HERE S TO YOUR HEALTH!

Transcription

1 For further information: (local rate) HERE S TO YOUR HEALTH! We wish you the best VGZ group health insurance With attractive supplementary insurance This brochure has been approved by Stichting Makkelijk Lezen (Easy Reading Foundation) Fully focused on good care

2 2 VGZ HEALTH INSURANCE 2010 Contents Foreword 3 Overview of insurances 4 Basic insurances 4 Supplementary insurances 4 Modular packages 6 Beperkte Aanvullende Verzekering 6 Uitgebreide Aanvullende Verzekering 6 Plus Aanvullende Verzekering 6 Dental insurances 8 Tand Goed Pakket 8 Tand Beter Pakket 8 Tand Best Pakket 8 Total care packages 10 VGZ Jong Pakket 10 VGZ Gezin Pakket 11 VGZ Vitaal Pakket 12 Determining your premium yourself 14 VGZ s extras 15 Ledenvoordeel 16 MijnGemak 17 A list of all our insurances 18

3 VGZ HEALTH INSURANCE Welcome! If you are considering opting for group health insurance, it is important to be aware that we offer a great deal of personal freedom of choice in spite of the group nature of the insurance. You can customise your own package. Moreover, because our supplementary insurances are based on budgets, you can determine for yourself which treatments you wish to have reimbursed. We also offer additional reimbursements and substantial premium discounts. Best quality care Opting for VGZ means opting for a health insurer that is fully focused on good care. We ensure the quality of care that you receive, actively guiding you to the best care providers. If necessary, we mediate so that you are assisted as quickly as possible. To continuously improve the quality of care, we also support care providers. Very easy We also make it as easy as possible for you. Our packages have a clear structure: good, better, best. This makes it easy for you to choose with us. Our terms and conditions are brief and simple, and therefore easy for everyone to understand. In addition, the budgets you can commit to the desired treatments make it easy for you to use our health insurance. Additional reimbursements When covered by our group insurance, you also benefit from the MiX Aanvullende Verzekering (XAV), which includes additional reimbursements that are important to you as a person and as an employee. They concern prevention, physical therapies and psychological care, for example. Full focus We are sincerely proud of our group health insurances. You can be certain that we will make it easy for you and that you will have our full focus.

4 4 VGZ HEALTH INSURANCE 2010 We wish you the best VGZ group health insurance Opting for VGZ group health insurance means opting for a guarantee of good care. Moreover, group insurance means more generous reimbursements and, as an employee, you can obtain premium discounts through your employer. In spite of the group nature of the insurance, it allows for a great deal of freedom in the way you wish to put your package together. This is because an extensive range of supplementary insurances are available. In addition, when covered by our group insurance, you also benefit from the MiX Aanvullende Verzekering (XAV). Our basic insurance Every health insurer is legally obliged to cover the same basic care. This basic health insurance applies to commonly occurring types of care, such as general practitioner care, hospital care, maternity care and, until the age of 22, physiotherapy or dental care. VGZ has concluded agreements with thousands of care providers about the price and quality of care. At VGZ, you can choose between two basic insurance packages: VGZ Zorgverzekering (a contracted care policy) or VGZ Restitutieverzekering (a non-contracted care policy). VGZ Zorgverzekering allows you to choose which care provider you wish to go to. VGZ has concluded agreements with almost all care providers. It is also possible to go to a care provider that does not have an agreement with VGZ, although the reimbursement will then be less. On the other hand, the premium of this basic insurance is lower. VGZ Restitutieverzekering gives you complete freedom of choice with respect to care providers. As long as the care provider meets the requirements set out in the insurance terms and conditions, it does not matter whether he, she or it has concluded agreements with VGZ. A higher premium is paid for this complete freedom of choice. Our supplementary insurances Understandably, you may very well wish to take out additional insurance for care beyond that covered by the basic insurance. Doing so is possible through one of the modular packages, dental insurances and MiX Aanvullende Verzekering (XAV), or through a total care package. Whatever insurance you opt for, you are guaranteed good care and a low premium. MiX Aanvullende Verzekering When covered by our group insurance, you benefit from the special supplementary insurance MiX Aanvullende Verzekering (XAV) through your employer. This insurance includes budgets for, among other things, physical therapies, prevention and psychological care. Modular packages If you wish to have freedom of choice in the composition of your supplementary insurance and determine whether or not you wish to have dental insurance, you can opt for one of our three modular packages: Beperkte Aanvullende Verzekering, Uitgebreide Aanvullende Verzekering or Plus Aanvullende Verzekering. These insurances can be augmented by separate dental insurance. Page 6 provides further information about the possibilities and reimbursements of these insurances. Dental insurances If you opt for one of VGZ s modular packages you can take out supplementary dental insurance through one of our three dental insurances: Tand Goed Pakket, Tand Beter Pakket or Tand Best Pakket. Page 8 provides further information about the possibilities and reimbursements of these insurances. Total care package If you would prefer a package that meets your personal needs and lifestyle and that covers the kind of care most important to you, and if you also wish to have the convenience of a single package that includes dental cover, you can opt for one of our three total care packages: VGZ Jong Pakket, VGZ Gezin Pakket or VGZ Vitaal Pakket. Pages 10 up to and including 12 provide further information about the possibilities and reimbursements of these packages. Further information about the insurances can be found at Budgets Because we have grouped treatments, VGZ offers you freedom and convenience with respect to your reimbursements if you have supplementary insurance. This grouping allows you to see almost immediately which care is reimbursed by VGZ. A reimbursement is provided up to a certain maximum for each treatment group. We refer to this as a budget. You are free to choose which treatment you wish to spend your budget on and can therefore make optimal use of your reimbursement amount. Budgets are available for, among other things, prevention, physical therapies, foot treatments and care aids.

5 VGZ HEALTH INSURANCE Option 1 Basic Insurance Required by law MiX Aanvullende Verzekering Supplementary Modular Package Beperkt Uitgebreid Plus Supplementary Dental Insurance Tand Goed Tand Beter Tand Best Option 2 Basic Insurance Required by law MiX Aanvullende Verzekering Supplementary Total Care Package (including Dental Insurance) Jong Gezin Vitaal

6 6 VGZ HEALTH INSURANCE 2010 Modular package Beperkte Aanvullende Verzekering, Uitgebreide Aanvullende Verzekering and Plus Aanvullende Verzekering If you wish to have a great deal of freedom of choice and decide for yourself whether or not to take out dental insurance, you can opt for one of our three supplementary insurances: Beperkte Aanvullende Verzekering, Uitgebreide Aanvullende Verzekering or Plus Aanvullende Verzekering. Some reimbursements augment the basic insurance. Beperkte Aanvullende Verzekering Beperkte Aanvullende Verzekering entitles you to important additional reimbursements, for example for physiotherapy, Cesar/Mensendieck exercise therapy and alternative care. A lot of reimbursements are also provided with respect to prevention, such as health checks, first aid courses and vaccinations prior to foreign travel. Uitgebreide Aanvullende Verzekering VGZ Uitgebreide Aanvullende Verzekering provides higher maximum reimbursements than the Beperkt Aanvullende Verzekering, as it also reimburses spectacles and contact lenses, psychological care and the maternity care package. Plus Aanvullende Verzekering Plus Aanvullende Verzekering provides maximum security, as it provides the highest reimbursements. In addition, reimbursements are provided for eye laser treatment and sterilisation, for example. Dental insurance: Goed, Beter, Best To augment the Aanvullende series of insurances, you can take out one of the following three insurances: Tand Goed Pakket, Tand Beter Pakket or Tand Best Pakket. Additional information about the possibilities and reimbursements of these insurances is provided further below. Important reimbursements of VGZ supplementary insurances Beperkte Aanvullende Uitgebreide Aanvullende Plus Aanvullende Physical therapy (including physiotherapy) Alternative care Spectacles and contact lenses every 2 years 150 every 2 years Maternity care (reimbursement of excess) Full amount The complete overview of reimbursements is given on page 3 of the appendix. Further information can be found in the policy terms and conditions. These can be consulted at or requested by calling (local rate).

7 VGZ HEALTH INSURANCE I have VGZ group insurance, it s just easy I ve now had VGZ insurance through my work for four years. Everything s perfectly arranged for me and my wife, because I can simply include her in the cover as a co-insured person without any hassle. We re expecting our first child soon. My wife therefore has Plus Aanvullend insurance while I m covered by the Uitgebreid Aanvullend package insured together but each with our own package. You can choose yourself and I like that. Through my work I also get a discount on the premium. My family and I therefore get the best care for the best price. Dick van de Vorst, 30, Consultant

8 8 VGZ HEALTH INSURANCE 2010 Goed, Beter, Best VGZ dental insurances VGZ offers a range of options if you wish to take out dental insurance. If you opt for a modular package you can take out supplementary insurance to cover dental expenses. Some dental expenses are covered by the basic insurance package until the age of 22. If you opt for one of the total care packages Jong, Gezin or Vitaal you do not need to do anything, since they already include dental insurance. Three insurances You can opt for one of the three dental insurance packages: Tand Goed Pakket, Tand Beter Pakket or Tand Best. A maximum reimbursement amount for dental treatment applies to all three insurances. Needless to say, the Tand Best package provides the most comprehensive cover. Insured persons aged also pay a lower premium for all three insurances. Attractive reimbursements The supplementary dental insurance reimburses the costs of the most common treatments. Examples in this regard include half-yearly checks, the removal of dental tartar, anaesthesia and the filling of cavities. In addition, costs incurred for, for example, crowns and bridges and a variety of other treatments are reimbursed. You can opt to be insured up to an amount of 250, 500 or 1,000 a year. Orthodontics The Tand Beter and Tand Best packages include an attractive reimbursement for orthodontics. The Tand Best package even reimburses the full amount for an insured person up to the age of 22. Dental selection No dental selection applies to the Tand Goed package. You will therefore always be admitted to this insurance cover. Terms and conditions of acceptance do apply, however, to the Tand Beter and Tand Best packages. We look, for example, at whether you regularly have your teeth checked and ask you whether you expect to require treatment in the near future. Reimbursements for orthodontics Tand Goed Tand Beter Tand Best Up to the age of 22 - From the age of 22-80% up to a maximum once-only amount of 1,500 80% up to a maximum once-only amount of 500 Full amount 1,500 once-only The complete overview of reimbursements is given on page 7 of the appendix. Further information can be found in the policy terms and conditions. These can be consulted at or requested by calling (local rate).

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10 10 VGZ HEALTH INSURANCE 2010 VGZ Jong Pakket Good care specially for you If you are aged between 18 and 27 and would prefer to take out affordable insurance that requires you to pay only for the kind of care you really need or may use, such as vaccinations or visits to a dentist, and not for the kind that you will probably not need, like maternity care, the VGZ Jong Pakket is the thing for you. Some reimbursements augment the basic insurance. Reimbursements are provided for the following: Visits to a dentist; Emergency assistance required while on holiday, irrespective of where in the world; Vaccinations required in connection with a holiday abroad up to an amount of 200 a year; 150 for new spectacles or contact lenses every two years; some opticians even give an additional discount; Care relating to movement, including physiotherapy, up to an amount of 600; Condoms up to an amount of 20; A free test for sexually transmitted diseases once a year; Skin treatments such as acne treatment up to an amount of 300 a year; Weight consultancy or sports medical advice up to an amount of 200 a year. The complete overview of reimbursements is given on page 10 of the appendix. Further information can be found in the policy terms and conditions. These can be consulted at or requested by calling (local rate). Our Ledenvoordeelprogramma (Members Benefit Programme) also qualifies you for attractive discounts on wellness-related arrangements and your fitness centre subscription.

11 VGZ HEALTH INSURANCE VGZ Gezin Pakket Good care for you and your family As a family, you naturally wish to benefit optimally from the care made available through VGZ. You would rather not leave anything to chance. VGZ Gezin Pakket is specially tailored to you. Everything has been taken into consideration, from additional maternity care to orthodontics. Some reimbursements augment the basic insurance. Reimbursements are provided for the following: Orthodontics up to an amount of 2,500 for children under the age of 22; 150 for spectacles every two years ( 200 every two years for children up to the age of 18); Emergency assistance required while on holiday, irrespective of where in the world; Care relating to movement, including physiotherapy, up to an amount of 600; Alternative care up to an amount of 300 a year; Care provided by a child psychologist if children have learning and behavioural problems; 15 additional hours of maternity care; Protruding ear correction up to an amount of 1,500 for children up to the age of 18; Reimbursement for adoption up to an amount of 300 per child; Broker for informal care that is, care provided by family members and friends up to an amount of 500 a year; Domestic help and childcare in the event of a hospital admission. The complete overview of reimbursements is given on page 10 of the appendix. Further information can be found in the policy terms and conditions. These can be consulted at or requested by calling (local rate). Care is quite expensive We transferred to the family package just before the birth of our son Mick purely for convenience and we ve never regretted doing so. Mick had eczema from birth and it took a couple of years to get rid of it. Luckily, all expenses were always reimbursed during that time. Boris was born three years after Mick and had to be admitted to hospital when he was six months old. His treatment included physiotherapy and speech therapy. All expenses were again reimbursed without any hassle. Our children are quite expensive but luckily we ve never had to worry about expenses. Astrid van Rooij-Van den Dungen, married to Alexander and mother of Mick (5) and Boris (2) Our Ledenvoordeelprogramma (Members Benefit Programme) also qualifies you for attractive discounts on wellness-related arrangements, spectacles/contact lenses, diaper service and various fitness centre subscriptions.

12 12 VGZ HEALTH INSURANCE 2010 VGZ Vitaal Pakket Enjoyment without a worry, sensibly insured Your children have left home and you are retired or will perhaps retire soon. At your age, you no longer require cover for maternity care or orthodontics. You would, however, like to have insurance for the kind of care you consider important or may require precisely in this phase of your life. If the foregoing applies to you, VGZ Vitaal Pakket has been specially designed for you. Some reimbursements augment the basic insurance. Reimbursements are provided for the following: Care relating to movement, including physiotherapy, up to an amount of 1,000 a year; Convalescent homes and care hotels up to an amount of 1,000 a year; Dietary advice up to an amount of 250 a year; Medical examination for the renewal of a driving licence; Up to a maximum amount of 150 for new spectacles or contact lenses every two years; some opticians even give an additional discount; Broker for informal care that is, care provided by family members and friends up to an amount of 750 a year; Therapeutic swimming; Emergency assistance required while on holiday, irrespective of where in the world; Vaccinations required in connection with a holiday abroad up to an amount of 500 a year. The complete overview of reimbursements is given on page 10 of the appendix. Further information can be found in the policy terms and conditions. These can be consulted at or requested by calling (local rate). Our Ledenvoordeelprogramma (Members Benefit Programme) also qualifies you for attractive discounts on activities and additional services like wellness-related arrangements and medical tests you can carry out yourself at home, for example.

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14 14 VGZ HEALTH INSURANCE 2010 An easy way to save money Determining your premium yourself The premium amount you pay depends on a variety of factors. You pay a lower premium if you only take out basic insurance or do not take out supplementary dental insurance, for example. You can also determine your premium in other ways, however. Compulsory excess Pursuant to government regulations, everyone aged 18 and above has a compulsory excess of 165 a year. The excess only applies to reimbursements paid under the basic insurance cover. There are a number of exceptions in this regard, however. The excess does not apply to expenses incurred for visits to a general practitioner, obstetric care, maternal care, care aids on loan and dental care up to the age of 22. Higher excess, lower premium You can voluntarily increase your mandatory excess to 265, 365, 465, 565 or 665. The benefit of doing so is that you will then have to pay a far lower premium for your basic insurance. The higher the excess, the lower the premium. Recovering the excess If you are going to have a knee, hip or groin operation at a hospital selected by us and engage the services of our Zorgbemiddeling (Care Mediation) Department, you will recover your mandatory excess. We settle this amount automatically after the operation. The hospitals we have selected for you are listed at Paying in one go You can pay your care premium on a monthly or yearly basis. If you opt to pay the total annual premium in one go in advance you will receive a 3% discount on the amount owed. Care allowance If you are eligible for a care allowance and meet the applicable requirements, you will receive a monthly amount from the Tax and Customs Administration. Further information in this regard can be obtained at or by calling (free number). No premium owed for children No premium is owed for the basic insurance or supplementary insurances for children under the age of 18. Of crucial importance, they also benefit from your or your partner s most comprehensive package. Group discount You can get a discount on the basic insurance and modular packages through your employer. Your employer will also be able to inform you about the agreements concluded. The group discount does not apply to the dental insurances and the total care packages. Premie Voordeel Plan Univé, VGZ, IZA, and Trias have an extensive range of non-life insurances. The more of them you take out with us, the greater the premium discount on them. The discount can amount to a maximum of 15% a year. We automatically settle all discounts retroactively. In addition, it is convenient to arrange all your insurances with a single insurer.

15 VGZ HEALTH INSURANCE Useful for everyone VGZ s extras At VGZ, you enjoy the benefits of good health insurance. We also offer many useful extras, however, like the VGZ Hulpdienst and Gezondheidslijn, for example, as well as special care programmes. VGZ Apotheek The VGZ Apotheek (VGZ Pharmacy) means you no longer have to leave the house for your medicines, as you can simply order them from the comfort of home. If you would also like to make use of our online pharmacy, simply visit VGZ Zorgbemiddeling If you are obliged to wait a long time for care, our Zorgbemiddeling (Care Mediation) Department will assist you in finding another care provider. We will also find you a new general practitioner or dentist if you relocate. You can reach us through zorgbemiddelaar@vgziza.nl. VGZ Zorgprogramma s It is important for different kinds of care to link together properly and easily, especially for insured persons with a chronic condition. The VGZ Zorgprogramma s (VGZ Care Programmes) can arrange a great deal for you. If you would like further information in this regard, simply call the VGZ Verzekeringslijn (VGZ Insurance Line) on (local rate). VGZ Vakantiedokter If you become ill abroad, you can obtain medical advice from the VGZ Vakantiedokter (VGZ Holiday Doctor). We also help you to find a doctor or hospital close to your holiday address. The VGZ Vakantiedokter can be contacted day and night on +31 (0) (regular call costs). VGZ Hulpdienst If you become ill abroad and require a stay of at least one night in a hospital, you are obliged to contact the VGZ Hulpdienst (VGZ Assistance Service). Staff will then inform you of what needs to be arranged and will also determine which expenses are or are not insured. The VGZ Hulpdienst can be contacted day and night on +31 (0) (regular call costs). VGZ Gezondheidslijn If you have a question about your health or would like to obtain reliable medical advice, you can call the nurses of the VGZ Gezondheidslijn (VGZ Health Line). They can be contacted 24 hours a day on ( 0.10 a minute). VGZ Kraamzorg To apply for maternity care and/or a maternity care package, simply call the central number of VGZ Kraamzorg (VGZ Maternity Care): ( 0.10 a minute).

16 16 VGZ HEALTH INSURANCE 2010 Attractive discounts Ledenvoordeel As a VGZ client, you are assured of complete cover and a favourable premium. We wish to do even more for you, however, and therefore offer the Ledenvoordeel (Members Benefit). Your VGZ health insurance card will entitle you to attractive discounts on a variety of products and services. The most important members benefits: Spectacles and lenses: Ravot Guarantee, multifocal spectacles, contact lenses, coloured lenses and free spectacles for children. Thermae and Beauty Group: a discount of up to 25% for relaxation and wellness-related arrangements. VerzekerdFit: 15% discount and no registration fee owed at 350 specially selected fitness centres. In cooperation with a renowned electronics supplier, Univé-VGZ-IZA-Trias will launch a unique webshop with numerous benefits and extras on 1 January Mosacare: 50,000 healthcare and chemist products, with new offers and benefits each month. Visit to discover the benefits available to you. For further information, please visit Ledenvoordeel very useful Our 12-year-old daughter Robin has been wearing spectacles for nine years. She likes to pick out a different coloured frame once in a while, especially in recent years. The members benefit comes in very useful then: 20% discount on the entire spectacles collection of Pearle Opticians and Eye Wish Groeneveld. The Ravot Guarantee is also very nice for that matter. When Robin s spectacles broke while she was playing during the holiday period, she could simply choose new ones without a hitch. Marco and Yolanda van Rijn, Sleeuwijk

17 VGZ HEALTH INSURANCE MijnGemak leaflet arrived at just the right time MijnGemak.nl Een helpende hand eenvoudig geregeld Of bel * MijnGemak: *lokaal tarief your convenience MijnGemak (My Convenience) is a free mediation service specially provided for Univé, VGZ, IZA and Trias clients. Should you urgently require a painter or domestic help in short, a reliable professional make it easy for yourself and call or visit MijnGemak is available 24/7. Because my wife and I both work, we needed someone to clean the house. Well, needed would be stretching it. It s just that after a full week of work we found it a bit too much to spend the weekend cleaning. We first tried to find someone through the Internet. That didn t lead to anything. Anyway, just when we were about to try something else a MijnGemak leaflet arrived. We called and explained what we needed and after a couple of weeks we were contacted by someone willing to clean our place. We first scheduled an appointment to see if things clicked between us and they did. She s worked for us for a year now and things are fine. Everything happens in consultation and we re very satisfied with the way things are. I haven t used other services yet but may well do in the future. It s all very convenient. Jack Ambags, Amersfoort

18 18 VGZ HEALTH INSURANCE 2010 A list of all our insurances Your health Your leisure time Your convenience Your surviving dependants Health insurance Short-term travel insurance against inconvenience Funeral insurance - Basic insurance Continuous travel insurance Family accident insurance Nabestaanden Plan - MiX Aanvullende Car assistance package Temporary inconvenience (surviving dependant s Verzekering Caravan insurance insurance insurance) - Modular package Camper insurance - Dental insurance Water sports insurance Your rights - Total care insurance Legal counsel insurance Your home Aansprakelijkheid Particulier Your transport Home contents insurance (private liability insurance) Car insurance Residential premises insurance Motorcycle insurance Mortgages Your financial future Moped insurance Woon Zeker Plan Inkomens Profijt Plan Bicycle insurance (home insurance) (income benefit insurance) Classic vehicle insurance Valuables insurance Group health insurance through your employer means major benefits More favourable reimbursements, among other things through a special supplementary insurance for persons covered by group insurance, namely MiX Aanvullende Verzekering. Group discount on the basic insurance and modular packages. The discount does not apply to the dental insurances and total care packages. Your employer will be able to inform you about the agreements concluded. Guaranteed benefits of good health insurance and substantial freedom in the choice of your care provider. No paperwork hassle, just proper information about your health insurance. Taking out more insurances and receiving discount Jump to page 14 and read more about the Premie Voordeel Plan (premium benefits).

19 VGZ HEALTH INSURANCE United we stand VGZ-IZA-TRIAS merged with Univé on 1 January Together, we insure around five million individuals, which makes us one of the premier insurers of the Netherlands. Your interests take pride of place in everything we do. Using our scale and distribution across the Netherlands, as well as our knowledge and expertise in the market, we go to every length to offer you sound products and services for a fair price. Moreover, as one of the largest insurers, we have the clout to serve and protect your interests to the greatest extent possible.

20 VGZ.NL Further information Our website Our telephone number VGZ Verzekeringslijn: (local rate) Open Mondays to Fridays from to Saturdays from to VGZ Hulpdienst: (+31) VGZ Kraamzorg: (m 0.10 a minute) Our Zorgbemiddeling address zorgbemiddelaar@vgziza.nl Our postal address Univé-VGZ-IZA-Trias Postbus AK Eindhoven The Netherlands Our complaints department VGZ afdeling Klachtenmanagement Antwoordnummer VM Eindhoven, The Netherlands This brochure has been approved by Stichting Makkelijk Lezen (Easy Reading Foundation) It is a VGZ priority to provide you with proper and clear information about its insurances. The Gewone Taal (Ordinary Language) quality mark is accorded to informative texts that meet the criteria of Stichting Makkelijk Lezen (Easy Reading Foundation). This means that the brochure is accessible to everyone, including individuals with reading difficulties. No rights may be derived from the contents of this brochure. D0255 with XAV