Changes in our supplementary plans in 2025

Personal contribution for pharmaceuticals and list of medicines

The basic health-care plan covers the most common medicines for which you have a prescription. In 2024, the Benfit and higher supplementary health-care plans reimbursed your personal contribution under the basic health-care plan, plus other medicines. In 2025, this will change: 

• from 1 January 2025, the supplementary plans will no longer reimburse your personal contributions
• from 1 January 2025, the supplementary plans will no longer reimburse all medicines. The Overzicht geneesmiddelen aanvullende verzekering (list of medicines in supplementary health-care plans, in Dutch) shows which medicines are still covered by supplementary plans.

Personal contribution for maternity care and birth in an outpatient clinic

If you are pregnant, giving birth in an outpatient clinic or birth centre can be subject to a high personal contribution under the basic health-care plan. You also need to pay a personal contribution for maternity care. Our Benfit and higher supplementary health-care plans reimburse some of that personal contribution. From 1 January 2025, we will be increasing this reimbursement under our Optifit, Topfit and Superfit supplementary health-care plans to 100%. For Benfit it will still be capped at €250. The increase also applies to adoption care.

More preventive health-related courses

The Optifit and higher supplementary health-care plans include coverage for preventive health-related courses recognised by us. From 2025, we will recognise more preventive health-related courses. You can find a list of these on our website (in Dutch). The preventive health-related courses focus on quitting smoking, healthy pregnancies and childbirth, healthy weight, mental fitness, self-management and first aid. If you want to start working on things like finding more balance in life, take a look at our preventive health-related courses. 

Improved range of exercise programmes

If you have a chronic illness or if you have had heart surgery, an exercise programme can help you reduce pain and impairments, and improve your mental health. The Optifit and higher supplementary health-care plans sometimes provide coverage for exercise programmes. For 2025, we have improved access to these exercise programmes in these supplementary plans; they clearly state which therapists are the best choice for you. 

Qualifying period

From 1 January 2025, coverage for orthodontics up to the age of 18 under Optifit and Topfit is subject to a qualifying period. This means that coverage will only apply if the treatment is provided 12 months or more after taking out the supplementary health-care plan. If you want more information about qualifying periods, please see our information page on qualifying periods (in Dutch). If you took out your Optifit or Topfit plan over 12 months ago, nothing will change for you.

Changes to Optifit and Topfit reimbursements

From 1 January 2025, Optifit will cover 80% of orthodontics up to the age of 18 with a maximum of €2,000. Topfit will cover 80% of orthodontics up to the age of 18 with a maximum of €3,000. Once the maximum amount has been reached, we will not cover any further costs for this type of health care, not even in a subsequent year.

If your child is currently being treated by an orthodontist and this is covered by your Optifit or Topfit plan, a transitional scheme will apply. Your child will be able to finish the treatment based on the reimbursements for 2024. If you have any questions about this, please contact us.

If you have excessive hair growth on your face (more than normal), the Benfit and higher supplementary health-care plans cover the costs of electrical epilation and laser treatment. From 1 January 2025, Optifit and Topfit will be subject to a qualifying period for this coverage. This means that coverage will only apply if the treatment is provided 12 months or more after taking out the supplementary health-care plan. If you took out your Optifit or Topfit supplementary health-care plan over a year ago, nothing will change for you.

If you have a Topfit supplementary health-care plan and are thinking about getting stuttering therapy in 2025, as of 1 January 2025, the maximum reimbursement for stuttering therapy in Topfit will be lowered to €750 for the entire term of your health-care plan. The reimbursement for stuttering therapy in Benfit, Optifit and Superfit will remain the same. 

The basic health-care plan covers the first three IVF or ICSI attempts. From 1 January 2025, the Topfit supplementary health-care plan will no longer cover the fourth or fifth IVF or ICSI attempt. If you are currently undergoing an IVF or ICSI attempt and you have Topfit, a transitional scheme may apply to you. Please contact our Service Centre for this. We would be happy to help.

The basic health-care plan covers plannable hospital care in Belgium and Germany up to a maximum of what we would have reimbursed for the care in the Netherlands. The Superfit supplementary health-care plan supplemented this reimbursement in 2024. This meant that you did not need to pay the difference if the health care was more expensive than in the Netherlands. From 1 January 2025, this supplementary coverage will no longer apply. Your Superfit plan will still supplement the reimbursement under the basic health-care plan up to twice our maximum reimbursement. This applies to health care in an EU, EEA or treaty country, so also in Belgium and Germany.

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.

Maximum reimbursement after an accident the same for all dental health-care plans

From 1 January 2025, the maximum reimbursement for dental health care after an accident will be the same for every supplementary health-care plan. This means that the reimbursement in Tandfit A, B and C has been raised to € 10,000. If you cancel this plan during your treatment, our coverage will also end.

Tandfit Preventief to be withdrawn

You will no longer be able to take out Tandfit Preventief. If you current already have Tandfit Preventief, you may also keep this dental health-care plan in 2025.

As of 1 January 2025, Tandfit Preventief will no longer cover the toothbrushes and corresponding brush heads. The good news is that you will still receive one last set of 4 brush heads in 2025. We will tell you more about this in late February.

If you are looking for a dental health-care plan, we will still be offering the Tandfit A, B and C packages in 2025. 

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.

If you are going abroad temporarily, as of 1 January 2025 the Wereldfit supplementary health-care plan will cover urgent care and other services if you go abroad for no more than 1 year. In 2024, this maximum period is only 180 days, so the period has been extended. 

The basic health-care plan covers plannable hospital care in Belgium and Germany up to a maximum of what we would have reimbursed for the care in the Netherlands. The Wereldfit supplementary health-care plan supplemented this reimbursement in 2024. This meant that you did not need to pay the difference if the health care was more expensive than in the Netherlands. From 1 January 2025, this supplementary coverage by Wereldfit will no longer apply. If you will be receiving plannable health care at a hospital in Belgium or Germany in 2025 and we have a contract with them, the basic health-care plan will provide coverage for this. If you will be seeing a health-care provider without a contract, our maximum reimbursements apply. Please see the Overzicht ziekenhuizen buitenland 2025 (list of foreign hospitals for 2025, in Dutch) to see which health-care providers have a contract with us. 

Wereldfit reimburses extra accommodation costs up to a maximum of €150 per day if there is a medical reason why your stay is longer or different, for example, if you or a travel companion end up in hospital. From 1 January 2025, meals provided during this stay will no longer be reimbursed.

If you are being admitted to hospital, the Zorgplan and Superfit supplementary health-care plans cover additional facilities or services to make your stay in hospital more pleasant. All facilities and services are covered up to a combined maximum of € 2,500 per calendar year. Do note, however, that our reimbursements are changing from 1 January 2025. Below is an overview of these changes:

Single room

If you are unable to get a single room in the hospital where you are staying, you will no longer receive compensation from 1 January 2025. If the hospital does offer a single room, the costs of this will be reimbursed. This also applies to hospital admissions in Belgium or Germany.

More comprehensive luxury package

Useful items such as bed reading glasses and a safe for your valuables will be added to the luxury package. We will also reimburse the costs for additional comfort if the hospital does not include this in their luxury package, for example, if you want to buy an extra snack or drink in the hospital shop.

Increased parking costs coverage

We are increasing the coverage for parking costs. In 2025 we will reimburse: € 100 for an admission of no more than 5 days and € 200 for an admission of 6 days or more. You can also use this amount for your visitors’ parking costs.

Hotel accommodation for partner

From 2025, we will also reimburse the costs if your partner wants to stay overnight near your hospital. We will reimburse € 100 per night for this as long as you are in hospital.

The Superfit and Zorgplan supplementary health-care plans cover assistance and extra service for your stay in hospital. This includes a reimbursement for transportation when you are admitted and discharged. From 1 January 2025, we will also reimburse transportation without a medical indication if you need to go to hospital for outpatient care. We will reimburse taxi or public transport fares in full and €0.27 per km for travel by car. The Zorgassistent can arrange your transportation, or you can do so yourself through the Transvision taxi service.