will be included in that admission. The number of remaining days/hours of maternity care to which you are still entitled after admission is determined on the basis of the number of days you were admitted.
The following care providers are permitted to provide maternity care:
Yes, maternity care at home is subject to a statutory personal contribution of € 5.70 per hour. As regards maternity care without medical grounds in an institution (hospital, birth centre or maternity hotel), the statutory personal contribution is € 22.50 per day for the mother and € 22.50 per day for the baby, plus that part of the institution's rate per day higher than € 161.50.
Example 1: You have given birth and recieved 49 hours of maternity care at home. In that case, your personal contribution is 49 x 5,70 = € 279,30.
Example 2: You have given birth without medical ground and are staying with your baby in hospital or a birth centre. The maximum reimbursement is 2 x € 161.50 = €323. A personal contribution of 2 x €22.50 = €45 per day will be deducted from this. The total reimbursement is therefore €323 - €45 = €278 per day. You must pay the difference between the daily costs charged by the hospital or birth centre and the maximum reimbursement of €278 per day as a personal contribution.
No.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026, under maternity care. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to prenatal screening. Prenatal screening comprises tests that can determine whether your unborn child has an increased risk of a congenital chromosomal or structural abnormality. You decide if you want to have these tests done.
They are:
A hospital is authorised to conduct prenatal screening. The hospital must then have a licence pursuant to the Population Screening Act (Wet op het bevolkingsonderzoek) or have a collaboration agreement with a regional centre for prenatal screening with a licence pursuant to the Population Screening Act.
Yes, from a general practitioner, obstetrician or medical specialist.
No.
No, not for the NIPT.
The excess does include the costs of invasive diagnostics and any other diagnostic follow-up examinations.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026, under medical specialist care. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to obstetric care without medical grounds. Obstetric care without medical grounds is care such as obstetricians generally provide.
If there is no increased risk to your health or that of your baby during pregnancy or delivery, you are entitled to obstetric care without medical grounds. Provided there are no medical grounds dictating otherwise, you are free to choose where you want to give birth. You can choose to give birth at home or in a birth centre or hospital. In most cases, the obstetric care is provided by your own midwife or general practitioner.
The following care providers are permitted to provide this type of care:
No
Yes, if you give birth in a birth centre or use a delivery room in a hospital. In that case, the personal contribution is € 22,50 per day for the mother and € 22,50 per day for the baby plus that part of the rate of the birth centre or hospital for the use of the delivery room per day higher than € 161,50.
Example: You have given birth without medical ground and are staying with your baby in hospital or a birth centre. The maximum reimbursement is 2 x € 161.50 = €323 per day. A personal contribution of 2 x €22.50 = €45 per day will be deducted from this. The total reimbursement is therefore €323 - €45 = €278 per day. You must pay the difference between the daily costs charged by the hospital or birth centre and the maximum reimbursement of €278 per day as a personal contribution.
No.
The following are included in the excess:
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026 under Obstetric care or medical specialist care. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to obstetric care and admission in a hospital for this, if there are medical grounds to do so. Obstetric care with medical grounds is care, such as obstetricians and medical specialists generally provide.
If there is an increased risk to your health or that of your baby during pregnancy or delivery, medical grounds are deemed to exist. In that case, the obstetric care in a hospital is provided by a gynaecologist or an obstetrician from the hospital.
The following care providers are permitted to provide this type of care:
Yes, for obstetric care with medical grounds in a hospital, you need a referral from a general practitioner, medical specialist, nursing specialist, obstetrician or physician assistant before the start of the care.
No
No.
The following are included in the excess:
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026, under medical specialist care. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to mental healthcare (GGZ) and admission if you are 18 or older. Medical mental healthcare includes diagnosis and treatment of mild to (highly) complex psychological issues or chronic conditions such as medical specialists (psychiatrists) clinical psychologists generally provide.
The care is aimed at the recovery or preventing the deterioration of a psychological disorder. Your need for care determines what care programme is used. A care programme can consist of various components, such as intake, diagnostics, individual consultations, group consultations or admission. A care programme can be offered both physically and online. A treatment plan, as part of your care programme, will be discussed with you and subsequently determined by your care provider.
Medical mental healthcare up to the age of 18 falls under the Youth Act. For this you can contact the municipality. Medical mental healthcare does not include:
Your treatment must comply with the state of the art and practice. Go to www.hollandzorg.com/conditions for more information about which treatments meet the current state of the art and practice and in which situation they may be applied by your care provider.
Admission includes stays 24 hours or longer during an uninterrupted period of no more than 1,095 days, for which there is a medical need in connection with medical care.
An interruption of admission for a maximum period of 30 days is not regarded as an interruption to the uninterrupted period. The duration of the interruption does not count in the calculation of the 1095 days, except in the event of weekend and holiday leave. Interruptions for weekend and holiday leave are included in the calculation of the 1095 days.
Do you need to stay in hospital for more than 1095 days in connection with your treatment? You can request an indication of medical grounds under the Long-term Care Act, in consultation with your care provider.
Nationally, field agreements for mental healthcare are established by representatives of the government, care providers, health insurers and patients. The care provider must provide the care in accordance with nationally established field agreements. You can view and download the nationally determined field agreements at www.zorgprestatiemodel.nl.
The following care providers can provide medical mental healthcare as the coordinating practitioner:
Medical mental healthcare up to the age of 18 falls under the Youth Act. This involves other coordinating practitioners as those prescribed by your health insurance. If treatment needs to continue with this youth mental healthcare coordinating practitioner after your 18th birthday, this care provider may continue the treatment for a maximum of 365 days (1 year) after your 18th birthday. This must be a coordinating practitioner with a post-master's registration in the register of Stichting kwaliteitsregister Jeugd (SKJ) or the BIG register (usually a remedial educationalist or care provider registered as an NIP-certified paediatric and adolescent psychologist in the association register of the Netherlands Institute of Psychologists). In that case, this care provider does not need to prescribe to a certain Quality Charter. Continuation of treatment should aim at closure or transfer.
The care provider must have a Quality Charter, based on the ggz National Quality Charter that is included in the Register of Quality Standards and Measuring Instruments of the National Health Care Institute and must comply with the quality charter.
In the quality charter, the care provider must indicate how the quality standards are given form and content. The quality charter of the care provider also states who is responsible for the indication and/or coordination of the care. This is the coordinating practitioner.
We make agreements with contracted care providers about the quality and deployment of the coordinating practitioner. In the case of non-contracted care, when submitting the invoice, we check, among other things, whether the deployment of the coordinating practitioner has been provided in accordance with the quality charter. We may request additional information for this. Based on this information we decide on the reimbursement of the costs of care.
Yes, from a general practitioner, medical specialist, coordinating practitioner (in case of a referral), a company doctor or a doctor affiliated to Nederlandse Straatdokters Groep:
This does not apply to the exploratory consultation. For an exploratory consultation you need a referral from your general practitioner.
The referral must comply with the ‘Referral Agreements on Mental Health Care’ as established by the Ministry of Health, Welfare and Sport. You can view this at www.hollandzorg.com/conditions.
The referral is valid for a maximum of 9 months (275 days). This means that your treatment must start within 9 months of the referral being issued.
Receiving the care is subject to our written authorisation in the following cases:
One of the requirements for authorisation is that we come to a written agreement with your care provider for the provision of the healthcare. If the application is not submitted by your care provider on your behalf but by yourself or another representative, we need your explicit permission to contact your care provider in order to reach written agreement about the provision of the care.
Most care providers that are allowed to act as coordinating practitioners are registered with the national Authorisation Portal. Your care provider can request digital authorisation via this portal. Your care provider will receive an answer from us to your request via the Authorisation Portal.
If you visit a care provider who is not registered with the Authorisation Portal or if you go abroad for treatment, you must request and obtain authorisation from us to be entitled to care before the start of treatment. Each time you apply for care, you will need to send us a copy of a report from the attending coordinating practitioner with the medical diagnosis/diagnoses, a description of the current problem and the medical need for the requested care.
No
Yes, from 18 years and older.
This does not apply to the costs of the exploratory consultation. The costs of the exploratory consultation have been exempted from the compulsory excess.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to medicinal care. Medicinal care (pharmaceutical care) consists of the dispensing (by the chemist) of the medicines and dietary preparations listed below. Medicinal care also includes the advice and support which dispensing chemists generally provide for the medication assessment and responsible use of prescribed medicines.
You are entitled to the following medicines and dietary preparations:
the following registered medicines contained in Appendices 1 and 2 of the Healthcare Insurance Regulations (Regeling zorgverzekering):
Appendix 2 of the Healthcare Insurance Regulations (Regeling zorgverzekering) states additional conditions for the provision of the medicines mentioned in those regulations. You are only entitled to those medicines if you meet these conditions.
the following unregistered medicines, if used as part of rational pharmacotherapy:
the dietary preparations as referred to in appendix 2 of the Healthcare Insurance Regulations (Regeling zorgverzekering). You are only entitled to the dietary preparations referred to in appendix 2 of the Healthcare Insurance Regulations (Regeling zorgverzekering) if the relevant conditions contained in appendix 2 of the Healthcare Insurance Regulations (Regeling zorgverzekering) have been met.
the following over-the-counter medicines and gastric acid inhibitors:
Medicinal care does not include:
The contents of Appendices 1 and 2 of the Healthcare Insurance Regulations may change from time to time. You can view and download the current content at www.hollandzorg.com/conditions.
In order for you to be entitled to these medicines contained in Appendix 2 of the Healthcare Insurance Regulations (Regeling zorgverzekering), you must have received our written authorisation before receiving the care.
You must enclose a copy of the prescription with your request.
The procedure of the doctor's note and dispensing chemist's instruction may apply to the right to other medicines included in Appendix 2 of the Healthcare Insurance Regulations. In that case, the dispensing chemist or dispensing general practitioner must determine the right to the medicine based on a doctor's note or dispensing chemist's instruction. The prescription must then be accompanied by a fully completed, dated and signed doctor's note. The dispensing chemist or dispensing general practitioner must act in accordance with the associated dispensing chemist's instruction and, on that basis, assess whether you are entitled to reimbursement of the costs of the medicine. Visit www.znformulieren.nl to check whether the procedure of the doctor's note and dispensing chemist's instruction applies. The procedure of the doctor's note and dispensing chemist's instruction and their content may change from time to time. Visit www.znformulieren.nl for up-to- date information.
If you object to the procedure of doctor's note and dispensing chemist's instruction, you can also submit a request for authorisation directly to us.
Chemist's preparations are non-registered medicines that are made on a small scale in one pharmacy by or on behalf of a chemist or dispensing general practitioner. Transferred chemist's preparations are chemist's preparations that are transferred to another pharmacy. The reimbursement of certain chemist's preparations, designated by us, is subject to our written authorisation before you receive the care. The chemist's preparations for which authorisation is required are listed in the overview Reimbursement for chemist's preparations. This overview can be viewed and downloaded at www.hollandzorg.com/conditions.
When applying for care you will need to send us a copy of the prescription and a report from the attending physician including the medical diagnosis/diagnoses, a description of the current problem and the proposed treatment plan.
Yes, if the medicine is classified into a group of interchangeable medicines and the purchase price is higher than the reimbursement limit. A statutory personal contribution is also due when a medicine is prepared from a medicine for which a statutory personal contribution is due. The Healthcare Insurance Regulations (Regeling zorgverzekering) stipulate how the personal contribution is calculated. In the year 2025, the extent of your statutory personal contribution will be a maximum of €250 per calendar year. If your public healthcare insurance does not commence or end on 1 January of a calendar year, the compulsory contribution for your public healthcare insurance for that calendar year is set lower, in proportion to the number of days insured. The calculated amount is rounded off to whole Euros.
Example: your public healthcare insurance comes into force on 15 June. In that case, the statutory personal contribution for the remainder of the calendar year is € 136.98. The calculation is (€ 250 : 365 days) x 200 days. This amount is rounded to € 137.
Yes, from 18 years and older with the exception of the following cases.
No compulsory excess applies to contraceptives and the dispensing thereof as referred to in appendix 2 of the Health Insurance Regulations. Nor does compulsory excess exist for a medication assessment, as included in and under the conditions of the overview 'Designated care not subject to excess'. The up-to-date overview can be viewed and downloaded at www.hollandzorg.com/conditions.
No compulsory excess applies to preferred medicines allocated by us as included in and under the conditions of the overview 'Designated care not subject to excess'. The delivery costs, the counselling consultation for a preference medicine and inhaler instructions do fall under the compulsory excess.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to general practitioner care. General practitioner care is care such as general practitioners generally provide. This does not include tests that the general practitioner has asked others to perform and that are charged separately, such as laboratory tests.
General practitioners are entitled to provide this type of care.
No
No. The costs of medicines or (laboratory) testing in a hospital or an independent laboratory at the request of the general practitioner do count towards the compulsory excess.
You are entitled to integrated care. Integrated care means that a group of care providers works together surrounding a specific condition, in which your general practitioner remains your point of contact. Integrated care is available to people aged 18 and older suffering from Diabetes Mellitus type 2, COPD, asthma or with an increased risk of cardiovascular disease.
The following care providers are permitted to provide this type of care:
a contracted care group. Contracted care groups are listed at hollandzorg.z-zoeker.nl. You can also contact our Customer Service on +31 (0)570 687 123.
a care provider appointed by us for providing general practitioner care, preventive foot care and dietetic care, each for the relevant part of the integrated care.
Yes, from a general practitioner or a medical specialist for those parts of the integrated care not provided by the general practitioner himself.
No
No. The compulsory excess does include the costs of any (laboratory) testing in a hospital or independent laboratory at the request of a general practitioner.
You are entitled to medical aids (care in kind). Medical aids concerns functioning aids and dressings designated in the Medical Devices Regulations (Reglement Hulpmiddelen). The regulations also stipulate the scope of the care and whether you become the owner of the medical aids or are given them on loan. Other conditions for the right to care and the use of the medical aids are also contained in the regulations. You can view and download the Medical Aids Regulations at www.hollandzorg.com/conditions.
The cover for medical aids does not include:
The Medical Devices Regulations (Reglement hulpmiddelen) set out in which cases you need our written authorisation before you receive the care, and which conditions the request must meet.
Yes, for some aids. The personal contribution is set out in the Medical Aids Regulation. Some medical aids are subject to a statutory maximum reimbursement. The personal contribution also includes the costs that exceed that maximum reimbursement and which therefore remain payable by you.
Yes, from 18 years and older. This does not apply to aids that you receive on loan. The consumables or usage costs associated with the loaned aids are covered by the excess.
If the medical aids are available from a contracted care provider in time, but you buy or hire the medical aid or dressing from a non-contracted care provider, the reimbursement is subject to a maximum. In that case, we will reimburse up to a maximum of 75% of the costs we would incur if you would have received the care from a contracted care provider. In that case, we also reimburse a maximum of 75% of any repair costs in connection with the medical aid.
The costs of a medical aid that we would normally give on loan are in that case reimbursed per calendar year. In that case, we will reimburse a maximum of 75% of the costs. The reimbursement is in proportion to the number of days you are entitled to that care and actually have the medical aid at your disposal in that calendar year. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to oral care. Oral care is care such as dentists generally provide.
You are entitled to oral care if:
If the insured party is younger than 18, the insured party, in addition to all-ages oral care, is also entitled to:
If you are aged 18 or older, you are, in addition to all-age oral care, entitled to:
If you are younger than 23 and the care does not fall under the heading of 'Dental care for all ages', you are entitled to dental replacement care involving non-plastic materials and the fitting of dental implants. This only applies if this serves to replace one or more permanent incisors or canines which were either never developed or missing as a direct result of an accident. This is subject to the condition that the necessity of the care is established before you reached the age of 18.
A number of forms of oral care are subject to our written authorisation before you receive the care. They are:
Most oral care providers are registered with the national Authorisation Portal. Your oral care provider can request digital authorisation via this portal. Your oral care provider will receive an answer from us to your request via the Authorisation Portal.
If you visit an oral care provider who is not registered with the Authorisation Portal or if you go abroad for treatment, you must request and obtain authorisation from us to be entitled to care before the start of treatment. Requests for care must be accompanied by a written, substantiated treatment plan stating the medical diagnosis/diagnoses and the performance codes, plus X-rays and any models made of the teeth.
Yes, in the following cases:
Yes, in the following cases:
Yes, from 18 years and older.
No, unless the invoice exceeds the competitive Dutch rate. An exception to this is care provided by a dental surgeon. Do you wish to use the care from a dental surgeon in a hospital or an independent treatment centre (ZBC) with which we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. We apply a maximum reimbursement for dental surgery provided by a non-contracted hospital or ZBC. The maximum reimbursements can be found on the rates lists for non-contracted care on our website, under medical specialist care. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to orthodontics if you have a serious development or growth disorder of the dental and oral system. Orthodontia is care of an orthodontic nature such as dentists generally provide. The treatment must be necessary in order for you to retain or acquire dental function equal to that if the disorder had not been present. The disorder or deformation must be of such a nature that additional diagnosis or additional treatment under surgical dental care of a specialist nature or from disciplines other than oral care (multidisciplinary treatment) is required.
An orthodontist, whether or not affiliated to a centre for special dentistry, is permitted to provide this type of care.
Yes, from a general practitioner, dentist, dental surgeon or orthodontist.
You must obtain our written authorisation, prior to you receiving the care.
Most oral care providers are registered with the national Authorisation Portal. Your oral care provider can request digital authorisation via this portal. Your oral care provider will receive an answer from us to your request via the Authorisation Portal.
If you visit an oral care provider who is not registered with the Authorisation Portal or if you go abroad for treatment, you must request and obtain authorisation from us to be entitled to care before the start of treatment. Requests for care must be accompanied by a written, substantiated treatment plan stating the medical diagnosis/diagnoses and the performance codes, plus X-rays and any models made of the teeth.
No
Yes, from 18 years and older.
No, unless the invoice exceeds the competitive Dutch rate.
You are entitled to medical care for specific groups of patients (GZSP). This is general medical care for specific patient groups under or pursuant to the Healthcare Insurance Act (Zorgverzekeringswet).
This concerns care for vulnerable groups living at home, for example vulnerable elderly people, people with chronically progressive degenerative diseases, people with non-congenital brain damage and people with a mental impairment aged 18 and older.
This can involve diagnostics, consultations, specific consultation with your attending physician and implementation or management of the treatment plan. This care focuses on improving independent living, preventing the limitations from worsening and learning to live with the (progressive) limitations.
You are not eligible for this type of care if you have a Wlz indication or if you qualify for one.
This medical care for specific patient groups does not include care that is part of other types of care such as first-line in-patient stays and geriatric rehabilitation care.
The care provider must provide the care in accordance with the GZSP Principles. You can view and download these principles at www.hollandzorg.com/conditions.
Yes, from a general practitioner or medical specialist.
No
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to other medical care (e.g. GP care). Other medical (GP) care includes:
Other medical (GP) care does not cover preventive foot care. The cover for this is set out elsewhere in these policy conditions.
The following care providers are permitted to provide this type of care:
Yes, from a general practitioner, medical specialist, nursing specialist or physician.
No
No
You are entitled to preventive foot care as generally provided by general practitioners or medical specialists if you have an increased risk of developing wounds that penetrate all layers of the skin (foot ulcers) due to loss of protective sensitivity of the feet, reduced blood circulation in the feet, fragile skin or increased pressure on the skin due to illness or medical treatment, if you have a history of foot ulcers or amputation, an inactive Charcot foot or if you are in end-stage renal failure (eGFR < 15 ml/min) or if you are receiving kidney dialysis.
The preventive foot care includes the total package of examinations and treatments as laid down in the Position on foot care for diabetes mellitus and the Memorandum clarifying the position on foot care for people with diabetes mellitus of Zorginstituut Nederland, and as laid down in care profiles 1 to 4 in the 2019 Prevention of Diabetic Foot Ulcers Care Module. An individual treatment plan determines the number of treatments you will receive.
When your feet are examined, the Sims classification is used in order to express the risk of the feet being affected. Foot care is subdivided into the care profiles according to the Sims classification and several other factors. Your general practitioner or podiatrist determines your care profile. The preventive foot care comprises:
Please note: Treatments for cosmetic or nurturing reasons only, such as removing calluses and clipping toenails, are not covered under preventive foot care.
Preventive foot care can be part of integrated care or medical specialist care (general). The conditions for the right to integrated care or medical specialist care (general) are set out in the article on these forms of care. You are not entitled to preventive foot care on the grounds of this article if you already receive preventive foot care on the grounds of the article on integrated care or (general) medical specialised care.
The following care providers are permitted to provide this type of care:
For Sims classification 1 (care profile 1):
For Sims classifications 2 and 3 (care profiles 2 to 4):
A chiropodist may independently perform the annual foot examination for Sims classification 1 (care profile 1). A chiropodist may provide care for Sims classifications 2 and 3 (care profile 2 and higher) if requested by the podiatrist or registered podologist. In that case, the podiatrist or registered podologist acts as the medical specialist who is ultimately responsible and the podiatrist or registered podologist will invoice the care.
Yes, for preventive foot care by a chiropodist, podiatrist or registered podologist, you must have a referral from a general practitioner, medical specialist, nursing specialist or physician assistant. If a non-contracted care provider provides the care, you must include a copy of the referral when you submit the first invoice.
No
No
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. We apply a maximum reimbursement for preventive foot care provided by a non-contracted podiatrist and a non-contracted registered podologist. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to reimbursement of the costs of physiotherapy and remedial therapy. Physiotherapy is care such as physiotherapists generally provide. Remedial therapy is care such as remedial therapists generally provide. The conditions that you must meet in order to be eligible for the reimbursement are set out below.
If you are 18 or older, you are entitled to a reimbursement of the costs of:
long-term, active remedial therapy tailored to your situation under the supervision of a physiotherapist or remedial therapist if you have rheumatoid arthritis with severe functional restrictions or axial spondyloarthritis with severe functional restrictions.
If the insured party is younger than 18, the insured party is entitled to reimbursement of the costs of:
The insured party is only entitled to reimbursement of the costs of children's physiotherapy and children's remedial therapy if the insured party is younger than 18. The List of chronic disorders for physiotherapy and remedial therapy can be viewed at www.hollandzorg.com/conditions.
The following care providers are permitted to provide this type of care:
Please note: manual therapy treatment E.S. (Egg Shell) / Van der Bijl method and orthomanual medicine are not covered under physiotherapy and remedial therapy. These treatments may be covered under alternative treatments.
Yes, from a general practitioner, medical specialist, paediatrician, doctor for the mentally disabled, specialist geriatrics doctor, company doctor, dentist, nursing specialist, physician assistant or a coordinating practitioner within the framework of medical care for specific groups of patients (GZSP):
If you go to a non-contracted care provider, you must include a copy of the referral when you submit the first invoice.
No
Yes, from 18 years and older. With the exception of the compulsory excess for remedial therapy under the supervision of a physiotherapist or remedial therapist in the event of osteoarthritis in your hip or knee joint and walking therapy under the supervision of a physiotherapist or remedial therapist for peripheral arterial disease in Fontaine stage 2 (intermittent claudication), as included in and under the conditions of the overview Designated care not subject to a compulsory excess. The up-to-date overview form can be viewed and downloaded at www.hollandzorg.com/conditions.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to a reimbursement of the costs of occupational therapy such as occupational therapists generally provide, subject to a maximum of ten hours of treatment per year. Occupational therapy helps you improve your self-reliance and self-care.
You will receive advice, instructions, training or treatment to be able to perform general daily or work-related activities again and to function as independently as possible in your private or working situation. The care further includes conditionally permitted physiotherapy as referred to in Article 2.2 of the Healthcare Insurance Regulations under the associated conditions, insofar as it concerns responsible care. The current content can be found on the 'List of conditional care' at www.hollandzorg.com/conditions.
The following care providers are permitted to provide this type of care:
No
Yes, from 18 years and older.
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to dietetic care such as dieticians generally provide, subject to a maximum of 3 hours of treatment per year. You can go to a dietician for information about nutrition and eating habits, provided this serves a medical purpose.
You are not entitled to dietetic care if you already receive this care within the framework of integrated care or combined lifestyle intervention for the same condition, without an additional need for care based on a separate, specific indication.
The following care providers are permitted to provide this type of care:
No
No
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to reimbursement of the costs of speech therapy. Speech therapy is care such as speech therapists generally provide. The care must serve a medical purpose and the treatment must be expected to restore or improve speech function or the ability to speak. The care further includes stutter therapy.
This type of care does not include:
The following care providers are permitted to provide this type of care:
No
No
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to a combined lifestyle intervention (GLI) if you are 18 or older and there is a moderately increased weight-related health risk (GGR) in accordance with the indication criteria in the guidelines on overweight and obesity in adults and children. The reimbursement for a GLI for insured parties up to the age of 18 can be found under the heading Chain Approach care and support for overweight and obese minors.
The GLI is a tailor-made care programme and consists of a combination of interventions aimed at healthy eating, increased physical activity and, if necessary, psychological help in support of a behavioural change. The care programme consists of individual sessions and sessions offered in groups and distinguishes between a treatment phase and a maintenance phase. The care programme lasts 24 consecutive months (2 years).
You are entitled to the care programmes on the list of Designated care programmes of GLI for adults. This list may change in the interim. An up-to-date version can be found at www.hollandzorg.com/conditions.
The following care providers are permitted to provide this type of care:
Yes, from a general practitioner or medical specialist.
No
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
The insured party is entitled to care and support in the case of obesity if the insured party is younger than 18 and there is at least a moderately increased weight-related health risk (GGR) in accordance with the indication criteria in the Obesity guideline and obesity in adults and children of the Partnerschap Overgewicht Nederland (PON). The care and support in the case of obesity consist of:
The GLI for children is a tailor-made care programme, focused on a healthy diet, more exercise and, if necessary, psychological help in support of a behavioural change. The care programme consists of individual sessions and has a treatment phase and a maintenance phase. The care programme lasts 24 consecutive months (2 years).
The insured party entitled to the care programmes on the list of Designated care programmes of GLI for children. This list may change in the interim. The current content can be found at www.hollandzorg.com/conditions.
The following care providers are permitted to provide this type of care:
Comprehensive case history and guidance and coordination by the central care provider:
GLI for children:
Yes, from a general practitioner, youth doctor or medical specialist
No
No
You are entitled to fall prevention if you have a high risk of falling based on a fall risk assessment. Fall prevention consists of the following components:
The following care providers are permitted to provide this type of care:
Yes, a referral from a general practitioner is required for the intake for a training programme to prevent falls and the training programme itself.
No
No
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. We have a maximum reimbursement for the intake for a training programme to prevent falls and for the training programme itself by a non-contracted physiotherapist or remedial therapist The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to follow a programme to give up smoking. This comprises a medical care programme, possibly in combination with nicotine-replacement therapy (including medicines), aimed at a change in behaviour with the objective of giving up smoking. You are only entitled to nicotine- replacement therapy (including medicines) relating to giving up smoking if they form part of the programme. The care is limited to 3 programmes per calendar year. You are not entitled to a giving up smoking programme, if you receive counselling to stop smoking as part of integrated care, unless you need counselling that is more intensive than agreed within the integrated care.
The following care providers are permitted to provide this type of care:
No
The costs of the Stop Smoking programme are listed in the overview Designated care not subject to excess. The costs therefore do not count towards the compulsory excess.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The rates list can be viewed and downloaded at www.hollandzorg.com/insured/customer-services/rate-lists2026, under medical specialist care.
You are entitled to geriatric rehabilitation care plus the required admission. Geriatric rehabilitation includes integrated and multidisciplinary rehabilitation care provided by specialists in geriatric medicine. The care is intended for vulnerable elderly people who are dealing with complex problems due to various conditions (multi-morbidity). The aim of care is to restore or improve your functional restrictions and your participation in society.
You are only entitled to care if geriatric rehabilitation care does not correspond to a stay with treatment in a nursing home under the Long-Term Care Act.
Rehabilitation centres and institutions for geriatric rehabilitation care can provide this type of care and offer admission. The care must be provided under the final responsibility of a specialist geriatrics doctor (practitioner in charge).
For the right to rehabilitation care for a period longer than 6 months, you will need to have our written authorisation before the period of 6 months has elapsed. When applying for this type of care, you must enclose the following details: the reason why it is not possible to return home and the treatment plan for further treatment, including the prognosis for recuperation and a return to the home situation and the expected duration of the further treatment.
Yes, from a medical specialist or specialist geriatrics doctor.
No
Yes, from 18 years or older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The rates list can be viewed and downloaded at www.hollandzorg.com/insured/customer-services/rate-lists2026, under medical specialist care.
You are entitled to rehabilitation care plus the required admission. Rehabilitation means having to learn to live with a disability after an accident or illness. This involves examinations, advice and treatment. A multidisciplinary team of experts, under the management of a rehabilitation specialist, provides this type of care. You must need the care in order to prevent, reduce or overcome a handicap. The disability must be due to a musculoskeletal disorder, neurological disorder or another illness associated with problems moving your spine, body or limbs; or non-congenital brain damage with problems moving, thinking, speech or swallowing problems or a combination thereof.
Hospitals and rehabilitation centres can provide this type of care and offer admission. The care must be provided under the final responsibility of a rehabilitation specialist (practitioner in charge).
For rehabilitation care provided by a non-contracted care provider plus the required admission you need our written authorisation before you can receive the care. When applying for care you will need to send us (a copy of) a report from the attending physician with the medical diagnosis/diagnoses, a description of the current problems and the proposed treatment plan (care activity).
Yes, from a general practitioner, medical specialist, clinical technologist, paediatrician, doctor for the mentally disabled, sports doctor, geriatrics specialist or company doctor.
No
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The rates list can be viewed and downloaded at www.hollandzorg.com/insured/customer-services/rate-lists2026, under medical specialist care.
You are entitled to a second opinion. If you are in doubt about a diagnosis or treatment, you can ask for a second opinion from another independent medical specialist working in the same field. You must present the second opinion to the original care provider, who remains in control of your treatment.
Yes, from your general practitioner or attending physician. The referral will remain valid for a period of 12 months from the day it was issued.
You are entitled to first-line in-patient stays. A first-line in-patient stay involves a short-term stay for which there is a medical need in connection with medical care such as general practitioners provide. First-line in-patient stays are aimed at recovery and a return to the home situation in the short term. This can also concern palliative terminal care (care in the last phase of life).
The care does not include:
An institution for first-line in-patient stay can provide this type of care.
Yes, from a general practitioner or medical specialist.
If you wish to be admitted to an institution we do not have a contract with, your (extended) stay is subject to our prior written authorisation.
Is there a statutory personal contribution?
No
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to nursing without in-patient care if the care is related to your need for medical care as referred to in Article 2.4 of the Health Insurance Decree (Besluit zorgverzekering) or if you have a high risk of needing such care. If you need nursing and care at home, you can contact the district nurse.
Nursing without in-patient care involves care such as nurses generally provide.
The care consists of nursing (provision of care), as well as indicating, coordinating, identifying, coaching and prevention.
The care does not include:
These care providers may provide the indicated care, except for case management for dementia care:
If you receive care from a care provider contracted by us, the indicated care, except for case management for dementia care, may also be provided by:
These care providers may carry out case management for dementia care:
Receiving the care is subject to our written authorisation in the following cases:
No
No
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026.
Instead of the right to care, you may qualify for a personal budget. In that case, you will receive an amount to purchase the care and nursing yourself. The right to a personal budget is subject to special conditions. They are defined in the Healthcare Insurance Personal Budget Regulations. You can view and download the Healthcare Insurance Personal Budget Regulations at www.hollandzorg.com/conditions. If the costs you incur for nursing and care are higher than the reimbursement in the form of a personal budget, the difference between the costs and the personal budget will be payable by you.
You are entitled to ambulance transport. Ambulance transport is patient transport by ambulance over a distance of no more than 200 kilometres.
transport to a care provider for treatment which is (partially) charged to your public healthcare insurance.
transport to an institution where you are staying and (partly) paid for under the Long-term Care Act (Wlz institution).
transport to receive mental health care that falls under the Youth Act.
transport from a Wlz institution, to:
transport from one of the care providers as referred to under a. to d. back to your home or to another home, if you cannot reasonably receive the necessary care in your own home.
PLEASE NOTE! Transport over a distance of more than 200 kilometres only falls under ambulance transport if we have given our written authorisation prior to the transport.
PLEASE NOTE! Transport by a means of transport other than an ambulance can also fall under ambulance transport, if transport by ambulance is not possible and we have given our prior written authorisation for transport by a different mode of transport, to be designated by us.
An ambulance service provider with a recognized license is authorized to provide care.
You need a prescription from a general practitioner, medical specialist, doctor for the mentally disabled, specialist geriatrics doctor, physician assistant, nursing specialist or obstetrician. This condition does not apply in the case of unforeseen care that cannot reasonably be postponed (emergency care).
In 2 cases, the ambulance transport is subject to our written authorisation before you are transported. They are:
Authorisation is not required in the case of unforeseen care that cannot reasonably be postponed (emergency).
When submitting the request for transport, you must include a report from the attending physician stating the medical diagnosis/diagnoses, a description of the current problem and a substantiation of the request.
No
Yes, from 18 years and older.
You are entitled to patient transport. Patient transport is transport by (private) car, taxi (not an ambulance) or public transport, over a single travel distance of no more than 200 kilometres.
The transport consists of:
transport to a care provider for treatment which is (partially) charged to your public healthcare insurance.
transport to an institution where you are staying and (partly) paid for under the Long-term Care Act (Wlz institution).
transport from a Wlz institution, to:
transport from one of the care providers as referred to under a. to c. back to your home or to another home, if you cannot reasonably receive the necessary care in your own home.
This is subject to one of the following reasons:
The reimbursement for patient transport by car (private transport) is € 0.40 per kilometre. We calculate the number of kilometres based on the fastest route (assuming the absence of delays) according to the ANWB route planner on internet (www.anwb.nl/verkeer/routeplanner) by entering the departure postal code and the destination postal code. The reimbursement for the use of public transport only applies to the lowest class of public transport.
You are also entitled to patient transport if you rely on transport for a prolonged period of time in connection with the treatment of a long-term illness or disorder and for consultations, examinations and check-ups needed as part of the treatment and denying the reimbursement of that transport would be extremely unreasonable towards you.
We use various data in order to determine if you are nevertheless entitled to reimbursement of transport. To that end, we use the following formula: (the number of weeks the treatment takes) x (the number of times per week you need transport for the treatment) x (the single travel distance in kilometres for transport to the care provider) x 0.25. If the sum of this calculation is 250 or higher, you are entitled to patient transport.
Example: for a period of 12 weeks you need to visit the hospital 3 times a week for treatment, which is 40 kilometers from your place of residence. In that case, the calculation is 12 x 3 x 40 x 0.25 = 360. This is higher than 250. In this case, you are entitled to patient transport.
Patient transport also includes the transport of a companion. It must be medically necessary for the insured party to have a companion, or the insured party must be under the age of sixteen. In special cases, we can give our written authorisation for the transport of 2 companions.
Transport by a mode of transport other than a car or public transport may also fall under patient transport. This is the case if transport by car or public transport is not possible and we have given our written authorisation for transport by a different mode of transport, designated by us.
Transport over a distance of more than 200 kilometers falls under patient transport as well, provided we have given our written authorisation prior to the transport.
You are entitled to reimbursement of accommodation costs (stays) instead of (a reimbursement of the costs of) patient transport:
In that case, you qualify for transport to and from the treatment centre (to and from your home) and reimbursement of the costs of 2 overnight stays near the treatment centre. The reimbursement of accommodation costs is a maximum of € 94.50 per night. You must book the accommodation yourself. Any transport from your accommodation address to the treatment location and back to your accommodation address will not be reimbursed.
For patient transport with your (own) car, you can use your own car or that of someone else. For patient transport by taxi, you can use a taxi operator. For patient transport by public transport, you can use a public transport company.
Yes, from a general practitioner or medical specialist.
Ambulance transport is subject to our written authorisation prior to the transport. In doing so, we determine whether you are entitled to patient transport by (private) car, by public transport or by taxi. You also need our prior written authorisation for the reimbursement of accommodation costs. When requesting transport or accommodation, you must give the reason for your request and enclose the prescription. You can view and download the application form for patient transport at www.hollandzorg.com/forms.
Yes, a maximum of € 134 per calendar year. The statutory personal contribution does not apply:
The statutory personal contribution does apply to the return trip to the treatment centre if you use accommodation.
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
You are entitled to medical specialist care (general) plus the required admission. Specialist medical cares such as medical specialists generally provide. Most medical specialists are affiliated to a hospital.
Medical specialist care includes:
Medical specialist care does not include:
Please note: Cover provided by medical specialist care (general) does not include care for which is provided elsewhere in these policy conditions, such as transplant care or rehabilitation care.
You are entitled to reimbursement of the costs of stays near the institution for your treatment if this is medically necessary in connection with medical specialist care, not involving nursing or (paramedical) care. However, some conditions apply, i.e.:
The reimbursement of the accommodation costs is a maximum of € 94.50 per night. You arrange the stay yourself.
Plastic surgery only falls under medical specialist care if it concerns:
Medical specialist care does not include:
Hospitals, medical specialists or dental surgeons who work outside a hospital and independent treatment centres can provide this type of care. Hospitals and independent treatment centres are authorised to offer admission. If you are staying outside the institution, you may determine your place of accommodation.
To be reimbursed for treatments on the Pre-Authorisation List and the Exhaustive List of Authorisations for Dental Surgery, you must have received written authorisation from us before receiving the care. These lists can be viewed and downloaded at www.hollandzorg.com/conditions.
Your medical specialist knows for which treatments authorisation must be requested and which conditions you must meet for authorisation. Most hospitals are registered with the national Authorisation Portal. Your medical specialist can request digital authorisation via this portal. Your medical specialist will receive an answer from us to your request via the Authorisation Portal. If you visit a medical specialist who is not registered with the Authorisation Portal or if you travel abroad for treatment, you must request and obtain authorisation from us to be entitled to reimbursement before the start of treatment. When applying for care, you must include a report from the attending physician, including the medical diagnosis/diagnoses, a description of the problem, the proposed treatment plan (care activity), the medical need for admission and, if applicable, relevant photographs.
Yes, from a general practitioner, medical specialist, clinical technologist, house officer, obstetrician, paediatrician, doctor for the mentally disabled, specialist geriatrics doctor, infectious disease and tuberculosis prevention doctor, A&E doctor, physician assistant, nursing specialist, sports doctor, clinical physicist-audiologist, company doctor, dental hygienist, dentist, dental surgeon, optometrist, forensic doctor, addiction specialist, orthoptist or triage hearing specialist.
No referral is needed in the case of unforeseen care that cannot reasonably be postponed (emergency care). The referral will remain valid for a period of 12 months from the day it was issued.
No.
Yes, from 18 years and older. The costs of a collegial consultation and collegial advice do not count towards the compulsory excess.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The rates list can be viewed and downloaded at www.hollandzorg.com/insured/customer-services/rate-lists2026, under medical specialist care.
You are entitled to audiological care. Audiological care consists of:
Audiological centres can provide this type of care.
Yes, from a general practitioner, medical specialist, clinical technologist, paediatrician, doctor for the mentally disabled, geriatrics specialist or triage hearing specialist. The referral will remain valid for a period of 12 months from the day it was issued.
No
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The rates list can be viewed and downloaded at www.hollandzorg.com/insured/customer-services/rate-lists2026, under medical specialist care.
You are entitled to reimbursement of the costs of dialysis care. Dialysis is an artificial way of removing excess waste and fluid from the body when the kidneys are not working properly. Dialysis care comprises non-clinical blood dialysis (haemodialysis) and abdominal irrigation (peritoneal dialysis). The dialysis care can take place in a dialysis centre or at home.
You are entitled to reimbursement of the costs of:
You are further entitled to reimbursement of:
The care must be provided under the final responsibility of a medical specialist.
Yes, from a medical specialist or clinical technologist.
No
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The rates list can be viewed and downloaded at www.hollandzorg.com/insured/customer-services/rate-lists2026, under medical specialist care.
You are entitled to genetic advice plus the required admission.
Sometimes your family can have a predisposition to a hereditary disease. This can be investigated. Genetic advice consists of:
A centre for genetic advice can provide this type of care and offer admission.
Yes, from a general practitioner, medical specialist, clinical technologist, doctor for the mentally disabled or geriatrics specialist. The referral will remain valid for a period of 12 months from the day it was issued.
No
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The rates list can be viewed and downloaded at www.hollandzorg.com/insured/customer-services/rate-lists2026, under medical specialist care.
You are entitled to the first, second and third IVF attempt or ICSI treatment and associated medication if you are under 43 at the start of the attempt and there are medical grounds to do so. If you are under 38, you are entitled to a maximum of 1 embryo transfer on the first and second attempt.
IVF is short for in vitro fertilisation. IVF treatment consists of:
ICSI treatment is a special form of IVF treatment. ICSI stands for 'intracytoplasmic sperm injection'.
ICSI treatment involves an extra step in the laboratory. An IVF attempt only counts as an attempt if a follicle puncture has been successful, regardless of the quality (e.g. ripe or immature) or the number of eggs obtained during the puncture. Only attempts that are subsequently abandoned count towards the total number of 3 attempts. An IVF attempt after a viable pregnancy counts as a new, first attempt. This also applies if the pregnancy was terminated prematurely. In that respect, an ICSI attempt is equivalent to an IVF attempt.
Within the meaning of this document, a viable pregnancy is:
An IVF centre can provide this type of care.
Yes, from a general practitioner or medical specialist.
No
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on our website. The rates list can be viewed and downloaded at www.hollandzorg.com/insured/customer- services/rate-lists2025, under medical specialist care.
It is possible that your IVF or ICSI treatment and associated medication will not be fully reimbursed if you choose to have this done abroad. That is why we advise you to contact us before you start the treatment process and enquire about the amount of the reimbursement for the planned process.
This way, you will not be faced with financial surprises. If admission is part of the care, you will require our written authorisation before you receive the care.
You are entitled to artificial respiration plus the required admission. This can be at a respiratory centre or at home, on the advice and under the responsibility of a respiratory centre.
Yes, from a general practitioner, medical specialist or clinical technologist.
No
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The rates list can be viewed and downloaded at www.hollandzorg.com/insured/customer-services/rate-lists2026, under medical specialist care.
You are entitled to transplant care plus the required admission. This applies to transplants of tissues and organs in the Netherlands.
Going abroad? In that case, you are only entitled to reimbursement of the costs of transplant care if the transplant care takes place in another EU or EEA country. Or in the country where the donor lives if the donor is your spouse, registered partner or blood relative in the first, second or third degree.
People with a malfunctioning or non-functioning organ may be eligible for a transplant.
The person who receives the organ or tissue is the recipient. The person who donates the organ or tissue is the donor.
As the recipient, you are entitled to reimbursement of the following costs of transplant care:
If someone else by virtue of health insurance is entitled to (reimbursement of the costs of) transplant care and you are the donor, you are entitled to reimbursement of:
A transplant centre can provide this type of care and offer admission.
Yes, from a medical specialist or clinical technologist. This condition does not apply in the case of unforeseen care that cannot reasonably be postponed (emergency).
No
Yes, from 18 years and older.
No
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The rates list can be viewed and downloaded at www.hollandzorg.com/insured/customer-services/rate-lists2026, under medical specialist care.
You are entitled to thrombosis care. People taking anticoagulant drugs will receive counselling and have their blood levels checked on a regular basis.
Thrombosis care consists of:
Thrombosis services can provide this type of care.
Yes, from a general practitioner, medical specialist, clinical technologist, doctor for the mentally disabled, geriatrics specialist or obstetrician.
No
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The rates list can be viewed and downloaded at www.hollandzorg.com/insured/customer-services/rate-lists2026, under medical specialist care.
You are entitled to sensory disability care plus the required admission. You are eligible if you are visually impaired, blind, hard of hearing and/or deaf or have a serious speech-language development disorder. This concerns multidisciplinary care aimed at learning to live with, the elimination of or the compensation of impairment, with the objective of allowing you to live as independently as possible. Multidisciplinary care means that different disciplines are involved in the treatment.
The care consists of:
Conditions for entitlement to care in the event of serious speech and linguistic difficulties are:
You are not over the age of 22 years.
You suffer from serious difficulty in acquiring your native language due to neurobiological and/or neuropsychological factors. Other (psychiatric, physiological, neurological) issues need to be subordinate to the language development disorder.
A centre for sensory disability care can provide this type of care and offer admission.
Admission for sensory disability care by a non-contracted care provider is subject to our written authorisation, prior to you being admitted. You must enclose a (copy of the) treatment plan with your application.
Yes, from a medical specialist or clinical physicist-audiologist. You must have a second or subsequent referral from a medical specialist, clinical physicist-audiologist, paediatrician or general practitioner.
A second or subsequent referral is not required if you have a visual impairment and meet the following conditions:
A second or subsequent referral is also not necessary if the insured party is younger than 18 years of age and has a new need for care that is the result of a predictable treatment need due to the insured party growing up.
No
Yes, from 18 years and older.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
The following apply for the Supplementary insurances Compact, Start, Extra, Plus:
The supplementary insurance is further based on the information provided by you (policyholder) during your application for supplementary insurance and on agreements in connection with any group scheme you participate in.
The following acceptance conditions apply to taking out supplementary insurance:
Example: Parent/guardian A has taken out Start dental insurance and parent/guardian B Plus dental insurance. In that case, the minor child for whom you take out dental insurance will automatically receive the same cover as parent/guardian B.
We reserve the right to refuse the provision of supplementary insurance for other reasons.
If you (policyholder) apply to take out supplementary health insurance simultaneously with a request to take out public healthcare insurance for the same person, that supplementary insurance comes into force on the same day that the public healthcare insurance for that person commences. In all other cases, the supplementary insurance commences on 1 January of the following year.
If you (policyholder) submit a request to take out supplementary insurance for someone, we assume that by doing so, you have authorised us to terminate the supplementary healthcare insurance that person has with a previous health insurer. If you do not want this, you must notify us thereof in writing when making the application.
You (policyholder) can change the supplementary insurance of an insured party with effect from 1 January of the year. We must receive your request for a change no later than 31 January of that year. So you can change the supplementary insurance for the year 2026 up to and including 31 January 2026.
Has your supplementary insurance changed to a supplementary insurance with less extensive cover? Did you receive a reimbursement for healthcare expenses incurred in January on the basis of the previous supplementary insurance (with more extensive cover)? In that case, we will recover the over-reimbursed healthcare expenses from you (insured party/policyholder) or offset these healthcare expenses against amounts to be reimbursed to you (insured party/policyholder).
Has your supplementary insurance changed to a supplementary insurance with more extensive cover? Did you receive a rejection for healthcare expenses incurred in January on the basis of the previous supplementary insurance (with less extensive cover)? In that case, you can resubmit the claim forms and we will assess them again.
You (policyholder) can make the request for change in one of the following ways:
NOTE: a verbal request or a request via social media is not accepted.
Otherwise, the same conditions apply to modifications to the supplementary insurance and dental insurance as for taking out the supplementary insurance. This means that the supplementary insurance and/or dental insurance of your minor child(ren) automatically changes if the supplementary insurance and/or dental insurance of the parents/guardians insured by you (policyholder) changes.
You (policyholder) must pay us premiums, except in the following cases:
For supplementary insurance and/or dental insurance for an insured party up to the age of 18, you (policyholder) do not have to pay a premium until the 1st day of the month following the month in which the insured party turns 18. This means that this insured party must have a parent/guardian insured by you (policyholder) with supplementary insurance and/or dental insurance with the same premium calculation basis.
Example: The insured party turns 18 on 10 September. In that case, you start paying premiums for the health insurance from 1 October of that year.
during the period that the cover of the supplementary insurance is suspended (temporarily discontinued) due to the insured party's detention, you (policyholder) do not have to pay premium.
The content and scope of the care are partially determined by the state of the art and practice. If there is no such benchmark, it is determined by that which is regarded as responsible and adequate care in the discipline in question.
You are only entitled to reimbursement of the costs of care if:
Your care provider must provide care in accordance with the professional standard and the quality standards as referred to in the Healthcare Quality, Complaints and Disputes Act (Wet kwaliteit, klachten en geschillen zorg (Wkkgz)). Has a guideline, care standard or quality standard been established for the care? Then you are entitled to (reimbursement of costs of) the care, if the care was provided in accordance with that standard.
The current quality standards can be viewed and downloaded at www.zorginzicht.nl/kwaliteitsinstrumenten.
Does your care provider deviate from the guideline, care standard or quality standard? You are still entitled to (reimbursement of costs of) the care if your care provider demonstrates that a deviation from this is medically necessary in your case and your care provider motivates this in your medical file.
You are not entitled to a higher level of reimbursement of the cost of care exceeding the actual cost paid for that care.
You may only receive the care from a care provider designated by us. Which care providers may deliver the care is specified for each type of care. You are entitled to reimbursement of the costs of care provided by a care provider not appointed by us, provided we have given our written authorisation before you receive the care.
For some forms of care, we set a maximum rate per session or treatment from a non-contracted care provider. The maximum rates do not apply to care from contracted care providers. The care providers contracted by us can be found at hollandzorg.z-zoeker.nl.
In some cases, the agreement between us and the care provider ends the moment you receive care from that care provider. In that case, you are entitled to reimbursement of the costs of the remaining care to be provided by this care provider as if the contract still existed.
If you have to pay VAT on that care, the reimbursement also covers those costs.
It is possible that a waiting period applies to entitlement to reimbursement or entitlement to care. During that period, you are insured, but you cannot claim yet. If a waiting period applies, we will state this with the care form in question.
You are not entitled to reimbursement of the costs of care:
You are not entitled to reimbursement of the costs of search, rescue and recovery.
You are not entitled to reimbursement of the costs of care if the harm is caused by, occurred during or ensues from a nuclear reaction. This exclusion does not apply to harm caused by radioactive nuclides which are located outside a nuclear facility and are used or intended for use for industrial, commercial, agricultural, medical, scientific or security purposes. The above is subject to a valid permit having been issued by the central government for the manufacture, use, storage and disposal of radioactive substances. The provisions of the previous 3 sentences do not apply if somebody else is liable for the injury caused, pursuant to Dutch law or the law of another country.
You are not entitled to reimbursement of the costs of care:
The Concurrence Agreement (Convenant Samenloop) contains agreements on the distribution of costs by health insurers and travel insurers. Are you insured under a (travel) insurance policy that provides cover for medical expenses abroad with a (travel) insurer that has not signed the Concurrence Agreement? In that case, our supplementary insurance will apply as excess insurance. In that case, you are only entitled to reimbursement if the medical costs abroad exceed the cover of that (travel) insurance.
This also applies to costs that the other (travel) insurer has paid or advanced on other grounds.
No excess or personal contribution applicable to that other agreement, law or other provision is ever covered by the supplementary insurance.
In a number of cases it is possible that your supplementary insurance changes during the year. In that case:
The same applies if the maximum reimbursement, the number of treatments or the period within which you are entitled to certain reimbursement has changed in the new supplementary insurance compared to the previous supplementary insurance.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | a maximum of € 40 per day, up to a maximum of € 350 per calendar year |
The reimbursement applies to the various elements jointly.
You are entitled to reimbursement of the costs of anthroposophic and homeopathic medicines listed in the G-standard. For further information about the reimbursement of medicines, please contact our Customer Service on +31 (0)570 687 123.
You are entitled to reimbursement of the costs of the following
You can contact an alternative healer or therapist who has a valid personal and practice AGB code and who meets the conditions of the List of Alternative Care Providers 2025. The list states which professional association or umbrella association the care provider must be affiliated to or be a member of and/or in which register the care provider must be listed. You are only entitled to reimbursement of consultations or treatments that fall under the specific area for which the professional association, umbrella association or register is included in the overview.
The up-to-date List of alternative care providers can be viewed and downloaded at www.hollandzorg.com/conditions.
It is important that the following information is stated on the invoice:
Without this information, we are unable to reimburse the costs.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | a maximum of € 75 per 2 calendar years | Plus ++++ | a maximum of € 100 per 2 calendar years |
You are entitled to reimbursement of the costs of:
Spectacles and (contact) lenses may be supplied by an optician with a qualified optometrist or contact lens specialist.
PLEASE NOTE! The invoice you submit must clearly state the prescription of the spectacle lenses or contact lenses.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | 100% | Extra +++ | 100% | Plus ++++ | 100% |
If you require emergency care during a temporary stay abroad or if transport to the Netherlands is a medical requirement, we will reimburse the following:
You are entitled to reimbursement of the costs of emergency care. The care in question must fall under the cover of the public healthcare insurance but not be fully reimbursed under the public healthcare insurance. Since healthcare can be more expensive in some countries than In the Netherlands, you sometimes have to pay extra. This difference is reimbursed through your supplementary insurance. The care is deemed an emergency if, in our opinion, it is unforeseen care that cannot reasonably be postponed until your return to the Netherlands.
You are entitled to reimbursement of the costs of medically required transport to the Netherlands. Repatriation is deemed a medical requirement if, in our opinion, proper local care is not available or is not of a sufficient medical standard, or is much more expensive than in the Netherlands. You are obliged to cooperate in repatriation if we deem this to be necessary and your condition permits.
You or, in case of your death, your next of kin, must contact our emergency centre within 24 hours or as soon as possible after the need for care has arisen. You can reach the emergency centre day and night on +31 570 687 112 (standard rate).
PLEASE NOTE! You are only entitled to reimbursement if the Emergency Centre coordinates the care or transport.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | 100% | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | no reimbursement |
You are entitled to transport of yourself and the organisation of such transport:
Transport of family members and other travel companions does not fall under this. Furthermore, there has to be a medical need for the transport.
A medical need is deemed to exist if, in our opinion, treatment in your country of origin is medically needed, because proper local care is not available or is not of a sufficient medical standard, or because medical treatment locally entails higher costs than in the Netherlands or your country of origin. Social reasons such as family reunion and language problems are not included.
You retain entitlement to this cover for a 14-day period after termination of your Compact supplementary insurance.
We will arrange the repatriation. To that end, you or your representative has to contact the emergency center. You can reach the emergency centre day and night on +31 570 687 112 (standard rate).
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | 100% |
Your next of kin are entitled to reimbursement of the costs for transport of your mortal remains from the place of your death to the Netherlands. This includes the costs of the transport itself plus that of any additional services necessary for the transport.
Your next of kin must contact our emergency centre within 24 hours, or as soon as possible. You can reach the emergency centre day and night on +31 570 687 112 (standard rate).
PLEASE NOTE! You are only entitled to reimbursement if the Emergency Centre coordinates the transport.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | 3 sessions per calendar year | Start ++ | 6 sessions per calendar year | Extra +++ | 9 sessions per calendar year | Plus ++++ | 15 sessions per calendar year, a maximum of 9 of which for the same disorder relate to manual therapy |
You are entitled to reimbursement of the costs of:
The reimbursement applies to the various therapies jointly.
The insured party is only entitled to paediatric physiotherapy and children's remedial therapy if the insured party is younger than 18.
NOTE: manual therapy treatments E.S. (Egg Shell) / Van der Bijl method and orthomanual medicine are not covered under physiotherapy and remedial therapy. These treatments may be covered under alternative treatments.
A treatment or consultation is referred to as a session. We also reimburse sessions abroad. Sessions abroad are subject to the rates for non-contracted care.
Not every treatment counts as one session. A session is calculated as follows:
If you have used fewer than the maximum number of sessions in the past year, you are entitled to reimbursement for additional physiotherapy and exercise therapy sessions in the current year. For each session covered in the past year that you did not use, you are entitled to reimbursement for one additional session in the current year, up to a maximum of three sessions.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | 1 tot 3 sessions per calendar year | Start ++ | 1 tot 3 sessions per calendar year | Extra +++ | 1 tot 3 sessions per calendar year | Plus ++++ | 1 tot 3 sessions per calendar year |
This is subject to the following conditions:
The following care providers are permitted to provide this type of care:
For treatment of a complaint on the List of chronic disorders for physiotherapy and remedial therapy, you need a referral from a general practitioner, medical specialist, youth healthcare doctor, doctor for the mentally disabled, specialist geriatrics doctor, company doctor, dentist, nursing specialist, physician assistant or a coordinating practitioner within the framework of medical care for specific groups of patients (GZSP). This list can be consulted at www.hollandzorg.com/conditions.
No referral is needed for all remaining treatments.
Do you wish to use the care from a care provider with whom we have not concluded a contract? In that case, the reimbursement may be less than the amount charged by your care provider. The maximum reimbursements can be found on the rates lists for non-contracted care on www.hollandzorg.com/insured/customer-services/rate-lists2026. Contracted care providers are listed at hollandzorg.z-zoeker.nl.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | 100% | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | no reimbursement |
You are entitled to reimbursement of the statutory personal contribution for medicinal care under the public healthcare insurance.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | 100% | Extra +++ | 100% | Plus ++++ | 100% |
Contraceptives are means to prevent pregnancy. When you are 21 or older, we reimburse:
Once every three years:
The costs of dispensing are included in this cover. The costs of dispensing are the costs you pay for the services of the chemist. The costs to apply the devices are not included.
For each prescription, we will reimburse the costs of the contraception for a maximum period of 12 months.
If you are entitled to a contraceptive or a specific contraceptive (preferred medicine) under the public healthcare insurance, you are not entitled to reimbursement of a contraceptive under supplementary insurances.
PLEASE NOTE! You can contact your general practitioner or medical specialist (in the event of a medical ground) for the placement of a contraceptive (e.g. an IUD). The costs thereof are reimbursed under the public healthcare insurance. The costs of general practitioner care are not subject to the compulsory excess. Does a medical specialist place the IUD? In that case an excess does apply.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | a maximum of € 100 per birth |
We will reimburse individual advice and support when breastfeeding your baby.
These care providers are authorised to give advice and guidance:
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | 60% |
We will reimburse part of the statutory personal contribution for giving birth without medical grounds in a hospital or a birth centre.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | Maternity package |
We will reimburse a maternity package, if you have been pregnant for at least 24 weeks.
The maternity package consists of underpads, maternity mattresses, a sterile navel clip, gauze compresses, maternity pad, a bottle of alcohol, surgical cotton wool, wound compresses.
PLEASE NOTE! You must submit the application for the maternity package, together with the registration for maternity care, in time. You can choose which maternity care organisation you register with. Your obstetrician can help you further. The maternity package will be delivered from the 34th week of pregnancy.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | Contracted care: 100% Non-contracted care:
|
We reimburse the costs of sterilization for both men and women. However, the maximum reimbursement varies.
Hospitals and independent treatment centres (ZBCs) are authorised to provide this type of care. Contracted care is care provided by a hospital or ZBC with which we have made arrangements especially for the performance of sterilisations. This does not include hospitals and independent treatment centres with which we have made general agreements for medical specialist care.
General practitioners with whom we have made arrangements especially for the performance of sterilisations, are also permitted to provide the care to men. This does not include general practitioners with whom we have made general agreements. Sterilisation by a general practitioner with whom we have not made specific arrangements for sterilisation is not eligible for reimbursement.
Contracted care providers are listed at hollandzorg.z-zoeker.nl. You can also contact our Customer Service on +31 (0)570 687 123.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | 60% |
We will reimburse part of the statutory personal contribution for giving birth without medical grounds in a hospital or a birth centre.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | 60% |
We will reimburse part of the statutory personal contribution for maternity care.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | a maximum of € 100 per pregnancy |
We will reimburse maternity and delivery training programmes and support for new mothers, including antenatal exercises, antenatal yoga, antenatal massage the Mother Fit Programme or a doula.
A professional provider of pregnancy courses or support classes for new mothers may provide the care. The doula must be a member of the Dutch Professional Association of Doulas (Nederlandse Beroepsvereniging voor Doula's).
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | 80% up to a maximum of € 250 per |
We will (partly) reimburse the use of an informal care broker. An informal care broker can take over organisational tasks from informal carers in order to reduce the burden on them. You can make use of an informal care broker if you receive informal care or if you are an informal carer.
PLEASE NOTE! The costs of the voluntary care boker cannot be claimed by both the voluntary carer and the person receiving voluntary care. We do not reimburse the benefit twice.
The informal care broker must be entered in the quality register of the Professional Association of Informal Care Brokers (Beroepsvereniging van mantelzorgmakelaars (BMZM)).
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | 75% up to a maximum of € 100 per |
The reimbursement applies to the health courses jointly.
We will reimburse a health course if the course is for yourself or to support a loved one. The course must be specially aimed at helping prevent illness or improve lifestyle habits in order to prevent loss or restriction of physical function.
A few examples:
Not all costs are eligible for reimbursement. A few examples:
The course may be delivered by a professional supplier of health courses, for example a home help organization, rheumatism association, diabetes association or the Netherlands Heart Foundation.
You must enclose a copy of the diploma or certificate of participation when submitting the invoice.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | a maximum of € 100 per calendar year | Plus ++++ | a maximum of € 200 per calendar year |
The reimbursement applies to the various elements jointly.
We will (partly) reimburse hip protectors, provided you have a prescription from a doctor. You must enclose a copy of the invoice when submitting the invoice.
We will reimburse (part) of the costs of your statutory personal contribution for hearing aids and (tinnitus) masks.
We will (partly) reimburse the purchase or rental of a bed-wetting alarm. The condition is that you have a prescription from a doctor. You must enclose a copy of the invoice when submitting the invoice.
We will (partly) reimburse the remaining costs of a wig over and above the maximum statutory reimbursement under the public healthcare insurance.
The aids may be provided by a supplier of medical aids.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | a maximum of € 125 per calender year |
We will (partly) reimburse sports medical examinations and (sports injury) consultations. Sports medical advice does not include health examinations, such as for a driver's licence, pilot's licence, balloon pilot's licence or SCUBA diving.
The sports medical institution must be affiliated to the Federation of Sports Medical Institutions (FSMI). The invoice must state that the institution is affiliated with the FSMI.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | a maximum of € 200 per calender year | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | no reimbursement |
You are entitled to reimbursement of the costs for urgent dental treatment in the Netherlands.
Here, emergency care is given as a meaning: unforeseen care that cannot reasonably be postponed. It concerns care that is intended to alleviate acute pain and ensure sufficient chewing capacity. A dental overhaul is not urgent care.
For every usual treatment a description of the care is available. The Dutch Healthcare Authority provides is. Only treatments with a description of care as referred to on the 'List of emergency oral care' qualify for reimbursement. The 'List of emergency oral care' can be found at www.hollandzorg.com/conditions.
You must have a referral from a dentist for the measuring, making, fitting and placing of a removable (full) prosthetic provision for the upper or lower jaw by a dental prosthodontist, secured on dental implants.
Contracted care providers are listed at hollandzorg.z-zoeker.nl. Alternatively, you can call our Customer Service on +31 (0)570 687 123.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | 75% up to a maximum of € 200 per calendar year | Plus ++++ | 75% up to a maximum of € 300 per calendar year |
The reimbursement applies to the various elements jointly.
We will reimburse acne treatment in cases of serious forms of acne on your face or neck.
We will reimburse camouflage therapy in case of highly unsightly scars or skin marks on your face or neck. The cover includes the costs for camouflage lessons and the purchase costs of the camouflage materials needed for the lessons. Camouflage materials that you use outside and after camouflage lessons are not reimbursed.
We will reimburse hair removal if you suffer from an extreme form of hypertrichosis (excess hair growth) on your face or neck.
A skin therapist can provide all types of care.
The care outlined below can only be provided by a beautician with core membership of the General Netherlands Trade Association for Beauty Care (Algemene Nederlandse Branche Organisatie Schoonheidsverzorging (ANBOS)):
No.
Yes, reimbursement of costs for facial care is subject to our prior written authorisation, prior to you receiving the care. You must include pictures of your face and neck along with your request.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | 75% up to a maximum of € 125 per calendar year |
The reimbursement applies to the various elements jointly.
We will reimburse podiatric therapy and podology care.
We will reimburse arch supports.
You must purchase the arch supports from a podiatrist, registered podologist, a podopostural therapist or a supplier of medical aids which is affiliated to the Dutch Association of Orthopaedic Shoe Technicians (Nederlandse vereniging orthopedische schoentechnici (NVOS)) and is recognised by the Foundation for Regulating Authorised Suppliers of Medical Aids (Stichting Erkenningsregeling leveranciers Medische Hulpmiddelen (SEMH)).
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | € 35 per day for a maximum of 2 months per calendar year |
We will reimburse accommodation in a hospice for the short-term care of terminal patients up to a maximum of 2 months per calendar year. This must be in an environment specifically designed for this purpose.
A 'Home From Home', an independent hospice or a hospice-unit of a nursing home or a hospital may offer this type of care.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | 75% up to a maximum of € 100 per calendar year |
We will reimburse a therapeutic holiday camp for insured parties aged up to 18. The camp must be specially geared towards children with an illness, complaint or handicap. We will only reimburse camps organised by:
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | a maximum of € 20 per day from the 11th day of admission for a maximum of 3 months |
We will reimburse childcare from the 11th consecutive day you are admitted to hospital for care. The reimbursement applies for a maximum period of 3 months. Your admission must involve care covered under the public healthcare insurance. Your children must be younger than 12 and also be insured with us.
PLEASE NOTE! The reimbursement only applies for childcare in connection with your admission. The reimbursement does not apply for the number of hours of childcare which you would normally already have arranged regardless of the hospital admission.
What do I need to keep in mind?
Only children's centres and childminder agencies listed on the national childcare register (www.landelijkregisterkinderopvang.nl) are entitled to provide this type of care.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | a maximum of € 25 per day, up to a maximum of € 250 per calendar year |
We will reimburse accommodation in a guesthouse for one or more visiting family members. The family member must live at the same address as you and be insured with us. The reason for staying at a guesthouse must be because you have been admitted to hospital. The maximum reimbursement applies for the total number of visiting family members staying in the guesthouse.
The guesthouse must be linked to the hospital. If there is no guesthouse nearby or there is no room available, you are entitled to reimbursement of accommodation in a bed and breakfast. An example of a guesthouse is a Ronald McDonald House.
NOTE: you must enclose proof of admission whenb submitting the invoice.
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | no reimbursement | Plus ++++ | a maximum of € 100 per calendar year |
The reimbursement 'Other care' applies to the various elements below jointly.
We will reimburse the costs of voluntary night-time home care for the dying for a maximum period of one month. Volunteers from an organisation affiliated to the Netherlands Voluntary Palliative Terminal Care Association (Vrijwilligers Palliatieve Terminale Zorg Nederland (VPTZ Nederland)) can provide this type of care.
We will reimburse a compulsory medical examination for the renewal of your driver's licence. The examination may be performed by a doctor.
We will reimburse personal alarm equipment for a central alarm service and corresponding connection costs. This type of care may be provided by a supplier of medical aids. Subscription costs or any response costs following a call-up are not reimbursed.
You are entitled to reimbursement of the care provided by a sexological care provider. This is subject to the condition that the sexological care provider is listed in the register of the Netherlands Association of Sexologists (NVVS).
| Compact + | Start ++ | Extra +++ | Plus ++++ | ||||
|---|---|---|---|---|---|---|---|
| Compact + | no reimbursement | Start ++ | no reimbursement | Extra +++ | a maximum of € 250 per calender year | Plus ++++ | a maximum of € 450 per calender year |
We reimburse the costs of:
The care focuses on improving women’s general health in relation to their hormonal balance to help them feel healthy during different stages of life.
This may be because you:
VitalFem offers the 12-week programmes. You can find information about this at www.vitalfem.nl.
Consultants from Care for Women perform the VitalFem basic blood test and the health check. You can find the consultants at www.careforwomen.nl.
These providers are permitted to do the consultations:
The supplements are only reimbursed if they are purchased from Care for Women specialists or on the webshop via VitalFem at www.vitalfem.nl, within six months of completing the 12-week programme.
The following apply to the dental insurances TandExtra and TandPlus:
| TandExtra + | TandPlus ++ | ||
|---|---|---|---|
| TandExtra + | Consultations: 100% Other oral care: 75% There is a maximum of € 250 per calendar year for consultations and other oral care combined. | TandPlus ++ | Consultations: 100% Other oral care: 75% There is a maximum of € 500 per calendar year for consultations and other oral care combined. |
By a consultation, we mean a consultation for a periodic check-up (C002) and a consultation other than a periodic check-up (C003) as listed in the performance list for oral care of the Dutch Healthcare Authority (NZA).
Codes are shown next to each type of treatment, the so-called performance codes. These have been formulated by the Dutch Healthcare Authority. You can view them and download the list at www.nza.nl. You are only entitled to reimbursement of the costs of care with those service codes. We will not reimburse the costs of an appointment which you fail to keep.
You are entitled to reimbursement of all treatments listed below which are included in the list of oral care services of the Dutch Healthcare Authority.
Type of treatment | Performance code | |
|---|---|---|
consultation and diagnosis | Performance code | all C codes |
taking and assessing X-rays | Performance code | all X codes |
preventive oral care | Performance code | all M codes |
anaesthetic | Performance code | all A codes |
light anaesthetic | Performance code | all B codes |
fillings | Performance code | All V codes |
root canal treatments | Performance code | all E codes, with the exception of E97 (external bleaching of teeth and molars) |
crowns and bridges | Performance code | All R codes |
gnathological treatments | Performance code | All G codes |
surgery | Performance code | All H codes |
dentures | Performance code | All P codes |
gum treatments | Performance code | All T codes |
implants | Performance code | all J codes and, for care provided by dental surgeons, the relevant medical specialist performance services (other care products). |
You are not entitled to reimbursement of the costs of cosmetic oral care. By cosmetic oral care we mean the non-medically necessary dental treatments ‘placement of facings’ and ‘external whitening of teeth and molars’, which fall within the experiment ‘deregulated rates for Cosmetic Oral Care’ and for which deregulated rates according to the regulations of the Dutch Healthcare Authority apply.
You are entitled to reimbursement of orthodontic treatment if the insured party is under 18. This relates to the following codes.
Type of treatment | Performance code | |
|---|---|---|
Braces (orthodontics) | Performance code | all F codes, ending in the letter 'A' |
You are entitled to reimbursement of material and technical costs for the codes listed above, if they apply. Material and technical costs are the costs of creating e.g. crowns, dentures or braces. Your reimbursement is calculated on the basis of no more than the amount included for the treatment in question on the Maximum reimbursement for technical costs list. This list can be viewed and downloaded at www.hollandzorg.com/forms.
You are entitled to reimbursement of the statutory personal contribution for removable full dental prostheses, whether or not secured on dental implants. Reimbursement for dental prostheses secured on dental implants is subject to restriction. Your reimbursement is calculated on the basis of no more than € 275 (a maximum of € 250 for TandExtra) of the statutory personal contribution for the implants or the removable dental prostheses.
You are entitled to reimbursement of emergency oral care abroad. The cover for oral care abroad is limited to treatments on the 'List of emergency oral care'. You can view this list at www.hollandzorg.com/conditions.
Yes, you need a referral from a dentist, dental surgeon or orthodontist for the measuring, making and fitting of removable (full) prostheses on dental implants by a prosthodontist.
In these policy conditions, the following terms are defined as follows:
The agreement for non-life insurance concluded or to be concluded with Salland Aanvullende Verzekeringen N.V. This insurance covers a number of other services in addition to cover provided under the public healthcare insurance. Dental insurance also falls under this, unless explicitly stated otherwise.
A motor vehicle, vessel or helicopter as referred to in Article 1, paragraph 1 of the Ambulance Care Services Act (Wet Ambulancezorgvoorzieningen).
A medicine that is prepared on a small scale at a dispensing chemist's pharmacy by or on behalf of the dispensing chemist or (a general practitioner who runs a joint practice with a) dispensing general practitioner in his pharmacy, as referred to in Article 40, paragraph 3, subparagraph d of the Medicine Act (Geneesmiddelenwet).
The instruction for the dispensing chemist or dispensing general practitioner for the assessment of a doctor's note, drawn up by Zorgverzekeraars Nederland. You can view it at www.znformulieren.nl.
A chemist listed in the register of established dispensing chemists as defined in Article 61, paragraph 5 of the Medicines Act.
A doctor registered in the register defined in Article 3 of the Individual Health Care Professions Act (Wet BIG).
An AIOS, House Officer or an ANIOS, Senior House Officer, who is entered as a doctor in the register defined in Article 3 of the Individual Health Care Professions Act (Wet BIG).
Een doctor registered as Public Health Doctor in the Infectious Disease Prevention register or Tuberculosis Prevention register the of the Commission for the Registration of Social Medicine of the KNMG (Royal Netherlands Medical Society).
A doctor registered as a doctor for the mentally disabled in the register of general practitioners, geriatrics specialists and doctors for the mentally disabled of the KNMG's Registration Committee for Medical Specialists.
The note to be completed, dated and signed by the prescriber for the medicine in question. The doctor's note is drawn up by Zorgverzekeraars Nederland. You can view it at www.znformulieren.nl.
A centre that provides audiological care and, insofar as required by law, is licensed accordingly.
A centre that provides artificial respiration and, insofar as required by law, has a permit for this. A respiratory centre may be affiliated to a hospital, but not necessarily so.
A doctor who is listed as a company doctor in the register of Society and Health Doctors of KNMG's Registration Committee for Medical Specialists and acts on behalf of the employer or the Working Conditions Service (Arbodienst) with which the employer is affiliated.
A physiotherapist who is registered as a pelvic physiotherapist in the Register of the Kwaliteitshuis Fysiotherapie (IRF) or the Keurmerk Fysiotherapie Individueel Register (KFIR) of Stichting Keurmerk Fysiotherapie (SKF).
A remedial therapist listed in the Paramedics Quality Register as a pelvic remedial therapist.
Body Mass Index. The BMI shows whether a person's weight is healthy in relation to his or her height.
The Central Administrative Office for Exceptional Medical Insurance (CAK) referred to Article 6.1.1, paragraph 1 of the Long-Term Care Act.
A university or other centre considered by us to be equivalent to a university for providing oral care in special cases where treatment by a team or special skills are required.
A centre with a permit under the Special Medical Procedures Act (Wet op bijzondere medische verrichtingen) for the application of clinical genetic research and genetic advice and, insofar as required by law, has a permit pursuant to the Healthcare and Care Providers (Accreditation) Act (Wet toetreding zorginstellingen). A centre for genetic advice examines whether your symptoms, or those of your child or other family members have a hereditary cause.
An agreement between us and a third party, such as an employer or association, that sets out agreements about benefits which the persons described in that agreement, such as employees or members, can enjoy if they comply with the conditions stipulated in the agreement. We refer to such employees or persons as participants.
dbc is the abbreviation for diagnostic treatment combination. A dbc or dbc care product describes the finished process of (medical) specialised care, as set out in decisions by the Dutch Healthcare Authority, by means of a dbc performance code or care product code. The dbc procedure commences when the insured party reports his care requirement and is completed at the end of the treatment or after the maximum number of days the dbc (care product) can be 'open' if the treatment has not yet been completed by that time.
A doctor who is listed as a dermatologist in the Dermatology and venerology register of the KNMG's Registration Committee for Medical Specialists.
A centre that provides dialysis care and, insofar as required by law, has a permit for this. A dialysis centre may be affiliated to a hospital, but not necessarily so.
A dietician who complies with the requirements of the Dieticians, Occupational Therapists, Speech Therapists, Oral Hygienists, Remedial Therapists, Orthoptists and Podiatrists Decree and is listed in the Paramedics Quality Register.
A centre for prenatal screening which holds a licence pursuant to the Population Screening Act (Wet op het bevolkingsonderzoek).
A country which, like the EU countries, is party to the Agreement on the European Economic Area: Liechtenstein, Norway and Iceland.
An occupational therapist who complies with the requirements of the Dieticians, Occupational Therapists, Speech Therapists, Oral Hygienists, Remedial Therapists, Orthoptists and Podiatrists Decree and is listed in the Paramedics Quality Register.
A country that is a member of the European Union: Austria, Belgium, Bulgaria, Croatia, the Czech Republic, Cyprus (Greek part), Denmark, Estonia, Finland, France (including Guadeloupe, French Guyana, Martinique, Réunion, St. Martin), Germany, Greece, Hungary, Iceland, Ireland, Italy, Latvia, Lithuania, Luxembourg, Malta, Norway, Poland, Portugal (including Madeira and the Azores), Romania, Slovenia, Slovakia, Spain (including Ceuta, Melilla and the Canaries) and Sweden.
Care that phlebologists tend to provide, including the treatment of varicose veins and oedema.
A doctor who is registered as a forensic doctor in the specialists' register of the KNMG's Registration Committee for Medical Specialists.
To commit, to attempt to commit or to instruct others to commit forgery of documents, fraud, deceit, embezzlement or deliberate prejudice to us, aimed at obtaining (a reimbursement of the costs of) care to which no right exists, or to conclude, extend or terminate an insurance contract or to obtain insurance cover under false pretences.
A physiotherapist who is registered as a physiotherapist according to the conditions defined in Article 3 of the Individual Health Care Professions Act (Wet BIG) and is registered in the Register of the Kwaliteitshuis Fysiotherapie (IRF) or the Keurmerk Fysiotherapie Individueel Register (KFIR) of Stichting Keurmerk Fysiotherapie (SKF).
A centre that provides obstetric care and, insofar as required by law, has a permit for this. Here you can give birth and possibly stay during the maternity period after delivery.
A care provider with whom we have concluded an agreement. This agreement outlines arrangements such as the ability to claim directly for the care provided and the quality of the care. Contracted care providers are listed at hollandzorg.z-zoeker.nl. You can also contact our Customer Service on +31 (0)570 687 123.
A registered medicine specified by us temporarily cannot be delivered (or not in sufficient quantities) by the holder or holders of the (parallel) trade licence granted pursuant to the Medicine Act or pursuant to European Regulation 726/2004.
The uninterrupted period during which you were insured by virtue of supplementary insurance.
A medicine for which a trade licence or a parallel trade licence has been granted pursuant to the Medicines Act (Geneesmiddelenwet) or pursuant to regulation 726/2004/EC, Pb EC L136. Interchangeable medicines are registered medicines that are considered to be interchangeable under the Healthcare Insurance Regulations. Non-interchangeable medicines are registered medicines that are not considered to be interchangeable under the Healthcare Insurance Regulations.
A physiotherapist who is registered as a geriatric physiotherapist in the Register of the Kwaliteitshuis Fysiotherapie (IRF) or the Keurmerk Fysiotherapie Individueel Register (KFIR) of Stichting Keurmerk Fysiotherapie (SKF).
A remedial therapist listed in the Paramedics Quality Register as a geriatric remedial therapist.
A healthcare psychologist registered as such in the register defined in Article 3 of the Wet BIG.
An electronic database that lists all medicines, aids and health products that can be obtained through the pharmacy and institutions. The database is kept up-to-date by the company Z-index B.V.
Label of the same name from Salland Zorgverzekeraar N.V. In the event of references to supplementary insurance, 'HollandZorg' is taken to mean: the label of the same name of Salland Aanvullende Verzekeringen N.V.
A skin therapist who complies with the requirements of the Skin therapist training requirements and area of expertise decree (Besluit opleidingseisen en deskundigheidsgebied huidtherapeut) and is listed in the Paramedics Quality Register.
A doctor entered as a general practitioner in the register of general practitioners, geriatrics specialists and doctors for the mentally disabled of the KNMG's Registration Committee for Medical Specialists. The general practitioner may be independently established or work in a general practitioner services structure (GP out-of-hours surgery), a GP surgery or care group.
An organisational association of general practitioners with a corporate personality. The association is set up to provide general practitioner's care in the evening, at night and at the weekends and charges a legally valid rate.
An institution for the provision of oral care characterised by oral care providers with specific expertise and skills and facilities for consultation, diagnosis and treatment for insured parties aged up to 18. Insofar as legally required, the institution must be licensed.
An institution for the provision of sensory disability care, which is a member of FENAC (Netherlands Federation of Audiological Centres or NOG (Netherlands Ophthalmological Society).
A care provider in which the various disciplines of the birth care chain are equally represented and which provides that integrated birth care.
An institution licensed under the Special Medical Procedures Act (Wet op bijzondere medische verrichtingen) to provide transplant care.
A doctor who:
In both cases, it must be a doctor who provides youth healthcare as referred to in the Public Health (Preventive Measures) Act.
A nurse with completed higher professional education in youth nursing.
A Dental, Oral and Maxillofacial Surgery specialist registered by the Dentistry Specialisms Board of Registration (RTS) of the KNMT in the Dental, Oral and Maxillofacial Surgery specialists register.
Coordinated, multidisciplinary care for a specific disorder on the basis of the relevant care standard as referred to in the policy document for general practitioner care and multidisciplinary care defined on the basis of the Healthcare (Market Regulation) Act (Wet Marktordening gezondheidszorg). The objective is for care providers to work closely together and to properly coordinate the care for you.
A care provider registered as a paediatric and adolescent psychologist in the register of the Netherlands Institute of Psychologists (NIP).
A physiotherapist who is registered as a paediatric physiotherapist in the Register of the Kwaliteitshuis Fysiotherapie (IRF) or the Keurmerk Fysiotherapie Individueel Register (KFIR) of Stichting Keurmerk Fysiotherapie (SKF).
A remedial therapist listed in the Paramedics Quality Register as a paediatric remedial therapist.
A qualified nurse having completed nationally recognised higher professional education in nursing children.
A clinical physicist having completed nationally recognised training as a clinical physiologic- audiologist. The clinical physicist/audiologist investigates hearing problems in children and adults with complex hearing problems, such as irritating tinnitus.
A clinical technologist (technical physician) registered as a clinical technologist in the register defined in Article 3 of the Individual Health Care Professions Act (Wet BIG).
A doctor who is entered as clinical geriatrics doctor in the specialists' register of the KNMG's Registration Committee for Medical Specialists.
A healthcare psychologist registered as a clinical neuropsychologist in accordance with the conditions defined in Article 14 of the Individual Health Care Professions Act (Wet BIG).
A healthcare psychologist registered as a clinical psychologist in accordance with the conditions defined in Article 14 of the Individual Health Care Professions Act (Wet BIG).
A trained care provider who provides support and care during childbirth (in addition to the obstetric care provided by the obstetrician) and to the mother and her family during the maternity period. A maternity carer ensures the wellbeing of mother and child, and reports to the obstetrician or doctor if necessary.
An organisation which provides (medical) aids and which is registered in the General Care Providers Database (AGB database). This database records data on care providers in the Netherlands. This data is given a unique code, the AGB code. This ensures a uniform registration of care provider data for the health insurers.
Physiotherapy aimed at preventing or reducing pain and movement restrictions due to scars.
A speech therapist who complies with the requirements of the Dieticians, Occupational Therapists, Speech Therapists, Oral Hygienists, Remedial Therapists, Orthoptists and Podiatrists Decree and is listed in the Paramedics Quality Register.
A physiotherapist who is registered as a manual therapist in the Register of the Kwaliteitshuis Fysiotherapie (IRF) or the Keurmerk Fysiotherapie Individueel Register (KFIR) of Stichting Keurmerk Fysiotherapie (SKF).
Unpaid care for an elderly, chronically ill or handicapped loved one in need of assistance. The care is provided for more than 8 hours per week and at least 3 months in a row.
An informal carer is a person who provides care other than in a professional capacity.
The costs of care minus the costs in excess of what can reasonably be regarded as appropriate under Dutch market conditions.
One of our employees who is listed in the registers in accordance with the conditions defined in Article 3 of the Individual Health Care Professions Act (Wet BIG).
A doctor who is listed as a specialist with a legally recognised specialist title in a specialists register as referred to in Article 14, paragraph 1 of the Individual Health Care Professions Act (Wet BIG).
Care provided to children up to the age of 18 whereby there is a need for care as usually offered by nurses in relation to medical care or a high risk thereof, whereby:
In a collegial consultation, the general practitioner (GP) calls on the expertise of another more specialised care provider to decide on a suitable diagnosis, treatment policy or referral. This involves direct patient contact, face-to-face or digital, between you and that other care provider.
In collegial advice, the general practitioner (GP) calls on the expertise of another more specialised care provider to decide on a suitable diagnosis, treatment policy or referral, but there is no direct patient contact between you and that care provider.
An oral hygienist who complies with the requirements of the Dieticians, Occupational Therapists, Speech Therapists, Oral Hygienists, Remedial Therapists, Orthoptists and Podotherapists Decree and is listed in the Paramedics Quality Register.
A care provider with whom we have not concluded an agreement. We apply a maximum reimbursement for many types of care provided by a non-contracted care provider. In that case, the reimbursement is limited to the rates in accordance with the rates list for non-contracted care. The rates list can be viewed and downloaded at www.hollandzorg.com/insured/customer-services/rate-lists2026. If the rates of the non-contracted care provider are higher than our listed maximum rates, the difference will be at your expense. Contracted care providers are listed at hollandzorg.z-zoeker.nl. You can also contact our Customer Service on +31 (0)570 687 123.
A physiotherapist who is registered as an oedema therapist in the Register of the Kwaliteitshuis Fysiotherapie (IRF) or the Keurmerk Fysiotherapie Individueel Register (KFIR) of Stichting Keurmerk Fysiotherapie (SKF).
A Cesar or Mensendiek remedial therapist who complies with the requirements of the Dieticians, Occupational Therapists, Speech Therapists, Oral Hygienists, Remedial Therapists, Orthoptists and Podiatrists Decree and is listed in the Paramedics Quality Register.
Passenger transport open to all operated in accordance with a timetable by car, bus, train, underground train, tram or a vehicle propelled by a guidance system as defined in the Passenger Transport Act 2000 (Wet personenvervoer), and passenger transport open to all operated in accordance with a timetable in the form of a regular ferry service.
Medically necessary stay of 24 hours or more during an uninterrupted period of up to 1095 days (3 years). An interruption of the admission for a maximum period of 30 days is not regarded as an interruption to the uninterrupted period. The duration of the interruption does not count in the calculation of the 1095 days, except in the event of weekend and holiday leave. Interruptions for weekend and holiday leave are included in the calculation of the 1095 days.
Admission does not include:
Admission does not include first-line in-patient stays.
An optometrist who complies with the requirements of the Optometrist training requirements and area of expertise decree (Besluit opleidingseisen en deskundigheidsgebied optometrist) and is listed in the Paramedics Quality Register.
A dental specialist who is registered in the Orthodontic Specialist Register of the Dentistry Specialisms Board of Registration of the Royal Dutch Dental Organisation (KNMT).
A remedial educationalist who is registered in the NVO Register (Remedial Educationalist-Generalist of the Dutch Association of educationalists and teachers (NVO)).
A orthoptist who complies with the requirements of the Dieticians, Occupational Therapists, Speech Therapists, Oral Hygienists, Remedial Therapists, Orthoptists and Podiatrists Decree (Besluit diëtist, ergotherapeut, logopedist, mondhygiënist, oefentherapeut, orthoptist en podotherapeut) and is listed in the Paramedics Quality Register.
A performance within specialist medical care, other than a DBC care product.
A chiropodist who:
A chiropodist who provides pedicure treatment within the meaning of the supplementary insurance may also be listed in the Chiropodists Quality Register (KRP) specialising in foot care for rheumatics.
A physician assistant who complies with the requirements of the Temporary Decision on independent authority of physician assistants and is registered as physician assistant in the Dutch Association of Physician Assistants (NAPA) Quality Register of physician assistants.
The care provider is affiliated with the professional association Stichting LOOP and listed as a podopostural therapist in the Quality Registration and Accreditation of Health Care Professionals (Kwaliteitsregistratie en Accreditatie Beroepsbeoefenaren in de Zorg (KABIZ)).
A podiatrist who complies with the requirements of the Dieticians, Occupational Therapists, Speech Therapists, Oral Hygienists, Remedial Therapists, Orthoptists and Podiatrists Decree and is listed in the Paramedics Quality Register.
The rights and obligations as they apply to you (insured party/policyholder) and us, and which form the insurance.
A doctor who is registered in the specialists' register of the KNMG's Registration Committee for Medical Specialists.
A physiotherapist who is registered as a psychosomatic physiotherapist in the Register of the Kwaliteitshuis Fysiotherapie (IRF) or the Keurmerk Fysiotherapie Individueel Register (KFIR) of Stichting Keurmerk Fysiotherapie (SKF).
A remedial therapist listed in the Paramedics Quality Register as a Psychosomatic remedial therapist.
A psychotherapist registered in accordance with the conditions defined in Article 3 of the Individual Health Care Professions Act (Wet BIG).
Treatment with a medicine in a form that suits you. The effectiveness of the medicine must be evidenced by scientific literature. Furthermore, treatment with that medicine must be the most economical treatment.
The supplier who, in response to your request for care, diagnoses you and is responsible for the treatment. The coordinating practitioner may provide the care him/herself. If the care is also provided by others, the coordinating practitioner retains ultimate responsibility for the treatment. In medical care for specific patient groups, the coordinating practitioner is the officer responsible for drawing up the care and treatment plan and for implementing the care and treatment plan in a multidisciplinary context.
The care provider is affiliated with the professional association Stichting LOOP and listed as a registered podiatrist in the Quality Registration and Accreditation of Health Care Professionals (Kwaliteitsregistratie en Accreditatie Beroepsbeoefenaren in de Zorg (KABIZ)).
Also referred to as note or invoice. Written proof of the costs incurred by a care provider, which shall at least contain the following information: the name, address and profession of the care provider, invoice date, date on which the care was provided and description of that care and the name and date of birth of the insured party. An invoice also has to comply with the statutory requirements for claiming the care. A quotation, an advance bill, reminder or demand does not constitute an invoice.
A doctor who is listed as rehabilitation specialist in the specialists' register of the KNMG's Registration Committee for Medical Specialists.
A centre that provides rehabilitation care and, insofar as required by law, has a permit for this. A multidisciplinary team of experts, under the management of a medical specialist, is employed at the centre.
The entire organisation of legal entities that directly or indirectly fall under Coöperatie Salland U.A.
A doctor who is entered as A&E doctor (emergency doctor) in the profile register of the KNMG's Registration Committee for Medical Specialists.
The distinction between forms of care based on the required infrastructure and the use of different professions.
A doctor entered as a geriatrics specialist (nursing home doctor) in the register of general practitioners, geriatrics specialists and doctors for the mentally disabled of the KNMG's Registration Committee for Medical Specialists.
A doctor registered as a doctor of society and health in the register of society and health doctors of the KNMG's Registration Committee for Medical Specialists, designated as a sports doctor.
Nederlandse Straatdokters Groep (NSG) is the executive organisation of the Doctors for Homeless Foundation (DHF).
A dentist registered as such in accordance with the conditions defined in Article 3 of the Individual Health Care Professions Act (Wet BIG).
A prosthodontist who complies with the requirements of the Prosthodontist Training Requirements and Area of Expertise Decree (Besluit opleidingseisen en deskundigheidsgebied tandprotheticus).
Written authorisation from us for the purchase of specific care, prior to the purchase of that specific care.
An institution licensed under the Special Medical Procedures Act (Wet op bijzondere medische verrichtingen) to provide transplant care.
A triage hearing specialist who is listed in the Triage Specialist Quality Register of the Centre for Certification.
A centre that provides thrombosis care and which qualifies as such, insofar as required, pursuant to the law.
Whenever these policy conditions refer to 'you/your', they refer to the insured party. Whenever these policy conditions refer to 'you (policyholder)', they refer to the policyholder. Whenever these policy conditions refer to 'you (insured party/policyholder)', they refer to both the insured party and the policyholder.
A medicine that may only be provided on prescription as referred to in Article 1, preamble and under s, of the Medicines Act (Geneesmiddelenwet).
A country that is not an EU or EEA country with which the Netherlands has made agreements concerning the provision of medical care and the reimbursement of the costs of such care: Australia (only for temporary stays of less than 1 year), Bosnia-Herzegovina, North Macedonia, Montenegro, Serbia, Tunisia, Turkey, the United Kingdom (England, Northern Ireland, Scotland and Wales) and Switzerland.
The exploratory consultation as referred to in the NZa's policy rule on the experiment of mental healthcare professionals participating in the exploratory consultation. An exploratory consultation can be part of medical mental healthcare. The exploratory consultation is a consultation between you and at least a mental healthcare professional and a professional from the social domain (someone employed by the municipality or a welfare organisation). In addition, your loved one(s) or an expert by experience can also join. During the exploratory consultation, your request for help is central and mental healthcare and social domain professionals will help come up with the most appropriate solution.
An obstetrician registered as such in accordance with the conditions defined in Article 3 of the Individual Health Care Professions Act (Wet BIG).
A patient day as described in the policy document for medical specialist care performance and rates defined by the Dutch Healthcare Authority.
A treatment and accommodation facility as defined by the Long-Term Care Act (Wlz) for the treatment of somatic or psychogeriatric disorders.
A nurse registered as such in accordance with the conditions defined in Article 3 of the Individual Health Care Professions Act (Wet BIG).
A nurse registered as a specialist nurse in accordance with the conditions defined in Article 14 of the Dutch Individual Health Care Professions Act (Wet BIG).
A nurse registered as a specialist mental healthcare nurse in accordance with the conditions defined in Article 14 of the Dutch Individual Health Care Professions Act (Wet BIG).
The amount of healthcare expenses covered by the public healthcare insurance that you must pay yourself and that is determined by the government.
A doctor who is registered in the specialists' register of the KNMG's Registration Committee for Medical Specialists.
The written advice and explanations you receive from a care provider who provides you with care, addressed to the care provider who can provide you with further care and which you need on medical grounds. The care provider giving the referral is the referrer. A referrer cannot refer you to himself.
The person who has taken out insurance with us. If this person takes out the insurance for him/herself, he/she is also the insured party.
The person whose risk of requiring care is covered by the insurance and who is listed on the policy as the insured person.
The written direction and explanations you receive from a care provider for care to be provided to you, which you need on medical grounds. This may be for a certain medicine or aid. The care provider issuing the prescription is the prescribing party.
A prescription for medicines includes the quantity or number of each form of administration of one UR medicine, compound or otherwise. The prescription determines the duration of the prescription, the period for which the medicine is prescribed based on the combination of the stated quantity and method of use (including frequency and intake volume). The prescription thus determines the maximum term for the medicine. The Latin term ‘iter’ (itera) or similar designation on the prescription indicates repetition. In that case, the prescription also indicates how often the prescription must be repeated.
The share of the costs of care covered by the public healthcare insurance that remains payable by you. The minister has determined which costs this relates to. The statutory personal contribution exists in addition to the compulsory excess.
Whenever these policy conditions refer to 'we' or 'us', this refers to 'Salland Zorgverzekeraar N.V.'. In the event of references to supplementary insurance, these terms refer to 'Salland Aanvullende Verzekeringen N.V.'.
The care and other services as referred to in the Healthcare Insurance Act with regard to public healthcare insurance. The care and services in the articles on cover and reimbursement in the chapter 'Cover and reimbursement per care form' for the supplementary insurances as regards the supplementary insurances. The care and other services in the article General oral care and the article Orthodontics when under 18 in the chapter on dental insurance as regards dental insurances.
A care provider who, as the principal contractor, provides integrated care and/or combined lifestyle interventions. The care provider can provide the care with or without the help of other care providers who, at the instructions of the principal contractor, provide coherent and collaborative integrated care and/or combined lifestyle interventions. In principle, the care is invoiced by the principal contractor.
A dynamic set of agreements between you and your care provider(s) regarding nursing and care and your personal contribution to the care (self-management). These agreements are based on individual targets, needs and situations. They are formulated as part of a joint decision-making process. The care plan must at least state the type, scope and intended duration of the required nursing and care and the performances. You or your legal representative must have signed the care plan.
Care Programme 11 as referred to in Bureau HHM's Visual Care Programmes report, auditive and communicative, of November 2016. Care Programme 11 is available if you have a few non-complex questions about learning skills to enable you to carry on living as independently as possible. Questions relating to communication, housekeeping, the use of special aids, personal care and mobility, which can easily be answered.