Group health insurance for foreign workers
Your insurance and excess
In the Netherlands, you are expected to pay a contribution if you use health care under the basic health insurance policy. This is called ‘the excess’ (‘eigen risico’, literally ‘own risk’). The excess consists of a compulsory excess and a voluntary excess.
Your insurance policy covers the compulsory excess (a maximum of €385 per year) and is fully reimbursed by Zorg en Zekerheid.
You also have a voluntary excess of up to €500 per year. You only pay when you incur costs that come under this excess. Because you have a voluntary excess, you will receive a €25 discount on your premium every month.
The amount of the excess applies if you were insured from 1 January up to and including 31 December (a full year). Have you had a Dutch health insurance for six months? The costs will be adjusted proportionately: the compulsory excess for six months amounts to €162.50 and the voluntary excess amounts to €250.
What does the excess apply to?
Most of the health care that is reimbursed under the basic insurance policy comes under the excess. However, there are a number of exceptions. No excess applies when you:
visit the general practitioner
need obstetric care or maternity care
need district nursing care
However, all other healthcare costs that are reimbursed under the basic health insurance policy come under the excess.
An excess applies, for example, when you:
• receive medicines
• need to go to hospital
• have a blood test
What is the amount of the invoice for the voluntary excess?
The amount of the invoice for the voluntary excess depends on the costs you have incurred and the period you have been insured with Zorg en Zekerheid. This is determined after the closing of the calendar year. You will therefore receive an invoice from Zorg en Zekerheid in 2022 at the earliest.
Suppose you received treatment costing €1,000 and you were insured for six months. In that case, your compulsory excess is 50% * €385 = €162.50 and your voluntary excess is 50% * €500 = €250. The compulsory excess amounting to €162.50 will be reimbursed under the supplementary insurance. You will therefore receive an invoice for €250 from Zorg en Zekerheid for the voluntary excess.
Suppose you received treatment costing €250 and you were insured for a full year. In that case, the total amount of these costs come under the compulsory excess amounting to €385. Your compulsory excess is insured under a Zorg en Zekerheid supplementary insurance. You will therefore not receive an invoice from Zorg en Zekerheid.
When will you receive the invoice?
You have not yet been invoiced in 2020 for the voluntary excess amounting to €500. However, from 2021, you will be invoiced for the voluntary excess. This will take place after the end of the calendar year, which means in 2022. You can expect to receive the invoice around March 2022. If you have not used any health care under the basic health insurance policy, you do not need to pay any compulsory or voluntary excess.