IAK Supplementary Health Care Insurances - IAK Verzekeringen

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44 General VIII Supplementary insurance Hospital Plus (ZiekenhuisPlus) Entitlement to reimbursement of costs under above supplementary insurance shall be subject said supplementary insurance being recorded on the policy schedule and if and insofar as there is no entitlement under the IAK Health Care Insurance pursuant to the Zvw (Health Care Insurance Act) or under any other supplementary health care insurance. This supplementary insurance is governed by the IAK Supplementary Health Care Insurance General Conditions. 22 Cover 1.1 Nursing/hospitalisation Nursing/hospitalisation of the insured person in a hospital in the Netherlands (or abroad, provided that said hospital is recognised by the overseas competent authorities), that exceeds the standard or lowest rate or category (facility), in cases where for medical reasons nursing, investigation and/or treatment can only be provided in a hospital and uninterrupted treatment by a medical specialist or dental surgeon is essential. In this context, nursing/hospitalisation shall be understood to mean a stay of 24 hours or longer. Reimbursements: 1. Reimbursement will be granted in respect of the costs of nursing in a hospital that exceed the standard or lowest rate or category available, subject to a maximum of the standard rate charged in the Netherlands, this being determined at the discretion of the health care insurer. 2. In cases where nursing is provided at the standard or lowest rate or category available, or where the hospital in question does not have different rates or categories, the health care insurer will reimburse € 70.00 per nursing day. 3. If nursing takes place in a specially designed location or department within a hospital where the insured person has access to extra facilities, services and comforts that are not standardly provided by said hospital or institution, (or not provided under the standard or lowest or only available category), then the costs charged by the hospital will be reimbursed up to a maximum of € 200.00 per nursing day. No reimbursement will be made of the costs of a stay in the rehabilitation or psychiatric department of a hospital or psychiatric hospital. a. Convalescent homes Reimbursement of the costs of a stay in a convalescent home that provides somatic care selected by the health care insurer. Call us or visit our website for a list of the selected convalescent homes. Reimbursement is subject to a maximum of € 100.00 per day up to a maximum of 28 days per insured person per policy year. You are required to acquire prior written permission from the health care insurer. Reimbursement is subject to there being no entitlement (or no longer any entitlement) to reimbursement under another supplementary or other health care insurance. b. Transportation to and from the hospital by taxi Reimbursement of the costs of transportation by taxi on the first and last day of a hospital stay in the Netherlands. If the insured person is accompanied in the taxi by a second person, that person’s trip to and from the hospital will also be reimbursed. A maximum of 4 taxi journeys per hospital stay will be reimbursed. 23 Obligations of the insured person The insured person must demonstrate his/her entitlement to reimbursement of the costs named in this supplementary insurance by submitting an original, stamped invoice, from which the health care insurer can deduce which reimbursement should be made.
General IX Supplementary insurance Home Help (Huishoudelijke Hulp) 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 Health Care Insurance pursuant to the Zvw (Health Care Insurance Act) or under one or more of the supplementary insurances described in these policy conditions, that have been entered into supplementary to the IAK Health Care Insurance (main insurance). 24 Cover Payment of the amount indicated on the policy schedule for each day that the person who is insured under the policy is being cared for in a hospital as a matter of medical necessity, provided that the costs of said care qualify for full or partial reimbursement by the health care insurer under the IAK Health Care Insurance or supplementary insurance. In this context, ‘being cared for’ shall be understood to refer to a stay of 24 hours or longer. Reimbursement of the costs of home help will not apply in the case of hospitalisation in a psychiatric institution, psychiatric hospital, the psychiatric department of a hospital, rehabilitation centre, sanatorium or the Dutch Asthma Centre in Davos. Samen voor een perfect verzekerde toekomst 45
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 42 and 43: 42 Reimbursement will apply to medi
Page 46: 46 ZV-VW-AV ENG (01-2012)

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