Maximum reimbursements ONVZ Bewuste Keuze
The Reimbursements section of your ONVZ Bewuste Keuze policy specifies whether or not we will reimburse your treatment, and what you need to do to get reimbursed. If your health-care provider does not have a contract with us, we may not reimburse the whole invoice. To find out exactly whether, and if so how much, you have to pay out of your own pocket, take a look at our maximum reimbursements under the ONVZ Bewuste Keuze plan. If your health-care provider charges more than the amount listed, you will need to pay the rest yourself.
You can use our Zorgzoeker online search tool to see which health-care providers have a contract with us. A maximum reimbursement applies for non-contracted health-care providers. This reimbursement is based on a percentage of a predetermined rate, usually the average contracted rate. For ONVZ Bewuste Keuze, this percentage is between 60% and 80%. Take a look at the exact maximum reimbursements for each type of health care below.
Our maximum reimbursements
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If your general practitioner has referred you for further examination, such as a blood test, ultrasound or electrocardiogram, check this list to see what will be covered when going to a non-contracted health-care provider for your examination.
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If you are going to a skin therapist for scar treatment or oedema therapy, check this list to see what will be covered if your therapist does not have a contract with us.
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If you are (temporarily) staying at a facility such as a nursing home, and you need help from a physiotherapist, remedial therapist, occupational therapist, dietitian, or speech therapist who works at that facility, check this list to see what will be covered if that practitioner does not have a contract with us.
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If you go to a physiotherapist, remedial therapist, occupational therapist, dietitian, or speech therapist who works at a hospital, check this list to see what will be covered if we have not contracted that health care at the hospital in question. This does not apply if you have been admitted to that hospital, as the costs will then be included in the hospital bill.
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Good to know
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If you go to a health-care provider with whom we do not have a contract, you may need to pay part of the costs yourself. If these costs are so high that you are restricted in your choice of health-care provider, you can invoke the ‘hardship clause’. The hardship clause is a scheme under which you can request a higher reimbursement from us if your financial situation is such that you cannot afford the treatment.
To invoke the hardship clause, submit a request using the upload form. In your request, state that it relates to the hardship clause and explain why you need a higher reimbursement.
The hardship clause cannot be invoked for health care covered under a supplementary health-care plan.
