Services and products covered
Basic health insurance policies by law cover the following:
- Basic Medical Care; including care provided by General Practitioners, Medical Specialists and Obstetricians
- Hospital treatment
- Dental care up to the age of 18
- Maternity care
- Limited therapies such as Physiotherapy, Speech Therapy, Occupational Therapy and Dietary Advice
- Medical devices
- Medical products
Full details of what is covered can be found at the site of the National Health Care Institute (in Dutch).
Not all costs are fully covered
Not all costs of services covered by Basic health insurance, are fully reimbursed
- Consultations by your GP are fully reimbursed, but
- Cost of diagnostics, also if performed at the GP office, Medical Specialists and Hospital Care are payable by you to the maximum of your annual excess (eigen risico). Costs exceeding your annual excess are fully covered.
- For some medication and medical aids, you will have to make a personal contribution to cover their costs regardless if the total exceeds your excess.
What is not covered by Basic health insurance
It is not possible to give a complete list of what is not covered, but here are some healthcare services that are not (or only in very specific cases) covered by Basic health insurance:
- Orthodontics no matter if you are younger or older than 18 years)
- Dental care for persons of 18 years and older
- Physical therapy
- Complementary or alternative medicine
- Glasses and lenses
You can take out supplementary health insurance to cover these services.
Is coverage the same for all providers and policies
All basic health insurance policies by law cover the same medical services, treatments, diagnostics and medication. Changing this package is not an option. However, depending on your provider and policy type there are differences in your possibilities of choice: what healthcare providers are contracted for treatment, the range of providers for medical aids and consumables and the freedom to select a specific brand of medication.
This site (in Dutch) offers a detailed overview of coverage details of all insurance providers and policy types.