CZ Health insurance Collective 2014

Transcription

1 CZ Health insurance Collective 2014

2 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. 2

3 Select the best health insurance for you Health insurance consists of general insurance, usually together with an additional insurance package and/or a dental package. But how do you know which group 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 healthcare 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 must have general health 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 a group additional insurance You can take out additional insurance for care not included in the general insurance. CZ offers a wide choice of additional group packages. Step 4: Select a group dental package 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 on our website, by phone, at one of our centres or by post. 3

4 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 Reduction on products, services, and other insurance If you're insured with CZ you can receive discounts on products and services that help you stay fit and healthy. Such as discounts when you start a fitness course and for spectacles or contact lenses. As CZ is working with OHRA, you can also obtain discounts on, for instance, travel-, cancellation-, homeor carinsurance. For an overview, go to (information on Dutch). 4

5 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 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 ? This is also possible. For example, to a psychologist, a 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 5

6 Step 2 Step 2: Choose the best general insurance for you Everyone in the Netherlands is required by law to have general 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 package-comparer. 19% chose this 73% chose this 8% chose this 'CZ Zorg- bewustpolis' The in-kind policy 'CZ Zorg-op- maatpolis' The in-kind policy 'CZ Zorg- keuzepolis' The refund policy 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 Payment method Direct debit Direct debit or giro form Direct debit or giro form Voluntary deductible Choice of: Communications from CZ: None or 500 None, 100, 200, 300, 400 or 500 None, 100, 200, 300, 400 or 500 By By post or by By post or by Extra service None Best Doctors Best Doctors 6

7 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. Your employer has group health insurance with CZ, which means you receive a discount on the premium. The discount also applies if you have a spouse, partner or children. Children up to the age of 18 years are co -insured and pay no premium. You might be eligible for the healthcare allowance. You can check by calling the Tax Office ( ) or at (information in Dutch). 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 or by calling the 'CZ Zorgservice' on (013) 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 are 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 non-contracted 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 Every Dutch person 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, follow up visits for kidney or liver donors and medical aids on loan. Voluntary deductible In addition to the compulsory deductible you can opt for a 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 give you a second opinion on the best treatment for your illness or disorder. Duration of the insurance Your insurance is valid for one calendar year. 7

8 Step 3 Step 3: Choose the group 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 packages especially for people with group health insurance: 'Basis Collectief', 'Plus Collectief' and 'Top Collectief'. The package comparer sets out what is covered under CZ's additional insurance packages. Discount on additional insurance You and any spouse, partner or children receive a discount on the group additional insurance. Co insured children up to the age of 18 years don't pay a premium. They receive the same additional insurance as the parent/carer with the most expensive additional package. 'Basis Collectief', 'Plus Collectief' and 'Top Collectief'. These additional packages are specially designed for people with group health insurance. 'Plus Collectief' in particular is an ideal insurance for families when combined with dental cover. It provides ample reimbursement for physiotherapy, the flu jab and preventive health checks. The dental insurance provides extensive reimbursement for orthodontics. This is very useful if one of your children needs a brace. Choose 'Basis Collectief' if you want a slightly lower level of cover or 'Top Collectief' if you want comprehensive cover. 'Jongeren' and '50+' If the additional insurance packages outlined above are not right for you, you can choose a package to suit your phase of life. The benefit is that you only pay for things that are relevant to your phase of life. For instance, with the additional packages 'Jongeren' and '50+' you don't pay an extra premium for extra maternity care. The 'Jongeren' policy already has cover for dental costs. 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 Collectief' package. Duration of the insurance Your insurance is valid for one calendar year. 8

9 Step 4 Step 4: Choose the group 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 group additional insurance you have chosen. The additional package 'Jongeren' already provides 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. Dental insurance: 'Tandarts Collectief' and 'Uitgebreide Tandarts Collectief' CZ has two group dental insurance packages: 'Tandarts Collectief' and 'Uitgebreide Tandarts Collectief'. The difference between the two packages is the maximum amount reimbursed per year. With the group additional insurance package 'Tandarts Collectief' this is 450. With the group additional insurance 'Uitgebreide Tandarts Collectief' this is 1,150. Both packages include extensive reimbursement for orthodontics for all ages. 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 Collectief'. For the additional insurance 'Uitgebreide Tandarts Collectief' 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. 9

10 Step 5 Step 5: Join CZ Have you chosen the best group health insurance for you? Then apply to join CZ. Apply You can apply to join CZ in a number of ways. You will need your company's group number, available from your employer. We can also cancel your current health insurance for you. On our website Go to (information in Dutch) and apply online. Call CZ Call CZ on to apply. By post Complete the application form and send it to CZ. In person You can also visit one of our offices. You will find the addresses at Transferring Normally you can transfer on 1 January, but if you've changed employer and you already had group health insurance with your old employer you don't have to wait until 1 January. This also applies if you have a new employer and you now have individual insurance with CZ (i.e. not through your employer or organisation). 10

11 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 (information in Dutch) you can choose the best package for you. You will need your company's group number, available from your employer. Do you prefer personal contact via the internet? If you d, prefer to talk to us online, go to You will find the package comparer with this brochure and at Call CZ Of course you can just call CZ. Our advisers ( ) 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 View the package comparer The package comparer sets out the reimbursements for the different group insurance packages side by side, for easy comparison. 11

12 Legal information Everything for better healthcare Organisation OWM Centrale Zorgverzekeraars groep, Zorgverzekeraar U.A. (KVKnr ) OWM Centrale Zorgverzekeraars groep, Aanvullende Verzekering Zorgverzekeraar U.A. (KVKnr ) Address Postbus LD Tilburg CZ terms and conditions of insurance These can be inspected at 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 CZ is affiliated as a healthcare insurer with the mediation body 'Klachten en Geschillen Gezondheidszorg', (information in Dutch). The following bodies also monitor how we operate as an insurer: 'De Ned. Bank', 'Autoriteit Financiële Markten' (licences / ), the 'Ned. Zorgautoriteit' and 'College Toezicht Zorgverzekeringen'. No rights can be derived from the contents of this brochure