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Changes in Health Basic and Health Premium 2022

Overview of the changes in Health Basic and Health Premium in 2022.

What will change for you?

  • 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. Not paying your premium for the supplementary health-care plan (on time) has consequences.

    What does it mean for you?
    If you do not pay the premium for your Health Basic or Premium in time and fail to respond to payment reminders, we can terminate your health-care plan with effect from the day you failed to pay your premium. 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 it 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.

  • 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 it 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.

     

  • 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, Health Basic and Premium will reimburses overnight stays in, for example, a hotel. Up to €77.50 per night will be reimbursed.

    What does it 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, Health Basic and Premium 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 it 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).

  • Aid for third-party claims for injury

    Expansion of the area in which we provide this service. In addition to the countries of the EU, we will also offer our assistance for accidents in the countries of the EEA, Switzerland and the United Kingdom.

    What does it mean for you?
    If you have Health Premium, you can count on our aid for third-party claims for injury. From 1 January 2022, we will not just provide this service in EU countries, but in the countries of the EEA, Switzerland and the United Kingdom as well.

  • 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 it 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.

  • International health-care policies transferred to OOM

    The health-care plans ‘Zorgverzekering Buitenland’, ‘Basisfit Internationaal’ and the associated supplementary insurance plans will be transferred to OOM Verzekeringen per 1 January 2022.

    What does this mean for you?
    If you currently have one of the health-care plans mentioned above, you received a letter from us in October 2021. This letter contains more information about the acquisition and what it means for you. If you have not read the letter, you will also find the necessary information on this explanation page.



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