All changes in your basic health insurance in 2022

What will change for you?

• Excess

  The government has determined the excess will stay the same.
  
  What does this mean for you?

  The compulsory excess in 2022 is €385.

• Personal contributions

  The government has changed the statutory personal contributions for 2022.

  
  What does this mean for you?
  Medical appliances, dental health care, antenatal/postnatal care and ‘other’ medical transportation are subject to a personal contribution. The personal contribution amounts for 2022 can be found elsewhere on our website.

• Extension of permission requirement for mental health care

  As of 1 January 2022, our prior permission is required for more types of mental health care. This only applies if you go to a care provider with whom we do not have a contract. If that is the case, permission is required for:

  • all clinical treatments
  • for a treatment trajectory consisting of more than 35 consultations, or
  • if you are prescribed Spravato

  The permission for admissions longer than 1 year will not change.

  
  What does this mean for you?
  If you will be going to a non-contracted mental health-care provider in 2022, you must ask our prior permission for all admissions, treatments without admission consisting of more than 35 consultations and use of the drug Spravato as part of the treatment.

• Medical transportation - requesting permission

  As of 1 January 2022, ONVZ will assess applications for seated medical transportation. After we have given our permission, Transvision will arrange the taxi transport for you. They can be reached from Monday to Friday from 8 a.m. to 6 p.m. on 0900 333 33 30. After a telephone intake with Transvision, you can also book rides via their online reservation tool.

  
  What does this mean for you?
  If you need taxi transport in 2022, you need to request our prior permission.

  You can read more on how that works elsewhere on our website. If you have our permission, you can contact Transvision. They will arrange your taxi transport and send the claim directly to us.

  If you were already using Transvision's services in 2021 and still have authorisation for 2022, you can continue to use Transvision's taxi transport. Their opening hours have extended and you can book your rides online as well. For more information, please contact Transvision.

  If your permission expires, you must apply for an extension through ONVZ. You can no longer apply for an extension through Transvision.

• Obligation to contact the Zorgassistance emergency centre in the event of urgent care abroad

  If you need urgent care abroad, you are obliged to contact our Zorgassistance emergency centre as soon as possible.

  
  What does this mean for you?
  If you need urgent care abroad, for example due to an accident or a sudden illness, you should contact our Zorgassistance emergency centre as soon as possible. They are available 24 hours a day, 7 days a week. This obligation already applied to supplementary reimbursements from Superfit and Wereldfit. It now also applies to reimbursements from the basic health-care plan.

• Permission requirement for scheduled care abroad

  From 1 January 2022, you need our prior permission for a scheduled admission or outpatient stay in a foreign hospital or private clinic. This does not apply to emergency admissions.
  
  What does this mean for you?
  If you go to a hospital or private clinic abroad for a scheduled admission or outpatient stay, you must request prior permission.

  An outpatient stay means your treatment will last more than two hours and you will be going home the same day. If you are admitted, you will stay in hospital for at least one night.

• Abroad - scheduled care and additional costs

  We do not reimburse administration costs incurred because you are going abroad for treatment. For example, any costs the foreign hospital charges because they have to process your file from the Netherlands.

  
  What does this mean for you?
  If you go abroad for care, the hospital may sometimes incur additional administration costs. To assess your file from the Netherlands, for example. They may need to fill out an application form to obtain our permission. Or communicate the results of the treatment to Dutch doctors. We do not reimburse costs the hospital may charge for this.

• Abroad - scheduled care in accordance with European treaty law

  We will only issue an S2 form if the care you need is not (timely) available in the Netherlands. If you want to go abroad for care for other reasons, you will be reimbursed in accordance with Dutch regulations and up to a maximum of what the care would have cost in the Netherlands.

  
  What does this mean for you?
  If you opt for scheduled treatment in an EU or EEA country or Switzerland with reimbursement according to local regulations, you must take an S2 form with you to the care provider. From 1 January 2022, we will only provide such an S2 form if you need care that is not (timely) available in the Netherlands.

• Premium arrears

  From 1 January 2022, we will apply the same rules as other health-care insurers if you do not pay your premium on time. We will no longer terminate your basic health-care plan. If you are 6 months in arrears, we will register you for the Default Payments Scheme with the CAK.

  
  What does this mean for you?
  If you do not pay the premium for your health insurance for 6 months or longer and fail to respond to payment reminders, we will register you with the CAK for the Default Payments Scheme. We will not terminate your basic insurance, but you will have to pay a higher premium, among other things. We advise you to read the new rules surrounding premium payment carefully. You can find these rules at www.onvz.nl/algemeneregels.

• Medical appliances - prostheses

  From 1 January 2022, a physician assistant may also prescribe a number of aids that fall under the Prosthesis reimbursement.

  
  What does this mean for you?
  If you need a prosthesis for arms, hands, shoulders, hips, legs or feet, physician assistants may now also issue the prescription, in addition to medical specialists.

• New funding system for mental health care

  In 2022, a new funding system will be introduced for mental health care: the Care Performance Model [Zorgprestatiemodel]. This is one system for both generalist basic mental health care and specialised mental health care. No complicated DBCs, but simple rules and straightforward invoices with, for example, a consultation or an overnight stay.

  
  What does this mean for you?
  From 1 January 2022, your mental health care invoices will be more specific. They will list exactly on which date and with whom you had a consultation, and how long it took. Did you start a treatment trajectory in 2021 that will continue into 2022? Your care provider will close the dbc on 31 December 2021 and you will be billed one more time based on the old system. The new system will start on January 1, 2022. As a result, you may have to pay more excess. The care itself will not change due to the new funding.

• Overnight stays for CAR-T Cell therapy

  A few expert hospitals offer a new treatment for lymphoma: CAR-T cell therapy. After being in hospital for this treatment, the patient has to stay close to the hospital for another 2 weeks. For patients who live too far away, the basic health-care plan reimburses overnight stays in, for example, a hotel. Up to €77.50 per night will be reimbursed.

  
  What does this mean for you?
  If you have to undergo CAR-T cell therapy for an aggressive form of lymphoma and live far away from the hospital that treats you, the basic health-care plan will reimburse €77.50 for extra (paid) overnight stays in the vicinity of the hospital.

• Medicines part of other coverage

  From 2022 onwards, 2 medicine groups will fall under specialist medical care and will no longer be part of the medicines benefit. These 2 groups are epoetines and G-CSFs.

  
  What does this mean for you?
  If you will be taking medicines from one of the following groups in 2022:

  • Epoetins, also called growth factors for red blood cells
  • G-CSF agents, also called growth factors for white blood cells

  Not the pharmacy but the hospital will handle payment for these types of medicines. They will claim the costs directly from us as medical-specialist care (via the dbc system).

• Physiotherapy or remedial therapy for children: 2nd series of 9 treatments (referrer)

  In 2022, in addition to the general practitioner and medical specialist, a youth doctor, nurse specialist and physician assistant may also refer a child up to the age of 18 for a 2nd series of 9 physical therapy or remedial therapy treatments.

  
  What does this mean for you?

  If your child is undergoing physical therapy for a condition that is not on the list of chronic ailments for physical therapy, the basic health-care plan reimburses 9 physical therapy or remedial therapy treatments. To be reimbursed for another 9 treatments, you must have a referral from a general practitioner or medical specialist. From 1 January 2022, you may also obtain this referral from a youth doctor, nurse specialist or physician assistant.