Transcript OHRA Aanvullend

REIMBURSEMENTS OVERVIEW AS OF 01/01/2017
‘OHRA Aanvullend’ additional insurance package (model number: 7700103)
version 1
The reimbursements provided by the ‘OHRA Aanvullend’ additional insurance package are summarised
in the Reimbursements Overview below.
The reimbursement percentages (%) in this overview are calculated in accordance with the
statutory (set-point) rates, agreed rates or the market rates applicable in the Netherlands. For
more information, please refer to clause A.20.
This Reimbursements Overview contains several columns. There is a number in the last column,
“Terms and conditions”. This number refers to a clause in the Terms and Conditions of Health
Insurance and Additional Insurance Packages. This clause specifies the terms and conditions that
you need to satisfy in order to receive reimbursement for the healthcare provided.
What is reimbursed
Alternative healthcare and psychosocial
healthcare
Alternative healthcare and psychosocial
healthcare:
- alternative treatment and/or
psychosocial treatment
- alternative medicines
Urgent care abroad
Rate for healthcare under your general
insurance policy and additional insurance
package:
- outside the Netherlands/your country
of residence
- dental treatment for
insured persons from the age of 18
- transport of human remains
- sending medicines and/or medical aids
- telecommunications costs
- medical advice provided by emergency service
- repatriation of the insured person when ill
Occupational therapy
Occupational therapy for insured persons up to
the age of 18
Training and supervision for carers of insured
persons who receive occupational therapy
Physiotherapy and or Cesar/Mensendieck
exercise therapy
General physiotherapy and/or exercise therapy
(together)
Screening prior to physiotherapy or exercise
therapy sessions, performed by physiotherapist
or exercise therapist
Mental healthcare (GGZ)
Amount reimbursed
Terms and
conditions
D.7.
maximum of €250 per year for
the healthcare below combined
maximum of €45 per day of treatmen
D.7.
100%
D.7.2.
D.14.
D.14.1.
100% of the claimed rate
D.14.1.a.
maximum of €250 per year
D.14.1.b.
100%
100%
maximum of €350 per year
100%
100%
D.14.1.f.
D.14.1.g.
D.14.1.h.
D.14.1.i.
D.14.1.c.
D.17.
D.17.1.
maximum of 2 hours per year, in
addition to the reimbursement
provided by the general insurance
policy
maximum of 2 hours per year
D.7.1.a./b.
D.17.2.
D.16.
maximum of 9 sessions each year
D.16.1.
100%
D.16.1.
D.6.
1
REIMBURSEMENTS OVERVIEW AS OF 01/01/2017
What is reimbursed
Amount reimbursed
Terms and
conditions
Light therapy, seasonal affective disorder
Medicines
Contraceptive medicines (statutory personal
contribution) for insured persons up to the
age of 21
Contraceptive medicines and/or medical aids
for insured persons from the age of 21
Other medicines (statutory personal
contribution)
Skin therapies
maximum of €100 per year
100%
D.6.4.
D.3.
D.3.2.a.
maximum of €200 per year
D.3.5.
maximum of €25 per year
D.3.2.b.
Acne treatment
Camouflage therapy
Hair removal
Medical aids
Post-mastectomy lingerie
maximum of €50 per year
maximum of €50 per year
maximum of €100 per year
Contraceptive medical aids
Braces and bandages
Cranial orthosis
Carers and carer relief
Carer courses
Carer relief
Oral care
Crowns, bridges and inlays (codes starting
with ‘R’) for insured persons up to the age of 18
Prevention
Preventive flu (influenza) vaccination
Preventive vaccinations, medicines,
blood test for hepatitis B and Mantoux test
for tuberculosis in connection with holiday travel
Dietary advice
Accommodation/admission
Recuperation home
Foot care
General foot care
Foot care for serious circulation problems in the
legs and/or for rheumatoid arthritis
Non-standard terms and conditions
‘Meegroeiservice’
D.10.
maximum of €90 during the
entire period you are insured
with us.
see ‘Medicines’
maximum of €150 per year
100%
maximum of €150 during the entire
period you are insured with us
maximum of 14 days per year
D.10.3.
D.10.4.
D.10.2.
D.4.
D.4.22.
D.4.18.
D.4.21.
D.24.
D.24.1.
maximum of €500 per year
D.24.2.
D.8.
D.8.2.
once a year
maximum of €250 per year
D.2.
D.2.1.a.
D.2.3.e.
maximum of €100 per year
maximum of €250 per year
maximum of €50 per year
maximum of €50 per year
2
D.2.7.
D.13.
D.13.6.
D.15.
D.15.1.
D.15.2./
D.15.3.
C.11.
C.11.3.8.