Because we are all different

Transcription

1 IAK Unique Health Care Insurance, 2015 Important information Because we are all different IAK Unique health care insurance is based on your wishes. You decide which care you want coverage for, and for which amount.

2 IAK Unique: the choice is yours! IAK has a new health care insurance solution: IAK Unique Health Care Insurance. A perfect-fit health care insurance that you can tailor to suit your own wishes. Read this brochure for more detailed information, and for an overview of the main changes to your health care insurance for Select one of the 3 basic insurance options NEW: Broad range of choices Each person is unique. That s why you need health care insurance that you can tailor to suit your particular wishes. From this year, not only can you choose which reimbursements (toppings) you want to be included under your supplementary insurance but you can also choose from a number of different basic insurance options. So you have a say in the premium you pay, the reimbursement you receive and the choice of care provider. That s IAK Unique in a nutshell! IAK Zorg Plan Selectief (Selective contracted care) You can go to a select number of care providers for planable hospital care. Non-contracted = you pay some or all of the costs IAK Select Zorg Plan (Contracted care) Choice from a wide range of care providers in the Netherlands for all your care needs, making it less likely that you will need to pay some or all of the care costs yourself. IAK Keuze Zorg Plan (Non-contracted care) Freedom to choose any care provider; reimbursements based on prevailing market rates. A conscious choice Care in the Netherlands is good, but the quality does vary. That s why health care insurers are setting even higher standards for care providers, health care costs, quality and patient-friendliness. Only those care providers who meet the standards set are contracted. The basic insurance you choose determines the care providers you can use. If you use a care provider who is not contracted, you may have to pay some or all of the costs of the care you choose or have already received. Avoid unpleasant financial surprises by going to (Dutch only) to check whether your care provider is contracted. Lowest premium Good price/quality Higher premium, freedom of choice For more information, go to (Dutch only)

3 What will change for you? NEW: Packages with toppings Under the Compact, Compleet and Extra Compleet supplementary packages, you can now set the level of the following reimbursements (toppings) yourself: Physiotherapy Alternative care Orthodontic treatment OptiekPlan (glasses/contact lenses) Senior care Childbirth care Hooray I m pregnant! If you currently have a Compact, Compleet or Extra Compleet supplementary package, your package will automatically be converted to the IAK Unique Health Care Insurance. Under a number of packages, you can now adjust the level of the reimbursements to suit your own wishes. Childbirth care OFF AAN ON

4 Keuzehulp (decision aid) You might want some extra assistance choosing between all the options IAK Unique offers. The Keuzehulp will help you put together your IAK Health Care Insurance quickly and easily. It also enables you to see at a glance how your choice will affect the level of your premium. Go to (Dutch only) to make the very best insurance choices for 2015.

5 Put together your Unique healthcare insurance in 3 steps Select one of the 3 basic insurance options: 1 IAK Zorg Plan Selectief (Selective contracted care) IAK Select Zorg Plan (Contracted care) IAK Keuze Zorg Plan (Non-contracted care) 2 Select your supplementary health care package Compact Compleet Extra Compleet You can also opt for one of the special packages for target groups: Jong (< age 27) or Comfort (> age 55). For more information, go to (Dutch only) 3 Select the required toppings Physio OFF Physio OFF Physio OFF ,000 For a detailed overview and the related reimbursements, we refer you to the policy terms and conditions. Log on to Alternative care OFF OptiekPlan OFF ON Alternative care OFF OptiekPlan OFF ON Alternative care OFF OptiekPlan ON Orthodontic care <18 80% tot 1,250 90% tot 1,750 90% tot 2,000 Senior care OFF ON Childbirth care OFF ON

6 Statutory and other changes to the basic insurance This table shows the changes the government has made to the basic insurance and the general changes introduced by IAK. Changes to excess/individual contributions/maximum reimbursements Excess (mandatory) ( in 2014) Index-linked rates applicable to individual contributions and maximum reimbursements Each year, the government applies index-linking to the statutory individual contributions and the maximum reimbursements. See (Dutch only) for the index-linked rates for Changes to reimbursements under the basic insurance for 2015 AWBZ care (Exceptional Medical Expenses Act) New reimbursements under the basic insurance Reimbursements for non-contracted care Removed from basic insurance Some types of care currently covered under the AWBZ will be transferred to the basic insurance. The following categories of care will fall under the basic insurance from 2015: District nursing services (personal care and nursing, including PGB (personal budget)). Care for persons with an auditory or visual handicap. Long-term admissions to mental health care institutions for up to three years (was one year). Non-invasive pre-natal test (NIPT): this test detects chromosome abnormalities during pregnancy. Travel expenses incurred by organ donors. Geriatric rehabilitation, starting max. one week after discharge from hospital. Conditional reimbursement of new treatments, medicines and medical aids. In 2015, if you go to a care provider with whom we do not have a contract, the following reimbursement rates will apply: under the IAK Zorg Plan Selectief, a maximum of 75% of the average contracted rates for planable care provided by a non-selected hospital; under the IAK Select Zorg Plan, 75% of the average contracted rates; under the IAK Keuze Zorg Plan, the reimbursement is subject to a maximum of the prevailing market rate. We refer you to for the list of maximum reimbursements. Combined test for pregnant women aged 36 and over. Transferred to the Youth Act (administered by municipal authorities): Dyslexia diagnosis and treatment. Mental health care for young people. General changes for 2015 Maximum amount of excess that can be paid via direct debit raised Do you pay your excess via direct debit? We will debit a maximum of (was ). We will send you a payment slip for any amount due over and above the maximum.

7 Main changes to the IAK Unique supplementary health care packages for 2015 Alternative care (topping) Alternative care Physiotherapy Childbirth care OptiekPlan Orthodontic treatment up to age 18 Jong Compact Compleet Extra Compleet Comfort - reimbursement subject to care provider being a member of the relevant professional association (see - psychosocial care up to age 18 discontinued (youth care transferred to municipality) - max per year - max per year - max per year - no reimbursement - reimbursement subject to care provider being a member of the relevant professional association (see - psychosocial care up to age 18 discontinued (youth care transferred to municipality) - max per year - max per year - max per year - no reimbursement savings plan (if included under insurance): per year for max. 3 years to be spent on glasses, lenses or laser eye surgery - max per year - max per year - max per year - no reimbursement - reimbursement subject to care provider being a member of the relevant professional association (see - psychosocial care up to age 18 discontinued (youth care transferred to municipality) - max per year - max per year - max per year - no reimbursement childbirth care topping (optional): - individual contribution to delivery/ maternity care - maternity package - one-off reimbursement for multiple births lactation care max per insured person per year - maternity care following adoption 12 hours over 4 days - 12 hours of incubator aftercare - self-help programme Slimmer Zwanger : 1x during entire policy term savings plan (if included under insurance): per year for max. 3 years to be spent on glasses, lenses or laser eye surgery - 90% max. 2,000.00, once only - 90% max. 1,750.00, once only - 80% max. 1,250.00, once only - max per year - max per year - max per year - no reimbursement - reimbursement subject to care provider being a member of the relevant professional association (see zorgverleners) - psychosocial care up to age 18 discontinued (youth care transferred to municipality) - max. 1, per year - max per year - max per year - no reimbursement added: - self-help programme Slimmer Zwanger : 1x during entire policy term savings plan (if included under insurance): per year for max. 3 years to be spent on glasses, lenses or laser eye surgery - reimbursement subject to care provider being a member of the relevant professional association (see - psychosocial care up to age 18 discontinued (youth care transferred to municipality) Senior care (optional as topping) - individual contribution to medical aids - correction of upper eyelids - membership of patient association max pp per year - support pessary (including fitting) Medical aids added: - hand or finger splint for short-term use (max. 2 per year) added: - hand or finger splint for short-term use (max. 2 per year) added: - hand or finger splint for short-term use (max. 2 per year) - support pessary (including fitting) Psychological care: neurofeedback discontinued (youth care transferred to municipality) Vaccinations in connection with foreign travel added: vaccinations or preventive medication against: - tuberculosis - Japanese encephalitis - tick-borne encephalitis added: vaccinations or preventive medication against: - tuberculosis - Japanese encephalitis - tick-borne encephalitis added: vaccinations or preventive medication against: - tuberculosis - Japanese encephalitis - tick-borne encephalitis added: vaccinations or preventive medication against: - tuberculosis - Japanese encephalitis - tick-borne encephalitis added: vaccinations or preventive medication against: - tuberculosis - Japanese encephalitis - tick-borne encephalitis Pedicure added: pedicure for diabetes patients (care profile 1) added: pedicure for diabetes patients (care profile 1) Skin therapy on referral by GP or medical specialist only on referral by GP or medical specialist only on referral by GP or medical specialist only on referral by GP or medical specialist only on referral by GP or medical specialist only Please note: this is an abridged version of the changes to reimbursements for No rights (including rights to reimbursement) may be derived from the content of this summary of changes. For precise, up-to-date details of the reimbursements, log on to and consult the insurance terms and conditions.

8 Main changes to the IAK Unique supplementary health care packages for 2015 IAK Ziekenhuis Ontzorg Pakket (NEW) This package replaces the ZiekenhuisPlus and Huishoudelijke Hulp insurance Nursing in a hospital extra costs of nursing in a higher class than standard Compensation in cases where a higher class is not present or not available per day of nursing Extra facilities, service and comfort max per day of nursing Nursing at/admission to convalescent home max per day up to max. 28 days Transportation by taxi relating to admission to/discharge from hospital max. 4 journeys per admission Home help in case of hospital admission max. 10 hours per admission Childcare in case of hospital admission of parent per child under age 13 per working day from 4th day of admission, max. 60 working days Go to for the complete survey of reimbursements for 2015 Please note: this is an abridged version of the changes to reimbursements for No rights (including rights to reimbursement) may be derived from the content of this summary of changes. For precise, up-to-date details of the reimbursements, log on to and consult the insurance terms and conditions.

9 Digital convenience: Mijn IAK If you don t already have a digital account, create one today via Mijn IAK! A digital account allows you to submit your health care invoices quickly and easily, view your own personal online file containing all your important care-related correspondence, access an overview of your care costs and change your policy or apply for a health care insurance policy at the click of a button. Take a look on (Dutch only). IAK on your smartphone and tablet Download the IAK care app for optimal convenience. Via the app, you can easily: submit invoices; access your health insurance cards and those of your family, anywhere, anytime; have your European Health Insurance Card (EHIC) with you on holiday; establish direct contact with SOS International and IAK Customer Service. Download the app or go to (Dutch only) for more information.

10 Excess: a reminder about how it works The excess for 2015 has been set at You can opt to add a voluntary excess. Costs that do not fall under the excess include: Treatment by a GP (with the exception of tests contracted out to a laboratory); Maternity care and assistance during delivery; Nursing and care received at home; Medical aids on loan; Individual contributions and/or payments; Care covered under your supplementary insurance packages. For detailed information, go to (Dutch only).

11 From AWBZ to Zvw Life expectancy in the Netherlands is increasing. That means that more care is needed, which in turn is pushing health care costs higher and higher. From 1 January 2015, the AWBZ (Exceptional Medical Expenses Act) will undergo radical reforms in order to keep health care affordable. These reforms include the transfer of certain categories of care from the AWBZ to the Zvw (Health Care Insurance Act), i.e. the basic insurance. Nursing and care at home Nursing and care with PGB Care for people with a sensory handicap IAK basic insurance (Zvw) Long-term mental health care How this change will affect you Do you use a personal budget (pgb), or do you need nursing or care at home, such as a nurse who comes to dress a wound or give you an injection? At present, this care is paid for under the AWBZ. From 1 January 2015, these categories of care will fall under the Zvw instead. Care for people with a sensory handicap and long-term mental health care (up to 3 years) in a mental health care institution will also be reimbursed via the Zvw from 2015 onwards. In addition to the health care insurer and the care offices, the municipal authorities will also take on an important role. From 1 January 2015, they will become responsible for the support that currently falls under the AWBZ. They will also take up responsibility for the new Youth Act. The Youth Act covers all forms of youth care linked to parenting and developmental problems, including mental health care (GGZ) and the support of children with dyslexia. Mental health care and dyslexia care currently fall under the health care Insurance, but from 2015 the municipalities will assume responsibility for children under 18 who need support in these areas. For more information, go to (Dutch only).

12 We are here to help you Go to (Dutch only) 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 zorgdownloads and consult the insurance terms and conditions, or contact Customer Service. ZV-PB-UNIEK AA NUL ENG (2015) IAK Verzekeringen B.V. IAK Volmacht B.V. Postbus 90165, 5600 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: