IAK Supplementary Health Care Insurances - IAK Verzekeringen

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