IAK Supplementary Health Care Insurances - IAK Verzekeringen

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can be called in where the insured person is either in receipt of informal care or is an informal caregiver. The informal
care broker determines how many hours of support are required.
Reimbursement is subject to a maximum of € 250.00 per policy year. The services an informal caregiver provides are
eligible for reimbursement once only. Reimbursement of the costs of the services provided cannot be claimed by both
the informal caregiver and the person in receipt of informal care.
You can find a list of contracted care providers on our website. Alternatively, you can call us and ask for a list.
For more information, see article 2.4 of ‘General conditions’ in these insurance terms and conditions.
13 Specialist medical care / plastic surgery or reconstructive treatment
Reimbursement of the costs of the following treatments:
• uvuloplasty to correct snoring problems;
• correction of upper eye lids or ear position;
• the operative placement or replacement of breast prostheses, other than in the status following full or partial
mastectomy;
• circumcision of the insured person;
• sterilisation for both men and women.
For the first four treatments listed above, reimbursement will only be granted if and insofar as the treatment was
medically necessary and subject to the prior written permission of the health care insurer, all at the discretion of the
health care insurer's medical advisor.
Indication for correction of upper eyelids:
paralysed or weak upper eyelids, combined with a demonstrable impairment of the field of vision. This is the case if:
• the pupil is fully or partially covered by the lower edge of the upper eyelid or by the overhanging fold of skin when
the patient is relaxed and looking straight ahead, or;
• there is distinct peripheral vision impairment due to severe drooping of the upper eyelid or an overhanging fold of
skin to the outer edge, or;
• there is demonstrably incurable chafing in the skin crease of the upper eyelid.
A photo (taken by the hospital/independent treatment centre or by yourself) should be enclosed with the
application/request for authorisation, on which the abnormality described in the indication is clearly visible.
In the case of specialist treatment and/or nursing care in a hospital or independent treatment centre, reimbursement
will be granted on the basis of the DBC (Diagnosis Treatment Combination) agreed with the health care insurer.
Entitlement to reimbursement also exists in respect of this help in cases where there is no contractual arrangement
between the health care insurer and the service provider / care provider. In such cases, the statutory rate will apply,
and for treatments where there is no statutory rate, limited reimbursement will be granted per DBC. If the DBC
trajectory started in the previous policy year, the declaration must be submitted to the health care insurer with which
the insured person was insured when the treatment started.
14 Overnight stay following oncological treatment
Reimbursement of the costs of an overnight stay in a guesthouse associated with the hospital following outpatient
radiotherapy or cytostatic treatment, up to a maximum of € 35.00 per night per insured person.
15 Menopause consultation
Reimbursement of the costs of acquiring information, counselling and/or treatment for women undergoing menopause,
provided by a menopause consultant, up to a maximum of € 160.00 per insured person for the entire duration of the
insurance.
16 Pedicure for diabetics and patients with rheumatism
Reimbursement of the costs of foot care for an insured person who has diabetes or rheumatism. The health care
insurer may require a doctor's certificate.