CZ Health Insurance

CZ Health Insurance
Cross-border workers
2014
Everything for better
healthcare
CZ can give you advice about your
health insurance. We can help you find
the package that best suits your needs,
so you don't pay more than you have to.
At 'Mijn CZ' you can easily check your
cover and your healthcare costs. On this
personalised online page you can see
exactly how much we will reimburse,
you can submit bills in a few easy steps,
check if a claim has been paid and how
much deductible you have left.
We can also help you find and arrange
the best type of care for your situation.
For instance, if you're looking for the
best hospital to have treatment. If you
choose CZ and you need advice, you can
call one of our care advisers. We are here
to help you.
And did you know that CZ is a not-forprofit organisation? Everything we do is
to help you. Because we want you to
have the best possible care.
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Select the best health insurance for you
Do you work in the Netherlands, but you live in a country in
the EU, EER, Switzerland or a treaty country? Then you have to
take out health insurance in the Netherlands. Health
insurance consists of general insurance, usually together with
an additional insurance package and/or a dental package.
But how do you know which insurance is best for you? This
brochure will help you choose in five easy steps.
Step 1: Choose CZ
Our service is much more than just health insurance. CZ helps you
arrange your insurance cover and can advise and guide you when you
need care.
Step 2: Select your general insurance
Everyone in the Netherlands is required by law to have general
insurance. The general insurance covers the most essential healthcare
costs. At CZ, you can choose from three different types of general
insurances.
Step 3: Choose additional insurance
You can take out additional insurance for care not included in the
general insurance. CZ offers a wide choice of additional insurances.
Step 4: Select dental insurance
Do you want to insure dental care that is not covered by the general
insurance? At CZ you can choose from two additional dental packages.
Step 5: Join CZ
Have you made your choice? Then apply to join CZ. You can do this in
person or by post.
EU, EER, Switzerland and treaty countries include:
• EU countries: Belgium, Bulgaria, Croatia, Cyprus, Denmark, Germany,
Estonia, Finland, France, Greece, Hungary, Ireland, Italy, Latvia,
Lithuania, Luxembourg, Malta, Netherlands, Austria, Poland, Portugal, Romania, Slovenia, Slovakia, Spain, Czech Republic, United
Kingdom, Sweden;
• EER countries: Liechtenstein, Norway and Iceland;
• Switzerland;
• treaty countries: Bosnia-Herzegovina, Cape Verde, Macedonia,
Morocco, Serbia, Montenegro, Tunisia and Turkey.
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Step 1
Step 1: Choose CZ
At CZ you will find the right health
insurance for you. But CZ offers you
more. Our service is much more than
just health insurance. CZ helps you
arrange your insurance and is ready to
give you advice and support when you
need care.
Your health insurance
matters
’Mijn CZ’: arrange your insurance online
At 'Mijn CZ' you can arrange your insurance
online. Whether it's submitting a bill, changing your personal details or checking a
reimbursement - it's quick and easy. You will
also find a summary of all your claims and
the current level of your deductible. You can
log in at ’Mijn CZ‘ at any time of the day,
seven days a week.
CZ pays fast
CZ normally pays your care provider direct.
But if you've paid a bill yourself, CZ will
reimburse you within ten working days.
Spreading payment of the deductible
If you want to avoid a financial setback, you
can opt to pay the deductible in instalments.
For more information go to
www.cz.nl/deductible.
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Healthcare advice and support
Finding the best healthcare
Are you looking for a healthcare provider
such as a physiotherapist, general practitioner or speech therapist? You can find a list at
www.cz.nl/findcare. If you need hospital
treatment or are due to go into labour, you
can compare the quality of the hospitals or
maternity centres. This will help you make the
best choice for you.
If you need advice
Do you want to arrange the best type of care
for your condition, or find the best place for
treatment? Our care advisers are here to help
you. All our advisers have a medical background, so that they can properly assess your
situation. They can offer advice, for instance,
about waiting lists, 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.
by your healthcare provider, CZ can help you
write a letter of complaint and tell you where
to send it.
If you have a medical query
Do you have a query about your health or
lifestyle? Simply call the CZ Healthline. You
will be able to speak to a nurse who can
answer your questions. Do you prefer to ask
your question by e­mail? This is also possible.
For example, to a psychologist, dietician,
physiotherapist or dentist.
If you are 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
If you are not satisfied
If you are not satisfied with the care provided
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Step 2
Step 2: Choose the best general insurance for
you
You work in the Netherlands. You are therefore required by law to take out Dutch
health insurance. The general insurance covers the most essential healthcare costs. The
government decides what is covered by the general insurance. You can easily see what
is covered by the general insurance in our package comparer, enclosed with this
brochure and at www.cz.nl/package-comparer.
73%
19%
8%
chose
this
chose
this
chose
this
'CZ Zorgbewustpolis'
'CZ Zorg-opmaatpolis'
'CZ Zorgkeuzepolis'
Premium
Lower
Average
A bit more
Reimbursement with a
contracted healthcare
provider
100%
100%
100%
Reimbursement with a
non-contracted
healthcare provider
50% of the market
rate applicable in the
Netherlands
75% of the market
rate applicable in the
Netherlands
100% of the market
rate applicable in the
Netherlands
Paymentmethod
Direct debit
Direct debit or giro
form
Direct debit or giro
form
Voluntarydeductible
Choiceof:
None or € 500
None, € 100,
€ 200, € 300,
€ 400 or € 500
None, € 100,
€ 200, € 300,
€ 400 or € 500
Communications from
CZ:
Byemail
Bypostorbyemail
Bypostorbyemail
Extraservice
None
BestDoctors
BestDoctors
The in-kind policy
Premium
The nominal 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. You might be eligible for the
healthcare allowance. You can check by
callingtheTaxOfficeon08000543orat
www.toeslagen.nl (information in Dutch).
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The in-kind policy
The refund policy
Contracted healthcare provider
CZ has agreements concerning quality,
waiting times and prices with many healthcare providers. Healthcare from these
providers is reimbursed if it is included in the
general insurance. You can check which
healthcare providers CZ has an agreement
with at www.cz.nl/findcare, or by calling the
'CZ Zorgservice' on (013) 594 91 10.
Non-contracted healthcare provider
Are you using a non-contracted healthcare
provider? In this case, you can receive a
(partial) reimbursement of the market rate
applicable in the Netherlands. This is the
same rate as the one for healthcare providers
with whom we have an agreement. Are these
rates unavailable? We will then use the
average rate in the Netherlands.
In-kind or refund policy
With an in-kind policy you have opted to go to
a contracted healthcare provider. You pay a
lower premium because we have agreements
with these healthcare providers about price
and quality. Do you want cover for higher
reimbursement in case you go to a noncontracted healthcare provider? In this case
choose a refund policy. You will have to pay a
slightly higher premium.
Discount for full payment
If you pay your premium quarterly, twice or
once a year, CZ will give you a maximum
discount of 3% on the premium.
Compulsory deductible
Everyone from the age of 18 years has a
compulsory deductible of € 360 (in 2014).
This has been set by the government. The
deductible is the amount you have to pay
yourself; the remainder is reimbursed. The
deductible only applies to reimbursements
under the general insurance, except for a visit
to the general practitioner, obstetric care,
maternity care, chain care, follow­up visits for
kidney or liver donors and medical aids on
loan.
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.
Extra service: Best Doctors
CZ offers various services such as waiting list
mediation, the CZ Healthline, and its
e-experts. Are you opting for the ‘CZ Zorg­-op-­
maatpolis’ or the ‘CZ Zorgkeuzepolis’? In this
case you can also use Best Doctors. Best
Doctors is an international network of the
best specialists in various fields. They can
provide you with a second opinion on the best
treatment for your illness or disorder.
Duration of the insurance
Your insurance is valid for one calendar year.
Medical care in the country where you live
You are entitled to reimbursement of your
medical costs in the Netherlands and in the
country where you live. When you apply to CZ
we will give you treaty form 106. With this
form you have to apply to a health insurer in
your country of residence. The costs you
incur will then be reimbursed in accordance
with the conditions of that health insurer.
You can also choose to submit the costs
directly to CZ. Your costs will then be reimbursed according to the Dutch system. Note:
ask the insurer in your country of residence if
you need to take out additional insurance
there for healthcare costs. This is because
some costs are not reimbursed in the Netherlands nor in your country of residence. In this
way you will avoid having to pay unexpected
costs.
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Step 3
Step 3: Select the additional
insurance that best suits
your needs
You can take out additional insurance for care not
included in the general insurance. CZ has three
additional insurance packages for different stages
in your life: 'Jongeren', 'Gezinnen' and '50+'. Or you
can select one of our other additional insurance
policies, which offer increasing cover. The package
comparer sets out what is covered under CZ’s
additional insurance packages.
Additional insurance premium
If you take out additional insurance you pay an extra
premium.
'Jongeren', 'Gezinnen' and '50+'
These additional packages are customised. The benefit of
these is that you only pay for things that are relevant to
your phase in life. For the 'Jongeren' and ‘50+’, for
instance, you do not pay for extra maternity care. And the
'Gezinnen' policy includes the 'CZ Beugelplan' (plan for
braces): the longer your family remains insured with CZ,
the higher the reimbursement for orthodontics.
Other additional insurance
If the additional insurance outlined above is not right for
you, you can choose from the additional packages 'Basis',
'Plus' or 'Top'. The additional insurance ’Plus‘ has more
extensive cover than the additional insurance ’Basis‘.
The additional insurance ’Top‘ has even more cover.
Acceptance by CZ
CZ will accept you without a medical assessment for
nearly every additional insurance package. This means
that you can change your additional insurance package
from year to year without prior assessment. However, we
do require a dentist's statement for the 'Uitgebreide
Tandarts' package.
Duration of the insurance
Your insurance is valid for one calendar year.
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Step 4
Step 4: Choose the dental insurance
that suits you
You can take out additional insurance
for dental care that is not covered by the
general insurance.
When to take out dental insurance
First check which additional insurance you
have chosen. The additional packages
'Jongeren' and 'Gezinnen' already provide
cover for the dentist and/or orthodontist. In
this case you do not need a separate dental
package. If you have chosen any other
additional package, or none, and you want
good dental cover, select one of CZ's dental
packages. In that case, select one of CZ's
dental insurances.
Dental insurance: 'Tandarts' and 'Uitgebreide Tandarts'
CZ has two dental packages: 'Tandarts' and
'Uitgebreide Tandarts'. Both packages
reimburse 75% of dental treatments, except
for check-ups, which are reimbursed 100%.
The difference between the two packages is
the maximum amount reimbursed per year.
With the additional insurance package
'Tandarts' this is € 450. With the additional
insurance 'Uitgebreide Tandarts' this is
€ 1,150. Both packages reimburse 80% up to
€ 2,045 (once only) for orthodontics for
insured persons up to 22 years of age. For
insured persons over 22 years that is 80% up
to € 345 (once only). For a complete overview
of reimbursements for each type of insurance
see the package comparer.
Dentist's statement
Anyone can apply for the additional insurance 'Tandarts'. For the additional insurance
'Uitgebreide Tandarts' CZ requires a dentist's
statement. CZ will assess your current dental
health and tell you if you can take out this
additional insurance.
Duration of the insurance
Your insurance is valid for one calendar year.
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Step 5
Step 5: Join CZ
Have you chosen the best health insurance for you?
Then apply to join CZ. This must be within four
months of starting work in the Netherlands.
Apply
You can apply to join CZ in a number of ways. We can also
cancel your current health insurance for you.
By post
Complete the application form and send it to CZ.
In person
You can visit one of our offices. You will find the addresses at www.cz.nl/location.
Members of your family
If members of your family live abroad and don't work in
the Netherlands they will not be ’AWBZ‘ insured and not
obliged to be insured under the Health Insurance Act. This
means they can't take out health insurance (general
insurance or additional insurance) with CZ. Members of
your family can be co-insured as a family member through
you in their country of residence. The insurer in your
country of residence will determine whether your family
members can be included as a co-insured family member
in your country of residence. The insurer will inform the
’CVZ‘ (Health Insurance Board) of this by means of treaty
form 106. The ’CVZ‘ must be informed within four months
of the entitlement to co-insurance. It is important,
therefore, that you tell your insurer in your country of
residence as soon as possible.
Medical care for family members
Your family members are entitled in their country of
residence to medical care according to the statutory
conditions of insurance of that country. For planned
medical care in another EU/EER country or in Switzerland,
they must have prior authorisation from the insurer in
your country of residence. For medical care in the Netherlands, your family members must use the EHIC. They can
request this from the ’CVZ‘.
Premium for family members
Family members aged 18 years and over must pay a ’ZVW‘
contribution to the ’CVZ‘.
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Do you need help choosing?
If you would like advice about the best
CZ insurance for you, you can do the
following:
Compare our insurance packages online
At www.cz.nl/kies-uw-zorgverzekering
(information in Dutch) you can choose the
best package for you. Do you prefer personal
contact via the internet? If you'd prefer to
talk to us online, go to
www.cz.nl/english/contact.
View the package comparer
reimbursements for the different packages
side by side, for easy comparison. You will
find the package comparer with this brochure
and at www.cz.nl/package-comparer.
Call CZ
Of course you can just call CZ. Our advisers
(0800 024 44 88) are here to help you.
In person
If you'd like to talk to a CZ adviser in person,
please visit one of our service offices. You will
find the addresses at www.cz.nl/location.
The package comparer sets out the
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Everything for better
healthcare
Legal information
Organisation
OWM Centrale Zorgverzekeraars groep,
Zorgverzekeraar U.A. (KVKnr. 41095222)
OWM Centrale Zorgverzekeraars groep,
Aanvullende Verzekering Zorgverzekeraar U.A. (KVKnr. 18028752)
Address
Postbus 90152
5000 LD Tilburg
CZ terms and conditions of insurance
These can be inspected at www.cz.nl/reimbursements-terms-andconditions, a CZ office, the Tilburg Chamber of Commerce, or by
calling us. The insurance contract is subject to the law of the
Netherlands.
Dissatisfied?
Please tell us at www.cz.nl/complaints. CZ is affiliated as a healthcare
Gezondheidszorg', www.skgz.nl (information in Dutch). The following
bodies also monitor how we operate as an insurer: 'De Ned. Bank',
'Autoriteit Financiële Markten' (licenses 12001020/12000561),
the 'Ned. Zorgautoriteit' and 'College Toezicht Zorgverzekeringen'.
No rights can be derived from the contents of this brochure.
580.184.1338
insurer with the mediation body 'Stichting Klachten en Geschillen