Your health care insurance in 2016
Index
IAK health care insurance
3
An overview of your health care insurance options
4
Supplementary insurance packages
5
Statutory and other changes to the basic insurance package
6
Changes to the supplementary health care packages for 2016
7
Changes to the supplementary All-in-1 health care packages for 2016
8
New: video clips
9
New: 2-in-1 health insurance card
10
Digital convenience
11
Together for a perfectly insured future
Use this table of contents to go straight
to the information you need. Click on one of
IAK Health Care Insurance
Our IAK Health Care Insurance options offer you major discounts combined with extensive
reimbursements. This brochure contains information about the new health care packages for 2016.
The existing packages have undergone some changes: some dictated by the government and
others initiated by IAK. Read this brochure to find out more about these changes and our service.
Rest assured: next year you will once again be perfectly insured with IAK!
Mijn IAK more closely tailored to your wishes
We regularly ask you for input on how to improve our services. The responses show
that you prefer to receive personalised information and more details about your
health care costs. To accommodate these preferences, the brochure is now available
together with your survey of reimbursements in Mijn IAK.
We provide details of your health care costs, your reimbursements and the amount
of the excess that has been deducted as well. This allows you to see your exact
status whenever you want. Discover this new environment in Mijn IAK, under the
tab labelled ‘Mijn Zorgkosten’.
Find your care provider
Do you need a care provider? Evidently you want only the best possible care and
preferably nearby. But how do you find the right care provider? Take a look at
iak.nl/zorgverleners
(Dutch only) to quickly find a care provider close to you.
An overview of
your health care
insurance options
For a complete overview, including the accompanying
reimbursements, we refer you to the policy terms and
conditions. Go to
iak.nl/zorgdownloads
and log in.
1.
Select one of the 3 basic insurance packages:
2.
Optional: Select a supplementary package
3.
Optional: Select your dental care insurance
VGZ
Tand
Goed
VGZ
Tand
Beter
VGZ
Tand
Best
Dental care insurance
VGZ
Aanvullend
Goed
VGZ
Aanvullend
Beter
VGZ
Aanvullend
Best
VGZ
Jong
Pakket
Dental
care
included
VGZ
Fit & Vrij
Pakket
Dental
care
included
VGZ
Gezin
Pakket
Dental
care
included
VGZ
Vitaal
Pakket
Dental
care
included
Supplementary
health care packages
All-in-1 health care packages
Supplementary
VGZ
Tand
Goed
VGZ
Tand
Beter
VGZ
Tand
Best
Dental care insurance
VGZ
Aanvullend
Goed
VGZ
Aanvullend
Beter
VGZ
Aanvullend
Best
VGZ
Jong
Pakket
Dental
care
included
VGZ
Fit & Vrij
Pakket
Dental
care
included
VGZ
Gezin
Pakket
Dental
care
included
VGZ
Vitaal
Pakket
Dental
care
included
Supplementary
health care packages
Supplementary
All-in-1 health care packages
Choice of preselected care providers. For non-contracted care, you will receive a maximum of 75% of the average contracted rate.
IAK Goede Keuze
(Selective contracted care)
Extensive choice of care providers.
For non-contracted care, you will receive a maximum of 80% of the average contracted rate.
IAK Ruime Keuze
(Contracted care)
Free choice of any care provider.
Maximum of 100% of prevailing market rates.
IAK Eigen Keuze
Jong Pakket
Are you aged between 18 and 27 and looking for
affordable health care insurance whereby you only pay
for the care you actually need? The Jong Pakket is the ideal
health care insurance for young people and students.
Reimbursements for dental care are included.
Fit & Vrij Pakket
The Fit & Vrij Pakket is a unique supplementary health
care package. You receive a health care budget of € 1,000.00,
and you decide which health care you want reimbursed.
A straightforward total package for people aged under 50,
combining good care with optimal freedom of choice.
Gezin Pakket
The Gezin Pakket is especially designed for families.
All the reimbursements have been selected with the family
in mind, covering everything from extra maternity care
to orthodontic care. Therefore this is the ideal supplement
to the basic insurance for families.
Vitaal Pakket
As you get older, there are certain types of care you
no longer need. Why should you pay for maternity care
or orthodontic treatment? The Vitaal Pakket is an
excellent supplementary health care insurance for you
if you are 55 plus, a senior or elderly.
VGZ Aanvullend Goed
If you want to insure yourself for extra care at an
attractive premium rate, VGZ Aanvullend Goed is
a good supplement to the basic insurance. Coverage
includes a reimbursement for alternative care and a
budget for movement-related therapy.
VGZ Aanvullend Beter
VGZ Aanvullend Beter insurance offers you extensive
health care insurance at an attractive premium rate.
The maximum reimbursements and budgets are higher
than those under the VGZ Aanvullend Goed package.
Coverage includes a reimbursement for glasses and
contact lenses and a maternity package if you are pregnant.
VGZ Aanvullend Best
For maximum health care insurance security,
choose the VGZ Aanvullend Best package.
The reimbursements are higher than those under
the VGZ Aanvullend Beter package, and include
an extra budget for movement-related therapy, skin
therapy and a reimbursement for laser eye surgery.
You can extend your health care insurance by adding a supplementary insurance package.
There are three modular supplementary packages: VGZ Aanvullend Goed, VGZ Aanvullend
Beter and VGZ Aanvullend Best, with the option to add dental care Insurance. Alternatively,
you can select one of the following All-in-1 packages (including dental care insurance): Jong,
Fit & Vrij, Gezin or Vitaal. The reimbursements under these packages are carefully tailored to
suit your family situation and lifestyle.
Statutory and other changes to the basic insurance package
Together for a perfectly insured future
Changes to excess/individual contributions/maximum reimbursements
Mandatory excess
€ 385.00 per year (was € 375.00 in 2015)
Indexed rates for individual contributions and maximum reimbursements
Every year, the government indexes the statutory individual contributions and the maximum reimbursements in basic insurance
packages. For the indexed rates for 2016, visit
iak.nl/wijzigingenzorg
(Dutch only)
Changes in reimbursements under the basic insurance package in 2016
New reimbursements under the basic insurance package
• Ambulance transport for mental health care for younger persons (legislative and regulatory amendment having retroactive effect to
1 January 2015).
• Prenatal invasive diagnosis if an NIPT (non-invasive prenatal test) shows a significant risk of a chromosome defect in the child (previously
only following a combined test).
• Medically necessary seated patient transport for intensive childcare.
Contracting
A few care providers have been selected and contracted for various treatments, operations and medical aids. These care providers offer
a particular level of quality or are involved in care innovation. This means that fewer or more care providers might be contracted for
certain types of care than in 2015. To find out more about selective contracting and to see a full list of the contracted care providers,
visit
iak.nl/zorgverleners
(Dutch only)
Reimbursement for non-contracted care
• IAK Goede Keuze: the maximum reimbursement for care by non-contracted care providers has been raised from 50% to 70% of the
average contracted rate.
• IAK Ruime Keuze: the maximum reimbursement for specialist mental health care by non-contracted care providers has been raised from
75% to 80% of the average contracted rate.
Other changes to the basic insurance package
• The regulations relating to medical aids, pharmaceutical care and personal budgets for nursing and care have changed;
see
iak.nl/zorgdownloads
• Prior approval is needed for specialist mental health care that requires admission (see the approval procedure in the conditions).
• Specialist medical care may also be provided by a sports medicine doctor if it falls within the scope of his or her area of expertise.
• To have an IUD inserted or removed, you may also visit a contracted obstetrician (this does not fall within the scope of your excess).
• The frozen embryos that remain if an IVF attempt leads to pregnancy may be replaced. If the attempt does not yield a result, a new cycle
of IVF treatment can be started, which then qualifies as the first attempt.
• A note from a general practitioner or medical specialist is needed to qualify for palliative terminal care at home.
• New care providers qualified to make referrals for specialist medical care and mental health care have been added (for a full list of these
qualified providers, see the policy conditions).
Changes to the supplementary health care packages for 2016
VGZ Tand Goed
VGZ Tand Beter
VGZ Tand Best
added:
max. €10,000 dental care costs following an accident added:max. €10,000 dental care costs following an accident added:max. €10,000 dental care costs following an accident reimbursement for periodic checkups (C11) and problem-oriented appointments (C13)
increased from 80% to 100% (no change to annual budget amount) reimbursement for periodic checkups (C11) and problem-oriented appointments (C13) increased from 80% to 100% (no change to annual budget amount) reimbursement for periodic checkups (C11) and problem-oriented appointments (C13) increased from 80% to 100% (no change to annual budget amount)
VGZ MiX AV
VGZ Aanvullend Goed
VGZ Aanvullend Beter
VGZ Aanvullend Best
Breast pump reimbursement
added:reimbursement for rent or purchase of electric breast pump max. € 80 during entire policy term
added:
reimbursement for rent or purchase of electric breast pump max. € 80 during entire policy term
Circumcision
(medical indication only)
circumcision (medical indication only) may now be carried out by all general practitioner and other doctors included in the BIG register
circumcision (medical indication only) may now be carried out by all general practitioner and other doctors included in the BIG register
circumcision (medical indication only) may now be carried out by all general practitioner and other doctors included in the BIG register
Cogmed and neurofeedback
added:- neurofeedback in relation to ADHD and ADD max. € 1,000 per year up to age 18
- Cogmed in relation to learning disorders caused by ADHD and ADD max. € 400 per year up to age 18
Lens implantation
coverage extended to include reimbursement of additional costs of toric lens implant during cataract surgeryEyelid correction
- eyelid correction now reimbursed for more indications- added: reimbursement for levatorplasty
Psychosocial alternative care
age limit of 18 for psychosocial alternative careno longer applies age limit of 18 for psychosocial alternative care no longer applies age limit of 18 for psychosocial alternative care no longer applies
Pressure helmet
reimbursement for treatment with pressure helmet nolonger applies reimbursement for treatment with pressure helmet no longer applies
STD prevention
Arch supports
arch supports no longer covered by budget for foot treatments, but will still be reimbursed up to max. € 70 per year if manufactured by a podotherapist or orthopaedic shoemaker/shoemaking businessarch supports no longer covered by budget for foot treatments, but will still be reimbursed up to max. € 125 per year if manufactured by a podotherapist or orthopaedic shoemaker/shoemaking business
arch supports no longer covered by budget for foot treatments, but will still be reimbursed up to max. € 125 per year if manufactured by a podotherapist or orthopaedic shoemaker/shoemaking business
Dental care following an accident
reimbursement for crowns and bridges following an accident for insured patients aged under 22 no longer applies; a reimbursement for dental care following an accident is included under the Tand Goed, Tand Beter and Tand Best insurance optionsreimbursement for crowns and bridges following an accident for insured patients aged under 22 no longer applies; a reimbursement for dental care following an accident is included under the Tand Goed, Tand Beter and Tand Best insurance options
Dental care:
increased reimbursement for
preventive dental care
Fall prevention
added:reimbursement for fall prevention course max. € 50 during entire policy term
added:
reimbursement for fall prevention course max. € 100 during entire policy term
added:
reimbursement for fall prevention course max. € 150 during entire policy term
Replacement informal care
reimbursement increased from 4 to 5 days reimbursement increased from 9 to 10 days reimbursement increased from 14 to 15 daysTransport
reimbursement per km for private transport relatingto organ transplantation lowered from € 0.31 to € 0.30 reimbursement per km for private transport relating to organ transplantation lowered from € 0.31 to € 0.30 reimbursement per km for private transport relating to organ transplantation lowered from € 0.31 to € 0.30
Maternity courses
maternity courses no longer covered by preventivecare budget added:budget for maternity courses (was covered by preventive care budget) max. € 50 per year for courses such as Zwanger Fit, Samen Bevallen and Slimmer Zwanger
added:
budget for maternity courses (was covered by preventive care budget) max. € 75 per year for c ourses such as Zwanger Fit, Samen Bevallen and Slimmer Zwanger
added:
budget for maternity courses (was covered by preventive care budget) max. € 100 per year for courses such as Zwanger Fit, Samen Bevallen and Slimmer Zwanger
Changes to the supplementary All-in-1 health care packages for 2016
VGZ Jong Pakket
VGZ Gezin Pakket
VGZ Vitaal Pakket
VGZ Fit & Vrij Pakket
Breast pump reimbursement
added:reimbursement for rent or purchase of electric breast pump max. € 80 during entire policy term
Circumcision
(medical indication only)
circumcision (medical indication only) may now be carried out by all general practitioner and other doctors included in the BIG register
circumcision (medical indication only) may now be carried out by all general practitioner and other doctors included in the BIG register
circumcision (medical indication only) may now be carried out by all general practitioner and other doctors included in the BIG register
circumcision (medical indication only) may now be carried out by all general practitioner and other doctors included in the BIG register
Cogmed and neurofeedback
added:- neurofeedback in relation to ADHD and ADD max. € 1,000 per year up to age 18
- Cogmed in relation to learning disorders caused by ADHD and ADD max. € 400 per year up to age 18
Lens implantation
coverage extended to include reimbursement of additional costs of toric lens implant during cataract surgeryEyelid correction
- eyelid correction now reimbursed for more indications- added: reimbursement for levatorplasty
Psychosocial alternative care
age limit of 18 for psychosocial alternative careno longer applies age limit of 18 for psychosocial alternative care no longer applies age limit of 18 for psychosocial alternative care no longer applies age limit of 18 for psychosocial alternative care no longer applies
Pressure helmet
reimbursement for treatment with pressure helmet no longer appliesSTD prevention
reimbursement for preventive STD examination no longer appliesArch supports
arch supports no longer covered by budget for foot treatments, but will still be reimbursed up to max. € 70 per year if manufactured by a podotherapist or orthopaedic shoemaker/shoemaking businessarch supports no longer covered by budget for foot treatments, but will still be reimbursed up to max. € 125 per year if manufactured by a podotherapist or orthopaedic shoemaker/shoemaking business
arch supports will only be reimbursed if manufactured by a podotherapist or orthopaedic shoemaker/shoemaking business
Dental care following an accident
Dental care:
increased reimbursement for
preventive dental care
reimbursement for periodic checkups (C11) and problem-oriented appointments (C13) increased from 80% to 100% (no change to annual budget amount)
reimbursement for periodic checkups (C11) and problem-oriented appointments (C13) increased from 80% to 100% (no change to annual budget amount)
reimbursement for periodic checkups (C11) and problem-oriented appointments (C13) increased from 80% to 100% (no change to annual budget amount)
reimbursement for periodic checkups (C11) and problem-oriented appointments (C13) increased from 80% to 100% (no change to annual budget amount)
Fall prevention
added:reimbursement for fall prevention course max. € 100 during entire policy term
Replacement informal care
reimbursement increased from 9 to 10 days reimbursement increased from 9 to 10 daysTransport
reimbursement per km for private transport relatingto organ transplantation lowered from € 0.31 to € 0.30 reimbursement per km for private transport relating to organ transplantation lowered from € 0.31 to € 0.30 reimbursement per km for private transport relating to organ transplantation lowered from € 0.31 to € 0.30 reimbursement per km for private transport relating to organ transplantation lowered from € 0.31 to € 0.30
Maternity courses
maternity courses no longer included covered bypreventive care budget added:budget for maternity courses (was covered by preventive care budget) max. € 150 per year for courses such as Zwanger Fit, Samen Bevallen and Slimmer Zwanger
Please note: this is an abridged version of the changes to reimbursements for 2016. 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 iak.nl/mijniak and consult the insurance terms and conditions.
Go to iak.nl/mijniak
and log in for the complete survey of
New: video clips
Why try to describe a complicated issue in hundreds of words if we can explain
it more clearly in a short video clip? We now also provide visual answers to FAQs
about your health care insurance. For example, one of our people at IAK will
show you how to submit your claims online, or explain the difference between
an individual contribution and an excess. These and other short video clips are
available on our website.
New: 2-in-1 health
insurance card
You currently have an IAK Health Insurance Card. The EHIC (European Health
Insurance Card) is a card for care outside of the Netherlands but within Europe.
From now onwards, the two cards will be combined.
On the card you will see an SOS telephone number. This is the emergency number
for the international alarm centre. Call this number if you need emergency medical
assistance abroad. If you already have an EHIC or recently applied for one, you will
receive the new combicard automatically.
Together for a perfectly insured future
Digital convenience
We are working to create a sustainable future. By minimising the amount of paperwork
that we send by post, we are cutting back on our printed matter and helping the
environment.
Will you join us?
To help us, go to
iak.nl/mijniak
under the tab labelled ‘Correspondentie Zorg’,
and in your ‘Correspondentieprofiel’ change your settings to receive correspondence
from IAK by e-mail from now on.
Together for a perfectly insured future
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-PB
VGZ ENG (01-2016)
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 iak.nl/zorgdownloads and consult the insurance terms and conditions, or contact Customer Service.