I am Unique. IAK Unique Health Care Insurance, 2014 changes OFF MIN MAX. As a construction worker, I need lots of physiotherapy

Transcription

1 IAK Unique Health Care Insurance 2014 changes I am Unique As a construction worker I need lots of physiotherapy MIN MAX

2 IAK Unique suits your needs It is important that your health care insurance matches the phase of life you are in your wishes and your needs. That s why we offer IAK Unique the health care insurance that you can Put together your own IAK Unique Health Care Insurance. Senior care Birth care Orthondtic Treatment OpticalPlan Alternative and Special Remedies Physiotherapy Seniorzorg Geboortezorg Orthodontie <18 90% up to % up to % up to tailor to suit your particular circumstances. This brochure explains more about IAK Unique and the most important changes to your health care insurance. Tailored to suit your needs IAK Unique health care insurance was introduced last year - a health care insurance solution that you can adjust to suit your own personal or family situation. Under the Compact Compleet and Extra Compleet supplementary packages you can select the reimbursement level you want for Physiotherapy Alternative care and the (glasses/contact lenses). Under the Compleet package you can also select the level of reimbursement you want for Orthodontic treatment. 3 Then 2 And select your s choose your supplementary health care package Alternatieve zorg Fysio Alternatieve zorg (required) Alternatieve zorg Fysio Fysio Compact Compleet Extra Compleet Emergency medical assistance abroad Individual contribution medication Therapies Emergency medical assistance abroad Individual contribution medication Therapies (No) Emergency medical assistance abroad Individual contribution medication Therapies Ongoing development There is always room for improvement and IAK Unique is no exception. We have made some adjustments to the various s (reimbursements) with the aim of achieving an even closer match between your health care insurance and your needs. Of course you can also opt for one of the special packages created for specific target groups such as Jong (for young people) or Comfort (for senior citizens). For more information go to (Dutch only) and look under the header Aanvullende verzekeringen. Contraceptives Preventive treatments Seated patient transport Contraceptives Preventive treatments Crowns and bridges <18 years Stay in an institution Seated patient transport Contraceptives Preventive treatments Crowns and bridges <18 years Stay in an institution Seated patient transport Orthodontic treatment Geboortezorg Seniorzorg Health resorts and therapeutic camps Informal care Menopause consultation 2 1 Start with the Health Care Insurance This table simply shows which reimbursements are included under a supplementary health care package. We refer you to the policy terms and conditions for a more detailed overview that also states the precise reimbursement levels. 3

3 What has changed? From now onwards you can opt to switch off the reimbursements for Physiotherapy and Alternative care so that you will not be paying premium for care you do not expect to require. If you have specific physical problems or if there are health risks attached to your occupation you may wish to scale up various reimbursements to a maximum amount. If you are planning an addition to your family or are approaching old age you may be interested in one of the new s Geboortezorg (Childbirth care) or Seniorzorg (Senior care). More information? Go straight to (Dutch only) to find out for yourself what IAK Unique can mean for you. Statutory changes to the () This table shows the changes the government has made to the. Changes to excess/individual contributions/maximum reimbursements Excess (mandatory) 360 ( 350 in 2013) Index-linked rates applicable to individual contributions and maximum reimbursements Each year the statutory individual contributions and the maximum reimbursements are index-linked by the government. See (Dutch only) for the index-linked rates for Toppings you can set to the level you require* + Minimum reimbursement ++ Average reimbursement +++ Maximum reimbursement Changes to reimbursements for 2014 GGZ (Mental Health Care) The upper limit of 5 sessions set for first-line psychological care no longer applies. The individual contribution for first-line psychological care and care via internet no longer applies. I run a high risk I do not need glasses Hoorah I m pregnant Medical specialist care Subject to certain conditions reimbursement can be granted for: treatment of infected pancreatic necrosis (dying pancreatic tissue). performance of autologous stem cell transplantation on patients with severe refractory Crohn s disease. Home dialysis equipment From 1 January 2014 home dialysis equipment will be reimbursed as medical specialist care rather than as a medical aid. The cost of the equipment itself will be borne by the hospital but the insured person will remain liable for the cost of any home adaptations needed. Vacuum therapy (in wound management) From 1 January 2014 the cost of this aid will be borne by the hospital as part of the overall therapy. Physiotherapy Geboortezorg Dyslexia treatment From 2014 children aged 7 or older in primary education with severe dyslexia will be entitled to dyslexia treatment Homeopathy helps me UIT I m looking forward to having nice straight teeth AAN I don t need Senior care Diabetic foot care Liquid nutrition Foot care for insured persons with diabetes mellitus type 1 or 2 falls under GP care. From 2014 it may also be provided by a pedicurist or podotherapist with specialist training. Foot care for diabetes type 2 may form part of a chain care programme. Preferred products have been selected for certain types of liquid nutrition that are lower in price than the liquid nutrition provided by specific manufacturers or under certain brand names. If you use a preferred product the cost will not be set off against your excess. See for the preferred forms of liquid nutrition. Alternative care Orthodontic treatment < Seniorzorg UIT Medicines General changes for 2014 At present excess does not apply to preferred medicines. This will change partially in The medicines themselves will continue to fall outside your excess but excess will apply to the costs charged by your pharmacy for supplying the preferred medicines (delivery costs). Changes will also been made to the Pharmaceutical Care Regulations (the list of preferred medicines and the list of medicines that require prior permission). Go to for the regulations and a detailed explanation of the preferred medicines policy. * You can readjust the s each policy year to suit your wishes. Annual payment The discount for insured persons who pay their premium for the basic insurance and the supplementary insurance package(s) per year rather than per month will change from 3% to 1% of the total premium. 4 5

4 Changes to the supplementary health care packages for 2014 Jong Compact Compleet Extra Compleet Comfort Childbirth care (optional as ) - individual contribution delivery / maternity care - maternity package - extra reimb. for multiple births lactation care max. 115 p.p. per year - maternity care following adoption 12 hours over 4 days - incubator aftercare for 12 hours Senior care (optional as ) - individual contribution medical aids - upper eyelid correction - membership of patient association max. 75 per insured person per year Alternative treatments and medicines - amalgamation of reimbursement for treatments and medicines - amalgamation of reimbursement for treatments and medicines - amalgamation of reimbursement for treatments and medicines Preventive care - preventive examinations if prescribed by doctor if prescribed by doctor if prescribed by doctor Physiotherapy - adjustment of maximum amounts - adjustment of maximum amounts - adjustment of maximum amounts Skin treatments beautician named under Vergelijk en Kies will be reimbursed (log on to beautician named under Vergelijk en Kies will be reimbursed (log on to beautician named under Vergelijk en Kies will be reimbursed (log on to beautician named under Vergelijk en Kies will be reimbursed (log on to beautician named under Vergelijk en Kies will be reimbursed (log on to Pedicure for diabetics and rheumatism patients reimbursement for diabetics no longer applies: is covered under the basic insurance reimbursement for diabetics no longer applies: is covered under the basic insurance Psychological care (first-line care) Psychological care (neurofeedback treatment in relation to ADHD/ADD) maximum of 1000 per year for treatment by a psychologist who is a member of the NIP Psoriasis day treatment 6 Changes to the dental insurance for 2014 Dental care insurance Gum shield on medical grounds only on medical grounds only on medical grounds only Please note: This overview of changes is simply a summary of the changes to reimbursements scheduled to take place in No rights (including rights to reimbursement) may be derived from the content of this overview. Always log on to (Dutch only) and consult the insurance terms and conditions for precise up-to-date details of the reimbursements. Go to (Dutch only) for full details of the reimbursements for

5 * Vul hier de gegevens in van de verzekeringnemer Uw verzekerdenummer vindt u op uw zorgpolis of zorgpas. U kunt via dit formulier nota s opsturen voor meerdere personen op uw polis. U kunt uw gegevens zelf actueel houden door in te loggen of een account aan te maken op onze website. IAK Verzekeringen B.V. maakt deel uit van de Unirobe Meeùs Groep onderdeel van AEG. IAK Verzekeringen B.V. is geregistreerd bij de AFM onder nummer IAK Verzekeringen B.V. is statutair gevestigd te Eindhoven en bij de KvK geregistreerd onder nummer Postadres: Postbus RV Eindhoven. Important news 1 Gegevens verzekeringnemer Being Declaratieformulier aware of your health care costs Verzekerdenummer * BSN nummer Achternaam verzekeringnemer (+ meisjesnaam indien van toepassing) IBAN: the implications for you Voorletters Tussenvoegsels Straat Huisnummer Toevoeging Postcode Woonplaats Land Health care costs in the Netherlands are soaring. You have probably been aware of all the Voortaan kunt u ook eenvoudig uw declaraties online indienen. Voor meer informatie kijkt u op Dient u de declaraties liever schriftelijk in? Dan kunt u onderstaande richtlijnen aanhouden. 2 Belangrijk bij het invullen Overmaken aan mijzelf: wij maken de vergoeding over op het bij ons bekende rekeningnummer. Overmaken aan de zorgverlener: meestal is het mogelijk om de vergoeding aan de zorgverlener over te maken. Soms kan dit niet. In dat geval ziet u op de uitkeringsspecificatie dat wij de vergoeding aan u hebben overgemaakt. Let op ook als u voor deze optie kiest blijft u zelf verantwoordelijk om eventuele overige en/of extra kosten tijdig over te maken aan de zorgverlener. Declaratie van in het buitenland gemaakte kosten: voor de declaratie van deze kosten vragen wij u gebruik te maken van het Declaratieformulier You as the insured person need to be aware of what your medical treatment has actually cost. recent radio and television advertisements: medische kosten buitenland. Dit formulier vindt u terug op onze website Declaratie van vervoerskosten: voor de declaratie van deze kosten vragen wij u gebruik te maken van het Declaratieformulier vervoerskosten. Dit formulier vindt u terug op onze website 3 Sprake van een ongeval? That s why IAK always informs you of the health the Netherlands is switching to IBAN a new European payment system. Your bank will Is er sprake van een ongeval waarbij een tegenpartij betrokken is? Dan is het belangrijk dat u dit bij ons aangeeft. Wij kunnen dan de kosten en eventueel uw eigen risico terugvorderen bij de tegenpartij. U kunt op verschillende manieren de melding bij ons doen: Op staat onder het kopje Declareren en dan Zorgkosten verhalen een formulier dat u online kunt invullen. U kunt ook rechtstreeks contact met ons opnemen via zorgregres@iak.nl. 4 Opsturen van uw declaratie(s) Spaar uw nota s niet op. Stuur ze direct naar ons door. Voeg de originele nota s bij dit declaratieformulier. Kopieën duplicaten en betalingsherinneringen nemen wij niet in behandeling. U ontvangt uw originele nota s niet terug. Wij raden u aan een kopie te maken voor uw eigen administratie. Maak voor de verzending gebruik van de retourenvelop. Hebt u geen retourenvelop? care costs incurred by you and your family. automatically adjust your account number Stuur uw declaratie dan naar: IAK Verzekeringen B.V. t.a.v. Klantenservice Zorg Postbus RT Eindhoven. Notanummer/factuurkenmerk Wie werd behandeld? Bedrag van de nota s (EUR) Aan wie overmaken? van de nota s Voorletters Geboortedatum Mijzelf Zorgverlener Over view of expenses and send you a new cheque card. IAK has also Each insured person receives a digital overview amended its systems to make them compatible Totaal aantal nota s Datum inzending Totaalbedrag nota s of expenses twice per year. This overview with the new account numbers. You do not need Samen voor een perfect verzekerde toekomst provided for your information lists all the claims to do anything. In the future we will ask you for your IBAN instead of your old bank account or giro account number. You can find your IBAN Paper-based claim form soon to disappear submitted by you/on your behalf and paid out by IAK. Check the overview and contact the care provider if you find expenses on the overview on your bank statements. For more information that you do not recognise. The overview is only go to Veelgestelde vragen (FAQs) on With so many digital developments such as available online via your personal online file. (Dutch only). doing business online and the IAK Zorg app (see page 11 for more information) paper-based For more information go to claim forms have become redundant. From kostenoverzicht (Dutch only). 1 January 2014 these forms will no longer be available. If you still prefer to use paper-based communication you can continue to send us your paper-based invoices. Check that your name address town/city of residence and date of birth IAK Zorgvergelijker (Care Comparer) are shown on the invoice. Write your insurance number in the upper right-hand corner of the The IAK Zorgvergelijker draws an invoice put it in an envelope and send it to IAK. objective comparison between Once you have submitted a claim the relevant the terms and conditions and amount will be transferred to your account. Do reimbursements offered by the various you need to transfer the reimbursement relating health care insurers. It makes it easy to the claim to the care provider? Generally for you to pick out the health care speaking reimbursements are transferred to insurance that best suits your particular your account within 10 working days. So you will needs. You can access the always be able to pay your care provider on time. IAK Zorgvergelijker by logging on to So from now onwards submitting claims to IAK (Dutch only). will be even quicker and easier! 8 9

6 New: Keuzehulp (decision aid) IAK: promoting digital innovation Our new Keuzehulp (discision aid) makes putting together your health care insurance even easier. It enables you to see at a glance which supplementary package best suits your situation. Then set the s to tally with your wishes. And lastly select the level of your voluntary excess. You can see straight away what impact your choice will have on your monthly premium. Once you have put together a health care insurance you are happy with you can amend your existing health care insurance straight away. Go to (Dutch only) discover IAK Unique and decide for yourself which package you want and how much you pay. Clearly laid out and easy to operate The IAK Health Care app: submitting invoices has never been easier Use the IAK Health Care app to submit invoices quickly and easily. Download the app take a photo of the invoice indicate whether you are submitting a claim for yourself or on behalf of a family member and send the invoice at the press of a button. All the invoices you have submitted will be stored in your personal file in the app so that you can refer to them later if necessary. Or log on to Mijn IAK for a complete overview of all the claims you have submitted. More advantages of the IAK Health Care app: The IAK Health Care app is more than just a handy means of submitting invoices. It also means that: you have digital access to your IAK health insurance card (and your family members cards); you always have your European Health Insurance Card (EHIC) (and your family members EHICs) to hand; you can call the SOS International Alarm Centre and other emergency numbers without a hitch; you can call or IAK Customer Service with ease. Mijn IAK Have you already created a personal account via Mijn IAK? The advantages in terms of speed and efficiency are significant. You can arrange all your health care insurance affairs online from applying for your policy and amending it to submitting claims and keeping a precise record of all your important health care-related correspondence in your personal online file. For more information go to (Dutch only). Additions to Mijn IAK We are planning additions to Mijn IAK to provide you with an even more extensive service. Updates on new developments will be announced in the IAK newsletter. For more information on using the app and the advantages go to (Dutch only) 10 11

7 We re here to help you Go to to access detailed information and downloads. Call +31 (0) Our Customer Service staff will be pleased to assist you. Make an appointment with one of our advisors Our advisors arrange appointments regularly at a wide range of business locations. Visit one of our service desks At Beukenlaan 70 or at the High Tech Campus (The Strip) in Eindhoven. The content of this brochure has been compiled with the greatest possible care and is provided for your information. Please be aware however that no rights (including rights to reimbursement) may be derived from the content of this brochure. For precise up-to-date reimbursement details always log on to (Dutch only) and consult the insurance terms and conditions or contact Customer Service. IAK Verzekeringen B.V. IAK Volmacht B.V. Postbus RV Eindhoven Beukenlaan 70 Eindhoven T (040) F (040) IAK Verzekeringen B.V. Chamber of Commerce: IAK Volmacht B.V. Chamber of Commerce: AFM licence number: ZV-PB-UNIEK VGZ ENG ( )