IAK Supplementary Health Care Insurances - IAK Verzekeringen

More documents

Recommendations

Info

42 Reimbursement will apply to medically necessary patient transport within the Netherlands, to and from a hospital or the address of the medical specialist's practice or to and from facilities that fall fully or partially under the AWBZ (Exceptional Medical Expenses Act). Transport to and from an AWBZ establishment for a care session lasting part of a day qualifies for reimbursement under the AWBZ.
General VII Supplementary insurance Dental Care (Tandartskosten) Reimbursement will be provided for the following costs of care or services insofar as there is no entitlement (or no longer any entitlement) to such reimbursement under the IAK Zorgverzekering based on the Zvw (Health Care Insurance Act) or pursuant to one or more of the supplementary insurances described in these policy conditions that have been entered into supplementary to the IAK Zorgverzekering (main insurance). 20 Cover 1.1 1.2 Reimbursement of 80% of the costs of care normally provided by dentists on the basis of the rate agreed with the care provider by or on behalf of the health care insurer, unless the health care insurer has stipulated otherwise. Invoices must be prepared according to the Wmg (Health Care Market Regulation Act) description and coding as drawn up by the NZa (Dutch Care Authority). Reimbursement will be granted up to a maximum of the amount indicated on the policy schedule per insured person per policy year including technical costs, in respect of the costs of treatment provided by a dentist, dental prosthesist or oral hygienist. Reimbursement will include the technical costs linked to treatments provided by a dentist or a dental prosthesist on the basis of the rates recommended by the NTG (Dutch Dental Technical Society), the VLHT (Association of Laboratory Dental Technicians) and the ONT (Organisation of Dutch Dental Prosthesists) to their members. 21 Exclusions The following costs will not be reimbursed: • the filling in of diastemas that were already present at the time of the insurance application; • the placement of crowns on teeth to which root canal treatment had already been applied at the time of the insurance application, unless there was already a crown on the tooth in question; • orthodontics; • treatments that are unnecessarily expensive, unnecessarily complicated or inappropriate in dental terms. Samen voor een perfect verzekerde toekomst 43
Page 1: IAK Supplementary Health Care Insur
Page 4 and 5: 4 I General section 5 1 Definitions
Page 6 and 7: 6 1.19 1.20 1.21 1.22 1.23 1.24 1.2
Page 8 and 9: 8 1.65 1.66 Youth psychologist: a p
Page 10 and 11: 10 Below are the types of care for
Page 12 and 13: 12 Charge for payment via paper pay
Page 14 and 15: 14 6.5 6.6 The policyholder may giv
Page 16 and 17: 16 Cover II Jong Extent of the cove
Page 18 and 19: 18 6.2 Glasses / contact lenses Rei
Page 20 and 21: 20 Cover III Compact Extent of the
Page 22 and 23: 22 15 Medical aids 6.1 6.2 Individu
Page 24 and 25: 24 Cover IV Compleet Extent of the
Page 26 and 27: 26 You can find a list of care prov
Page 28 and 29: 28 14.2 14.3 For a list of patient
Page 30 and 31: 30 Cover V Extra Compleet Extent of
Page 32 and 33: 32 5 Pharmaceutical care 5.1 5.2 Co
Page 34 and 35: 34 can be called in where the insur
Page 36 and 37: 36 20 Second opinion Reimbursement
Page 38 and 39: 38 2.5 in advance to the health car
Page 40 and 41: 40 9.3 lenses that are replaced mon
Page 44 and 45: 44 General VIII Supplementary insur
Page 46: 46 ZV-VW-AV ENG (01-2012)

IAK Supplementary Health Care Insurances - IAK Verzekeringen

Create successful ePaper yourself

Delete template?

Save as template?