Changes Health Basic and Health Premium 2025
This overview below shows all changes of Health Basic and Health Premium as of January 1, 2025. We have only listed the changes that change the terms and conditions of your insurance.
What changes for you?
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Codeine no longer covered in most cases
As of 1 January 2025, Health Basic will only cover codeine prescribed for chronic and severe diarrhoea. Codeine will no longer be covered in cases of pain, cough, or acute diarrhoea. Do you have Health Premium? Then you have a supplementary reimbursement for self-care medicines up to € 500. From that supplementary reimbursement, you can be reimbursed for codeine up to € 500.
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Personal contribution for pharmaceuticals and list of medicines
Health Basic and Health Premium covers the most common medicines for which you have a prescription. In 2024, Health Premium reimbursed your personal contribution sometimes, plus other medicines. In 2025. From 1 January 2025, Health Premium will reimburse those medicines but no longer your personal contributions.
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Requesting permission for non-contracted health care
In 2024, you needed prior permission for mental health care provided by a health-care provider without a contract if you had more than 35 consultations. From 1 January 2025, you will always require our prior permission when visiting a facility without a contract. This applies from the very first treatment. If you are already being treated at a facility without a contract and this treatment continues in 2025, you will still need to request permission. Without permission, you will not be entitled to coverage. You do not need to request permission if you visit an independent practice (i.e. a psychologist, psychotherapist or psychiatrist who works independently at their own practice). You can use our Zorgzoeker (in Dutch) online search tool to see which health-care providers have a contract with us.
For more information, please see the page Asking for prior authorisation
More comprehensive coverage for mental health care
Mental health care in the Netherlands has been reorganised in recent years. We have also changed the relevant reimbursements. From 1 January 2025, Health Basic and Health Premium will provide more comprehensive coverage for mental health care. You can read the new conditions in the Health Basic and Health Premium coverage for medical mental health care and admission for medical mental health care.
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Changes to conditions for medical appliances
For 2025, like every year, we have made changes for a few appliances regarding who may prescribe the appliance or for how long you can use the appliance. If you will be receiving a medical appliance or a replacement in 2025, always check the conditions on our website.
Using your medical appliance without due care
In 2024, the basic health-care plan would not cover replacement or repair of a medical appliance only if you were reckless in handling it. As recklessness only applies in highly exceptional situations, we have tightened our conditions, because we believe that you should always handle your medical appliance with due care. In 2025, the basic health-care plan will therefore not cover replacement or repair of a medical appliance if you fail to handle it with due care and attention, for example, by not following the user and maintenance instructions. In this case, you will have to pay the replacement or repair costs out of your own pocket.
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Contacting us when being admitted to hospital abroad
If you urgently need health care abroad, you no longer need to contact our Zorgassistance emergency centre in every situation from 1 January 2025. You will only need to contact our Zorgassistance emergency centre as soon as possible if you are being admitted to hospital abroad. If you do not contact us, this may affect your coverage. If you have doubts as to whether you need a doctor or if you have any health-related questions while travelling, you can also contact our Zorgassistance emergency centre for advice.
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Maximum reimbursement for independent treatment centres without a contract
At ONVZ you have the freedom to make your own health-care choices. You will always have access to every hospital in the Netherlands. If you would prefer to visit an independent treatment centre, Health Basic and Health Premium covers most independent treatment centres as well. You can use our Zorgzoeker (in Dutch) online search tool to see which independent treatment centres currently have a contract with us.
If you would prefer to receive treatment at an independent treatment centre that does not have a contract with us, that is indeed possible, but do bear in mind that maximum reimbursements apply in that case.
Treatment at an independent treatment centre without a contract
If you are being treated at an independent treatment centre that does not have a contract, you may be worried about whether or not that treatment will be continued.
If your independent treatment centre had a contract with us in 2024:
You can finish the treatment at this independent treatment centre. We will reimburse the rest of this treatment for a maximum of one year, as if the 2024 contract continued in 2025. If you start a new treatment at this independent treatment centre in 2025, this transitional scheme will not apply. Remember that our maximum reimbursements apply in that case.
If your independent treatment centre did not have a contract with us in 2024 either:
We will be happy to help you find a solution. Please contact our Service Centre for this.
List of independent treatment centres that require permission will be withdrawn
In 2024, you needed to request permission for check-ups, examinations and treatment at a number of specific independent treatment centres, which were listed on our Overzicht zbc’s met toestemming (list of independent treatment centres that require permission). This condition will be withdrawn in 2025. Remember that our maximum reimbursements apply if you visit an independent treatment centre without a contract.
Requesting permission for treatment with a number of eye medicines at an independent treatment centre without a contract
If you are visiting an independent treatment centre that does not have a contract with us, you must request our prior permission for treatment with a number of eye medicines (in Dutch) from 1 January 2025.
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Changes to health-care plan cancellation
Under certain circumstances, we may cancel your health-care plan. From 1 January 2025, we have added the rule that we can also do this if we decide to stop offering or carrying out a certain plan. We will always inform you of this separately.
