Health insurance deductible explained - CZ (2024)

Everybody aged 18 or over has a compulsory deductible for healthcare provided under their general insurance policy. In 2024, you pay the first€385 for the costs of healthcare yourself and we reimburse the costs above this amount.

What is the deductible?

Compulsory deductible

If you are aged 18 or older, you pay a deductible for the first part of healthcare you receive under the general insurance. This is the compulsory deductible.

The amount of the compulsory deductible is set each year by the Dutch government. In 2024is this €385. The deductible applies to one calendar year (1 January to 31 December). You pay this amount in addition to your premium. Once you have paid the full amount of your compulsory deductible, we will reimburse any costs subsequently incurred.

Voluntary deductible

Types of healthcare to which the deductible applies

You pay a deductible for healthcare covered under the general insurance, like hospital care, blood tests and medicine for example. If you’d like to see whether you need to pay a deductible, check our reimbursem*nt guide.

Healthcare that is exempt from the deductible

You do not have to pay a deductible for things like GP visits, obstetric care and healthcare covered under the additional insurance package. See all the exceptions.

Do I have to pay the deductible all at once?

You can opt to pay the compulsory deductible in instalments so that you don’t have to pay the entire€385 in one go. Your deductible will then be split up into 10 monthly payments of €38.50. If you do not ‘use up’ all of your deductible, we will reimburse you for the excess amount you paid. If you want to pay the deductible in instalments next year, please notify us before 1 February.

Also interesting to know

Difference between the deductible and the personal contribution The deductible and the personal contribution are both amounts that you need to pay out of your own pocket for healthcare. They are not the same thing, however. When do you have to pay a personal contribution? Learn the difference

Important to know

Which costs are subject to the deductible?

You pay the deductible for healthcare costs that you incur under the general insurance. This includes care like:

  • healthcare in a hospital
  • laboratory tests
  • urgent medical care

If you'd like to see whether you need to pay a deductible, check our reimbursem*nt guide.

Which costs are not subject to the deductible?

You do not pay a deductible for healthcare costs like:

  • a visit to the general practitioner or after-hours general practice
  • healthcare for children under the age of 18
  • healthcare reimbursed under your additional insurance package
  • midwifery care and obstetric care
  • medical aids you have on loan
  • district nursing

See all the exceptions

What happens if I don’t use all of my deductible?

You pay the deductible for a calendar year, meaning from 1 January to 31 December. You only pay a deductible for healthcare covered under the general insurance. If you have not incurred any healthcare costs (or hardly any), you also pay little or no deductible. Your deductible will be recalculated on 1 January of the following year.

If you pay your deductible in 10 advance instalments and do not use the full amount of the deductible by 31 December, the surplus amount will be repaid to you by no later than 1 April of the following year.

When do I receive an invoice for the deductible?

We send the invoice for the deductible once every three months, meaning you may need to wait a while before you receive it.

For what year do I pay the deductible? And why do I sometimes have to pay it twice?

The year for which you are charged a deductible is determined by the start date of your treatment. If the first appointment for your treatment is in 2024, you will be charged the deductible for 2024.

Do you visit the hospital for treatment? The hospital groups together all your treatments in a sort of package, called the Diagnosis-Treatment-Combination, or DBC. The DBC will stop as soon as your treatment has finished, or it will stop after a certain number of days as stipulated by the NZa:

  • Most healthcare in hospital: 120 days
  • Surgery: 42 days
  • Mental healthcare: 365 days

If the treatment takes longer than that, a new (follow-up) DBC will start. If you had not yet paid all of your deductible or this new follow-up DBC is opened in a new year, you will be charged a deductible again. Your healthcare provider can tell you when a new DBC will be opened for you.

When can I increase the deductible for my health insurance?

If you seldom incur medical costs and if you have saved enough to pay the full deductible in the event that you do need healthcare or medicine, you might consider paying a higher deductible, that’s to say a ‘voluntary deductible’.

It is not wise to increase your deductible if you often need medicine or if you need to visit the hospital regularly. We also do not recommend opting for a voluntary deductible if you have not put money aside for when something does go wrong.

What is the compulsory deductible?

Are you 18 years or older? Then you pay a part of your health costs from the general insurance yourself. This is called the compulsory deductible. Every year the Dutch government sets this amount. In 2024this is €385. This means that the first€385 of your health costs you pay yourself. If you have more costs, we will pay these for you. Not if you have a voluntary deductible.

What is a voluntary deductible?

Do you want to save on your premium? You can choose for a voluntary extra deductible of €100, €200, €300, €400or €500. This adds up to the compulsory deductible. The maximum deductible is €500.

Health insurance deductible explained - CZ (2024)

FAQs

How to understand deductibles in health insurance? ›

The amount you pay for covered health care services before your insurance plan starts to pay. With a $2,000 deductible, for example, you pay the first $2,000 of covered services yourself.

What does $1000 deductible mean health insurance? ›

A health insurance deductible is the amount you pay before your insurance kicks in. For example, if you have a $1000 deductible, and you need a $1000 MRI procedure and a $2000 surgery, you will pay $1000 out-of-pocket for the MRI, and then $0 for the surgery.

Is it better to have a higher deductible or out-of-pocket maximum? ›

A health insurance deductible is more likely to play a role in your healthcare costs than an out-of-pocket maximum unless you need many healthcare services in a year. An out-of-pocket maximum is a safety net to save you from paying endless healthcare bills.

Is it better to have a higher copay or deductible? ›

Plans that charge higher monthly premiums have lower co-payments and lower deductibles. When choosing a plan, consider whether you expect to have a lot of medical bills. If so, then it may make financial sense to buy a more expensive plan with lower co-pays and a lower deductible.

Do copays count towards deductible? ›

As a general rule, copays do not count toward a health plan's deductible.

Do you want a higher or lower deductible? ›

A lower deductible plan is a great choice if you have unique medical concerns or chronic conditions that need frequent treatment. While this plan has a higher monthly premium, if you go to the doctor often or you're at risk of a possible medical emergency, you have a more affordable deductible.

Is it better to have a $500 deductible or $1000? ›

A higher deductible means you'll pay lower premiums, allowing you to save money overall as long as you drive safely and avoid filing claims. Just make sure you can afford to pay $1,000 if necessary.

How to meet your health insurance deductible fast? ›

Consider these ways to meet your deductible before the end of the year.
  1. Order a 90-day supply of your prescription medicine. ...
  2. See an out-of-network doctor. ...
  3. Pursue alternative treatment. ...
  4. Get your eyes examined.

What is too high of a deductible? ›

The deductible is separate from the monthly premiums. For individuals, a health plan can qualify as high deductible if the deductible is at least $1,350, and the max out-of-pocket cost (the most you'd pay in a year for medical expenses, with insurance covering everything else) is at least $6,750.

Which is better, high deductible or PPO? ›

An HDHP may be a good option if you're generally healthy, while a PPO might be better for those needing frequent medical care.

What is a disadvantage of having a high deductible? ›

The main drawback of an HDHP is high out-of-pocket expenses for nonpreventive care. If you're healthy but go to urgent care a few times, you can pay a lot out of pocket but not exceed your yearly deductible. Or you could require unexpected expensive treatment early in the year.

Is a $0 deductible good for health insurance? ›

Similar to any health plan, no-deductible health plans have benefits and drawbacks. You don't have to pay a deductible, which can save you money over the year. Not having a deductible may reduce financial barriers to getting care since deductibles can cause people to delay care.

Does your monthly premium count toward your deductible? ›

Premiums usually do not count towards your deductible or your maximum out-of-pocket limit. It is also important to note that you may have separate and unique deductibles or maximum out-of-pocket limits for individuals versus the whole family together, or for in-network versus out-of-network services.

Do prescriptions count towards the deductible? ›

Prescriptions typically count toward the deductible as long as they are covered under your plan. Your copay for a prescription may count toward the deductible, depending on your plan. Your health insurance agent can help you determine what type of deductible you have and which prescriptions your plan might cover.

Does insurance cover anything before the deductible? ›

Health insurance plans obtained from the marketplace are required to cover the cost of some preventative healthcare services before the deductible has been met. This is true no matter if you're looking at HMO plans or PPO plans. Some of these preventative benefits include: HIV screenings.

What does 80% of deductible mean? ›

You have an "80/20" plan. This means your insurance company pays for 80% of your costs after you've met your deductible. You must pay for the remaining 20%.

What does 70% deductible mean? ›

This means: You must pay $4,000 toward your covered medical costs before your health plan begins to cover costs. After you pay the $4,000 deductible, your health plan covers 70% of the costs, and you pay the other 30%.

What is a good deductible amount? ›

Generally, drivers tend to have average deductibles of $500. Common deductible amounts also include $250, $1000, and $2000, according to WalletHub. You can also select separate comprehensive and collision coverage deductibles.

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