What does the excess apply to?
The excess is the amount you need to pay yourself when your care is reimbursed out of the basic insurance. The excess applies to most care covered by the basic insurance, but there are exceptions.
The excess applies to the following types of care
- Ambulance
- Mental healthcare
- Medication not included in the preferred medication policy (the pharmacy’s operational costs are also settled with the excess)
- Care given to the recipient of a donor organ
- Dental care
- Nicotine replacements and medication to quit smoking. If you participate in a ‘stop smoking programme’ you do not have to pay excess
- Laboratory costs
- Paramedical care (care provided by allied health professions)
- Thrombosis service
- Specialist care
- Care for persons with sensory disabilities
- Seated patient transport
The excess does not apply to the following types of care
- General practitioner care
- Contraceptives, if you’re between 18 and 20
- Behavioural support to quit smoking
- Combined Lifestyle Intervention care
- Medication included in our preferred medication policy (the pharmacy’s operational costs are settled with the excess)
- Care aids on the basis of lending. If they are extended as property, the excess does apply
- Maternity care
- Medication check by a contracted pharmacist
- Follow-up examinations for organ donors up to 3 years after the procedure
- Patient transportation of a donor in the case of organ donation
- Obstetric care
- District nursing
- Foot care for type 1 and type 2 diabetes up from care profile 2