CZ Health Insurance 2015

Transcription

1 CZ Health Insurance 2015 Group: Basis Collectief, Plus Collectief, Top Collectief and Jongeren 1

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3 CZ helps you to choose the group health insurance that's right for you You would like to be insured for the best healthcare. Healthcare that is available whenever you need it and that fulfils your needs and wishes. That is why it is very important to choose the right group health insurance for. That is where we can help. Our advisers are available to provide you with advice tailored to you personally. Not only that, we also provide you with online support every step of the way towards finding the health insurance that suits your situation best. Do not hesitate to call our advisers so that we can help you further! CZ everything for better healthcare This brochure provides you with further information about the group health insurances offered by CZ. At CZ.nl/english you will find comprehensive information about our various health insurances and you can calculate your premium straight away. 3

4 First select a general insurance In accordance with the law, every person in the Netherlands is obliged to take out a general insurance. The general insurance reimburses for the most essential healthcare costs. The government determines the reimbursements that form part of the general insurance. For example, the general insurance includes healthcare from your general practitioner or medical specialist, ambulance transport, but also medicines and hospital care. You can find further information about the exact reimbursements at CZ.nl/english and in the package comparer. A general insurance lasts for 1 calendar year. At CZ, you can choose from 3 general insurances. The type of reimbursements in those general insurances are always the same. Sometimes the percentage that is reimbursed to you differs, however. The additional services that you receive as part of the policy also differ. You can find an overview showing the differences on the right-hand side. Do you have any other questions? Visit CZ.nl (in Dutch) for further details, call CZ Customer Services or drop into one of our offices. 4

5 19% chose this 73% chose this 8% chose this You can calculate your premium, including group discount, at CZ. n l /a p p ly 'Zorgbewustpolis' 'Zorg-op-maatpolis' 'Zorgkeuzepolis' This policy is an in-kind policy. You go to care providers with whom CZ has a contract and this means that you pay a lower premium. CZ has made agreements with contracted care providers with regard to prices and quality of service provision. If you go to a non-contracted care provider, CZ will reimburse 65% of the bill up to a maximum of 65% of the agreed rate. The 'Zorgbewustpolis' is an internet-based policy. This is also an in-kind policy. You go to care providers with whom CZ has a contract. If you go to a non-contracted care provider, CZ will reimburse 75% of the bill up to a maximum of 75% of the agreed rate. This policy is a refund policy. If you choose this policy, you may go to any care provider or supplier that fulfils the requirements in the terms and conditions of insurance. You therefore pay a slightly higher premium for this policy. 100% reimbursement of contracted care 65% reimbursement of non-contracted care choice of 2 deductibles communications from CZ are always sent electronically via 'Mijn CZ' and by . You are always welcome to call CZ, of course payment by direct debit 100% reimbursement of contracted care 75% reimbursement of non-contracted care choice of 6 deductibles correspondence by or by post payment by direct debit or by giro payment form you receive a reimbursement of up to 100% of the statutory rate for the costs of the healthcare. Has a statutory rate not been set for a particular type of healthcare? In that case, we will reimburse the costs up to the reasonable market rate. choice of 6 deductibles correspondence by or by post payment by direct debit or by giro payment form A second opinion using 'Best Doctors' Are you opting for the 'Zorg-op -maatpolis' or the 'Zorgkeuzepolis'? If so, you may use 'Best Doctors' in consultation with our care advisers. 'Best Doctors' is an international network of specialists. They can give you a second opinion on the best treatment for your illness or disorder. 5

6 Visit cz. n l /g ro u p be n e f it s for the benefits of group health insura nce Would you like a higher level of healthcare insurance? Group additional insurance Some costs are not reimbursed or are only partially reimbursed from the general insurance, such as costs of physiotherapy. However, you can take out insurance for these costs separately in a group additional insurance. CZ has different group additional insurances that offer reimbursements to increase the cover: 'Basis Collectief', 'Plus Collectief' and 'Top Collectief'. 'Plus Collectief' in particular is an ideal insurance for families when combined with dental cover. It provides ample reimbursement for physiotherapy, the flu jab and preventive health checks. The dental insurance provides extensive reimbursement for orthodontics. This is very useful if one of your children wears a brace. CZ also offers a additional insurance package Jongeren. We tailor-made this additional insurance package. The advantage is that you only pay for things that are relevant to your phase of life. You therefore do not pay for extra maternity care, for instance. You pay a premium for an additional insurance from the age of 18 years. Co-insured children under the age of 18 years do not pay any premium. They receive the same additional insurance as the parent/carer with the most comprehensive additional insurance. Your additional insurance is valid for one full calendar year. You can therefore change the insurance every year if your needs change. CZ will accept you without a medical assessment. Group dental insurance We reimburse dental costs for children up to the age of 18 years from the general insurance. Once over the age of 18 years, an individual is liable for their own dental costs and you can take out insurance for these in the form of dental insurance. This lasts for one full calendar year. CZ offers 2 different group dental insurances: 'Tandarts Collectief' and 'Uitgebreide Tandarts Collectief'. The difference between the two insurances is the maximum amount that CZ reimburses per year. Both insurances also reimburse costs for orthodontics. If you take out the 'Jongeren' additional insurance, you do not need to take out any separate dental insurance, because CZ already reimburses the costs of the dentist and/or orthodontist via these additional insurance. You can find further information in the package comparer or at CZ.nl/apply. Anyone can apply for 'Tandarts Collectief' dental insurance and CZ will accept you for this insurance without a medical assessment. In the case of the 'Uitgebreide Tandarts Collectief' dental insurance, CZ will assess the condition of your teeth on the basis of a statement from your dentist and tell you if you can take out this insurance later. 6

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8 Useful information about the deductible What is a deductible? Every Dutch person from the age of 18 years is liable for a compulsory deductible of 375 in This has been set by the government. The deductible is the amount you have to pay yourself, while the remainder is reimbursed. The deductible applies only to reimbursements from the general insurance. Exceptions to this are a visit to the general practitioner, obstetric care, maternity care, multi-disciplinary care, a follow-up check on kidney or liver donors, costs of transport of a donor in the case of organ transplants, medical aids on loan and district nursing care. Spreading payment of the compulsory You may pay your compulsory in equal instalments in advance. This means you avoid any unpleasant surprises as a result of receiving an invoice for treatment that we offset against your deductible. This way, you avoid any financial setback. For further information about this, visit CZ.nl/eigen-risico (in Dutch). Voluntary deductible In addition to the compulsory deductible you can opt for an additional voluntary deductible. The higher your deductible, the lower your premium. The voluntary deductible applies to the same reimbursements as the compulsory deductible. Nice to have on holiday Accidents can happen when you least expect them. If something happens on holiday and you need medical care, call the CZ Helpline. You will receive advice and information from a Dutch expert. For instance if you should go to a doctor, or the location of the nearest hospital. With an EHIC card, which you can apply for from CZ, you do not have to pay up front for any healthcare costs incurred within Europe. CZ will settle the costs directly with the care provider. You can also use the 'CZ Reishulp' travel assistance app with ease whilst abroad. 8

9 Save on your premium Premium The premium is the amount you pay for the general insurance. The premium for the different types of general insurance is shown on your quote or in the premium overview. Your employer has a group health insurance with CZ, which means you receive a discount on the premium. The discount also applies to your spouse, partner or children. Children up to the age of 18 years are co-insured and do not pay premiums; a deductible does not apply to them either. You can view all of the contracted care providers of CZ at CZ.nl/findcare The monthly premium for your health insurance is a sizeable expense and sometimes puts considerable pressure on your monthly outgoings. Here are a few tips to make savings on your healthcare premium. If your general practitioner and hospital are contracted by CZ, it might be worthwhile for you to choose the 'Zorgbewustpolis'. The monthly premium for this policy is lower than that of other policies. Consider whether a voluntary deductible is right for you. If you expect to incur few medical costs, this may save you money. However, you must be able to pay the deductible if you still incur medical costs. You may be entitled to a care allowance, in which case you will receive a contribution towards your healthcare costs from the Tax and Customs Administration. You can apply for this by contacting the Tax and Customs Administration at Toeslagen.nl or by calling the 'BelastingTelefoon' (tax line) service on If you opt for an annual, bi-annual or quarterly advance payment, you will receive a discount on your premium of up to 3% per year. Why does CZ conclude contracts with care providers? It is very important to CZ that care providers such as hospitals, pharmacists, physiotherapists and medical aids suppliers fulfil certain quality requirements. For that reason, we make agreements regarding treatments in order to assure ourselves that a specific treatment is being carried out effectively. We also make agreements concerning the price that these care providers may charge for the products and services they deliver. In this way, we endeavour to control the costs in the healthcare sector and to keep the healthcare system in the Netherlands affordable. 9

10 2014 Organise everything easily online With 'Mijn CZ', you can easily organise all of your insurance affairs. On 'Mijn CZ', you can: View your policy and reimbursements Change your details Claim for your bills Check the balance of your deductible Find out which bills have been paid directly to the care provider by us on your behalf CZ has been named as the health insurer with the best online service in 2014 CZ extras You can claim online for bills that you submit yourself to CZ. You may also claim by post, of course. The funds will be in your account within 10 days. As a customer of CZ you can receive discounts on products and services that help you stay fit and healthy. Such as discounts on fitness activities and for spectacles and contact lenses. As CZ is working together with OHRA, you can also obtain discounts on insurance for travel, cancellation, home or your car, for example. For an overview, visit CZ.nl/klantvoordeel (in Dutch). Are you wondering how to arrange the best type of care for your condition, or how to find the best place for treatment? Our care advisers are happy to help you. All of our advisers have a medical background, so that they can properly assess your situation. They can offer advice, for instance, if you are on a waiting list, or if you want a second opinion from another doctor. With our single point of contact, we will help you find the best healthcare solution for you. 10

11 The quickest way to apply is to go online and it also offers additional convenience Would you like to take out group insurance with CZ? If so, then visit our website at cz.nl/apply We will provide all of the help you need in making your choice. Please have your citizen service number to hand. You will also need your company's group number, which is available from your employer. CZ Customer Services Our advisers are available to help you. Monday to Friday from 8:00 am to 9:00 pm and Saturdays from 10:00 am to 2:00 pm by calling Would you prefer to receive advice in person? If so, then simply visit one of the CZ offices. Address details can be found at CZ.nl/office. You may also use the application form, which you can find in this information pack. Transferring Normally you can transfer on 1 January, but if you've changed employer and you already had group health insurance with your old employer you don't have to wait until 1 January. This also applies if you have a new employer and you now have individual insurance with CZ (i.e. not through your employer or organisation). 11

12 Everything for better healthcare Legal information Organisation CZ Groep Zorgverzekeraar, name given in Articles of Association as OWM Centrale Zorgverzekeraars groep, Zorgverzekeraar U.A. (CoC no ) CZ Groep Aanvullende Verzekering Zorgverzekeraar, name given in Articles of Association as OWM Centrale Zorgverzekeraars groep, Aanvullende Verzekering Zorgverzekeraar U.A. (CoC no ) Address Postbus 90152, 5000 LD Tilburg CZ terms and conditions of insurance These can be obtained from a CZ office, the Chamber of Commerce, or by calling us. The insurance contract is subject to the law of the Netherlands. Dissatisfied? If so, please let us know. Our internal complaints procedure can be viewed at CZ is affiliated as a health insurer with the Healthcare Complaints and Disputes Mediation Body ('Klachten en Geschillen Gezondheidszorg'), The following bodies also monitor how we operate as an insurer: De Nederlandsche Bank, Netherlands Authority for the Financial Markets ('Autoriteit Financiële Markten') (permits / ), the Dutch Healthcare Authority ('Nederlandse Zorgautoriteit') en the Netherlands Healthcare Institute ('Nederlands Zorginstituut'). 12 No rights may be derived from the contents of this brochure