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All changes in your basic health insurance in 2021

This overview below shows all changes in our basic health-care plan as of January 1, 2021. We have only listed the changes that change the terms and conditions of your insurance.

What will change for you?

  • Excess

    Change per 1 January 2021

    The government has determined the excess stays the same.

    What does this mean for you?

    The compulsory excess in 2021 is € 385, just like in 2020.

  • Excess for organ donation

    Change per 1 January 2021

    If you were an organ or tissue donor, the excess does not apply to the costs of any check-ups necessary after the initial care period of 13 weeks (26 weeks in the case of liver transplants) has come to an end. As of January 1, 2021, all care after that period related to the donation will remain exempt from the excess.

    What does this mean for you?

    If you donate an organ or tissue, the recipient's basic insurance will reimburse your medical expenses for the first 13 weeks after the donation, or the first 26 weeks after a liver donation. After that, your own basic health-care plan will cover the costs. In 2020, the excess did not apply to check-ups. As of 2021, this also applies to other medical costs related to the donation.

  • Personal contributions

    Change per 1 January 2021

    Statutory personal contributions have been changed for 2021. 

    What does this mean for you?

    Medicines, medical appliances, dental health care, antenatal/post-natal care and other medical transportation are subject to a personal contribution. The personal contribution amounts for 2021 can be found on our website.

  • Medical care for specific patient groups (GZSP)

    Change per 1 January 2021

    Until 2020, GZSP was subsidised. This care will be transferred to the basic insurance in 2 steps. In 2020 care provided by an elderly medical care specialist and doctor for the mentally disabled has been included in the basic insurance. From 1 January 2021, the basic insurance also covers the same care by a behavioral scientist, paramedical care and day treatment in a group.

    What does this mean for you?

    For vulnerable people with multiple health problems and for people with a mental disability, the general practitioner was already able to call in a elderly medical care specialist (SO) or a doctor for the mentally handicapped (AVG) as of 2020. From 1 January 2021 they can also call in other care providers. Day treatment in a group can be part of the care provided. This is all covered by the basic health-care plan. However, the costs are subject to the excess and you sometimes have to seek our permission beforehand.

  • ONVZ instates maximum reimbursement limits for district nursing and mental health care

    Change per 1 January 2021

    As a not-for-profit organisation, we want the best for all our members, including you. Aa you may have noticed, the premium for your health-care plan has increased in recent years. This was partly caused by an increase of health-care costs, as well as a small group of health-care providers who unnecessarily use our extensive benefits.

    Virtually all health-care providers are committed to providing good care on a daily basis. In order to sustain this quality care in the future, we make daily efforts to prevent improper and unnecessary use of health-care funds. Unfortunately, this approach turned out to be not effective enough for mental health care and district nursing (home care). This is why, after consulting the ONVZ member council, we have decided to instate maximum reimbursements for mental health care and home care organisations that do not have a contract with ONVZ. This change will take effect on 1 January 2021.

    What does this mean for you?

    If you are not using mental health care or district nursing, nothing will change for now. You are still free to choose your own doctor and hospital as you are used to from us. Remember this change for any district nursing or mental health care you may use in the future.

    If you are using district nursing and/or mental health care, please read more about what this change means for you.

  • Medical specialist care (referrer)

    Change per 1 January 2021

    From 1 January 2021, optometrists and orthoptists may also refer you to an ophthalmologist.

    What does this mean for you?

    If an optometrist or orthoptist determines that it would be better to refer you to an ophthalmologist, they may refer you directly. In that case there is no need to see your GP first. However, the optometrist must meet certain quality standards.

  • Physiotherapy and remedial therapy for COPD patients

    Change per 1 January 2021

    The basic insurance reimburses physiotherapy and remedial therapy for COPD (Chronic Obstructive Pulmonary Disease) from the first treatment. There is a maximum number of treatments, depending on the severity of the disease. As of January 1, 2021, this number will be increased for some patients with symptoms in class B.

    What does this mean for you?

    If you have COPD GOLD stage II or higher, the basic health-care plan will reimburse physiotherapy and remedial therapy from the first treatment. If your symptoms, disease burden and risk of lung attacks are of a certain severity, the basic insurance will reimburse more treatments in 2021.

  • Total parenteral nutrition

    Change per 1 January 2021

    From 2021 onwards, pumps for parenteral nutrition (infusion feeding) will no longer fall under the medical appliances benefit, but under specialist medical care. The food itself will also become part of this benefit.

    What does this mean for you?

    Patients with a disorder of the gastrointestinal tract sometimes need drip feeding, which can often be administered at home. Until this year, it was unclear exactly who was allowed to charge what costs. As of January 1, 2021, all costs for the pump and the food will be managed by the hospital. You will no longer receive bills from the supplier of the appliances or your pharmacy.

  • Medicines (Gaucher disease)

    Change per 1 January 2021

    In 2021, medicines for Gaucher disease are no longer part of the medicines benefit, but fall under specialist medical care from 2021 onwards. 

    What does this mean for you?

    If you will use medicines for Gaucher disease in 2021, not the pharmacy but the hospital will charge you for them. They will claim the costs directly from us as medical-specialist care (via the dbc system).

  • Medicines (resold pharmacy preparations)

    Change per 1 January 2021

    The list of resold pharmacy preparations has been updated.

    What does this mean for you?

    If you have used a resold pharmacy preparation in 2020 that you have to keep using in 2021, you can check on the list 'doorgeleverde (apotheek)bereidingen 2020-2021' whether our reimbursement has changed. You can also contact our Service Centre.

  • Dietary preparations

    Change per 1 January 2021

     From 1 January 2021, you must request our permission for the reimbursement of dietary preparations (infant nutrition) in the event of cow's milk allergy, if:

    • no provocation test has been carried out
    • the insured is 2 years or older, or
    • needs more than 1,000 ml per day

    What does this mean for you?

    If your child is allergic to cow's milk and needs special milk because of that, you have to ask us for permission in certain situations. If your child is already using special milk and one of the above applies, you do not have to ask for permission.

  • Medical appliances for diabetes

    Change per 1 January 2021

    As of January 1, 2021, all medical appliances for diabetes will be reimbursed as medical appliances. In 2020, some aids fell under specialist medical care. These aids will be added to the medical appliances benefit:

    • continuous glucose monitoring and flash glucose monitoring (freestyle libre) 
    • insulin pumps
    • ketone test strips 

    What does this mean for you?

    Do you have diabetes mellitus and do you use continuous glucose monitoring, flash glucose monitoring or an insulin pump? Funding of these aids is no longer channelled through the hospital. All costs of these medical appliances, plus the costs of ketone test strips, fall under the medical appliances benefit as of January 1, 2021.

  • Medical appliances (orthopaedic footwear and orthotics for footwear)

    Change per 1 January 2021

    From 2021 onwards. the minimum service life for orthopaedic modifications to regular footwear is the same as for orthopaedic footwear: 18 months.

    What does this mean for you?

    If you need orthopaedic modifications to your regular footwear in 2021, you can claim the costs of 1 pair of shoes, or 1 shoe, once every 18 months.

  • Medical appliances (hearing aids)

    Change per 1 January 2021

    From 1 January 2021, there is no more prescription requirement for a hearing aid in the case of age-related hearing loss.

    What does this mean for you?

     If you have hearing problems because of your age fow which you need a hearing aid, you no longer need to go to your GP, an audiological centre or an ENT doctor for a prescription first. Your audiologist will perform the hearing test and fir you with a suitable hearing aid.

  • Medical appliances (hearing (induction) loop, personal FM system or infrared hearing system)

    Change per 1 January 2021

    In addition to an ENT doctor, audiological centre or general practitioner, from 1 January 2021 an audiologist may also prescribe an induction loop, personal FM system or infrared hearing system.

    What does this mean for you?

    If you need an induction loop, personal FM system or infrared hearing system in 2021, you do not need to visit an ENT specialist, audiological centre or general practitioner for a prescription. You can directly go to your audiologist as well.

  • Dressings

    Change per 1 January 2021

    Annual update of the list of dressings (wound dressings and compression aids).

    What does this mean for you?

    If you used dressings in 2020 and will still need them in 2021, you can check our list of dressings to see whether our coverage has changed. You can also contact our Service Centre.

  • General basic mental health care (referrer)

    Change per 1 January 2021

    As of 1 January 2021, an A&E doctor (Accident and Emergency doctor) may also refer you to a general basic mental health care practitioner.

    What does this mean for you?

    In addition to a general practitioner or company doctor, the A&E doctor may also refer you to a general basic mental health care practitioner. 

  • Specialist mental health care (referrer)

    Change per 1 January 2021

    As of 1 January 2021, an A&E doctor (Accident and Emergency doctor) may also refer you to a specialist mental health care practitioner.

    What does this mean for you?

    In addition to a general practitioner or medical specialist, the A&E doctor may also refer you to a specialist mental health care practitioner. 

  • Medical transportation for GZSP

    Change per 1 January 2021

    As GZSP is fully included in the basic health-care plan in 2021 (see above), the basic insurance also reimburses transportation to and from day treatment for some specific groups.

    What does this mean for you?

    If you receive outpatient treatment in a group as part of GZSP, the basic insurance sometimes also covers medical transportation to the day treatment. Please be aware that you must seek our permission first. You will pay a statutory personal contribution for the transportation costs, which are also subject to your excess.

Changes in our supplementary plans

Go back to all changes in our health-care plans for 2021.

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