Test yourself
Almost a third of Dutch people pay for care that they did not know was covered by their deductible, according to research agency Markteffect. How is your knowledge of the deductible?
The First Aid in the hospital is covered by your deductible. True or False?
If you need a doctor urgently in the evening or at the weekend, you want to be helped quickly. For the wallet it makes a big difference where you go. The hospital’s First Aid post is covered by the deductible, the GP post in the same hospital is not. So, if possible, first visit the Huisartsenpost. Perhaps the GP can suture a bleeding wound there, for example.
If you end up in the ambulance after a heart attack, there is no deductible. Is that right?
Research by health insurer VGZ shows that 39 percent of the Dutch think that an ambulance or emergency care in the hospital does not fall under the deductible. Unfortunately, this is incorrect: payment must be made.
Medicines are sometimes covered, but sometimes not under the deductible. Fact or fable?
Medicines fall under the deductible, even if they have been prescribed by the GP – but sometimes not. Various health insurers have a preferential policy, also known as a ‘preference policy’. This means that they do not include certain (cheaper) medicines under the deductible.
The same applies to aids for which the insurer has concluded a favorable contract with the manufacturer or supplier. Sandra de Jong of the Consumers’ Association: “Suppose you use blood pressure lowering agents, and your insurer does not include a certain blood pressure lowering agent under the deductible: that makes a big difference.” If you are looking for an insurer for next year, check which medicines are not covered by the deductible with this insurer. You can find this information on the health insurer’s website or call the insurer.
A year later you can still get a deductible account. Or is that not allowed?
A hospital bill that is at the expense of your deductible can indeed come in a year later. This is because hospitals work with DBCs: diagnosis and treatment combinations. These DBCs contain the hospital’s declarations for specialist care. As long as a hospital does not ‘close’ such a DTC (for example because the patient is expected back for additional treatments), the DTC continues to count towards the patient’s own risk. It is therefore possible that a patient who saw a specialist in 2014 will still receive an invoice at the end of 2015 in which the deductible is settled.
Complaining about such a late bill usually makes no sense. The hospital is legally within its rights. Sandra de Jong of the Consumers’ Association: “It is impossible for patients to follow such a thing. In our opinion, hospitals must close their accounts at the end of each calendar year. But for the time being, that is not the case and the system remains very complicated.”
Sources):
- Plus Magazine
