Altijd zeker van goede Zorg We are there for you

Health Insurance Policies 2015
We arezeker
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Altijd
for youZorg
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We are there for you
Peace of mind. That is what health insurance should give you. By protecting you and your family against the high costs of
medical care. That is what our health insurance policies do. In fact, we have the best premium-cover ratio in the
Netherlands, as independent research has already proven for many years.
However, proper cover for your medical expenses does not
Or our Zorgversneller® [Care Accelerator], which solves the
necessarily mean you are guaranteed the best care. That is
problem of unnecessary waiting lists. We are there for you.
why we provide you with support in other ways. One of
At all times and in all places.
these is our new and unique Behandelinformatie Plus®
[Treatment Info Plus] service which helps you find the best
Incidentally, someone else who is there you is your
care provider for your specific problem. Then there is the
insurance adviser. This independent specialist can provide
Second Opinion Service provided via Best Doctors, to take
you with all the client-oriented knowledge you need, should
away any doubts you may have about a diagnosis or
you require advice on your health insurance. It is always a
treatment.
good idea to check things with him or her first!
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We are there for you. At all times and in all places.
We are there for you at all those important moments in life.
If you have too much on your mind
For example:
There are times when you have too much on your mind. For
example when you move house and need to find a new GP,
When you are looking for the best care provider
dentist or physiotherapist. How do you know whether they
How do you choose the care provider that is most suitable
will be up to standard and are willing to accept new
for the problem you have?
patients? We are only too pleased to take care of things on
By asking the staff providing our new service: Behandelinfo-
your behalf. All you have to do is call us and we will start
Plus® [Treatment Info Plus]. Within three days our medical
looking for the best care providers in your neighbourhood.
team will send you a report showing how well various care
providers score for a particular treatment method. We will
If you need assistance when abroad
also telephone you to explain the report to you. After that
Becoming ill abroad is bad enough. An accident is even
the choice is yours. Unique in the Netherlands.
worse. That is why, in such cases, our Eurocross Assistance
emergency centre can be contacted by telephone 24 hours
If you are on a waiting list
a day on +31 (0)71 364 62 00. The staff there can make all
All too often people have to wait a long time for treatment.
the necessary arrangements.
We want to spare you this inconvenience. Our
Zorgversneller [Care Accelerator] gives you rapid access to
If you are on holiday
the best care at all times. In other words, we make sure you
On holiday you may have questions which, although are
get the assistance you need on time.
bothering you, are not urgent in nature. You can submit
these questions day and night by telephoning our
If you have your doubts about a diagnosis or treatment
Vakantiedokter [Holiday Doctor] on +31 71 364 18 02. This
Happily it is a rare occurrence, but you will sometimes have
service is free and the staff speak Dutch.
your doubts about a certain diagnosis or the treatment
prescribed. If that is the case, you can always ask us for a
If you care for vulnerable people
second opinion. If you take out supplementary insurance,
From 2015, more and more of us will, as voluntary carers,
you can even use our worldwide Second Opinion Service®.
be looking after vulnerable people in our vicinity. This work
You can do so in two ways, by submitting any doubts and
is subject to new, but also complex, legislation and rules.
queries you have via InterConsultation and Ask the Expert
People who care for their parents, or for a child with a
to Best Doctors, which is a worldwide network of 53,000 of
disability, often do not know all the ins and outs. That is
leading specialists.
why we have staff who do understand the rules and
procedures. They can point you as voluntary carer or
insured party in the right direction.
We are there for you. That is why you can contact us day and night.
By telephone: (via +31 (0)71 751 00 22 on working days from 9.00
a.m. to 5.00 p.m.) By e-mail: [email protected]
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Our basic insurance policy
A lower premium or freedom of choice?
As far as the basic insurance is concerned you can choose
Rapid access to high-quality care at all times
between the Zorg Plan [Care Plan] or the Keuze Zorg [Options
All our insured parties - whether they opt for the Select
Care] Plan. While a lower premium applies to the first, the
Zorg Plan or the Keuze Zorg Plan - have access to high-
second offers you greater freedom of choice. In both cases
quality care throughout the country. Our network of
you are assured of GP care, specialist care and nursing
contracted care providers is one of the largest in the
(hospital), medicines, nursing articles, patient transport, oral
Netherlands. If you would like to know which care providers
care, paramedical care and maternity care. Children aged up
we have agreements with, you can find the answer using
to 18 are insured free.
our Zorgzoeker [Care Finder] at www.averoachmea.nl/
zorgzoeker.
Select Zorg Plan [Select Care Plan]
The Select Zorg Plan offers you care from care providers
with whom we have made agreements. As a result you
Extra benefit in the case of group health insurance
pay a lower premium. If you use other care providers, the
If your employer has taken out a group health insurance
reimbursements will always be lower.
with us, any employee can participate. That includes you
and your family. You will then benefit automatically
Keuze Zorg [Options Care] Plan
from all the benefits and discounts on the premium.
The Keuze Zorg Plan gives you freedom to choose whichever
Details are available at: www.averoachmea.nl/
care provider you want. It does not matter whether the care
collectiefvoordeel. Here you can make a choice from our
provider has a contract with us or not. You always receive a
health insurance policies and calculate how much you
full reimbursement to the maximum of the statutory
save on the premium. All you have to do is enter the
amount, or to the maximum of the rate (applicable on the
name of your group insurance. More information can be
market) in the Netherlands (with the exception of the excess
obtained from your employer or insurance adviser.
and the statutory personal contributions).
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Our supplementary insurance
The very best in the Netherlands
By far the majority of Dutch people opt for more security than the basic insurance policy offers. Examples are more generous
reimbursements of the costs of physiotherapy, alternative remedies or orthodontics. You can choose from the four supplementary
insurance packages we offer. These are known as Start, Extra, Royaal and Excellent. You can also opt for the packages for target groups
known as Juist Voor Jou [Right for You] and Beter Voor Nu [Better for Now]. All of them are the best in the Netherlands in their class.
Start
Extra
This package is for people who do not need a top-heavy
ogether you have chosen for a promising but safe future. That
insurance policy, but still want essential supplementary
also means a competitively priced insurance policy which
provisions for an attractive price. It offers suitable cover
gives you exactly the cover you are after. For example, a
and reimbursements for, among other things, travel
generous reimbursement for physiotherapy and alternative
vaccinations and physiotherapy.
forms of treatment. Not too much but, above all, not too little.
Physiotherapy
12 appointments per calendar year.
Physiotherapy
27 appointments per calendar year.
Alternative forms of treatment
A reimbursement of up to € 440 per calendar year.
Alternative forms of treatment
A reimbursement of up to € 640 per calendar year.
Orthodontics
A one-off 90% reimbursement for those aged up to 18, to a
maximum of € 1,500.
Orthodontie
A one-off 90% reimbursement for those aged up to 18, to a
maximum of € 2,000.
Glasses or lenses
A reimbursement of up to € 100 (incl. frame) per three
calendar years and a discount scheme at Eye Wish, Specsavers
and the Collectief van Zelfstandige Opticiens (CvZO).
Glasses or lenses
A reimbursement of up to € 150 (incl. frame) per three
calendar years and a discount scheme at Eye Wish, Specsavers
and the Collectief van Zelfstandige Opticiens (CvZO).
Contraception for female insured parties (aged 21 and over)
100% with the exception of the statutory personal
Contraception for female insured parties (aged 21 and over)
100% with the exception of the statutory personal
contribution.
contribution.
Eye laser treatment
A one-off reimbursement of up to € 500 and a discount
scheme at VisionClinics.
The very best in the Netherlands? Who says so?
We are not the only ones to claim that our supplementary insurance policies are the very best in the Netherlands. According
to the independent Rolls comparison programme we offer the best premium-cover ratio. To put it another way, with us you
get more health insurance for every euro you spend. According to the Consumentenbond [Consumers’ Association] our
international cover is, without doubt, the best in the Netherlands. In addition, the researchers at the MoneyView research
agency have awarded the highest five stars rating to our Excellent package for five consecutive years.
Eight out of ten Dutch people have supplementary insurance
Around eight out of ten Dutch people opt for the extra security provided by a
supplementary insurance policy. For families the figure is even higher. Which
supplementary package suits you and your family best? Find out from your
insurance adviser. He or she can provide objective and independent advice.
Royaal
Excellent
In a family with growing children, you prefer to leave
Avéro Achmea offers the very best to those who want it.
nothing to chance. For that reason you opt for health
One example is comprehensive cover for alternative forms
insurance which guarantees the best care and covers
of treatment, but also for cosmetic surgery. The cover is so
almost every eventuality. Examples are generous
comprehensive that we ask you to complete a short
reimbursements for braces and glasses and contact lenses,
questionnaire in advance to narrow the choices down.
but also for physiotherapy for the children and yourself.
Physiotherapy
27 appointments per calendar year.
Physiotherapy
A 100% reimbursement per calendar year.
Alternative forms of treatment
A reimbursement of up to € 960 per calendar year.
Alternative forms of treatment
A reimbursement of up to € 1,200 per calendar year.
Orthodontics A one-off 90% reimbursement for those aged
up to 22, to a maximum of € 2,000.
Orthodontics A 100% reimbursement for those aged up to
22 and a one-off 70% reimbursement for those aged 22
and over to a maximum of € 1.500.
Glasses or lenses
A reimbursement of up to € 200 (incl. frame) per three
calendar years and a discount scheme at Eye Wish, Specsavers
and the Collectief van Zelfstandige Opticiens (CvZO).
Glasses or lenses
A reimbursement of up to € 300 (incl. frame) per three
calendar years and a discount scheme at Eye Wish, Specsavers
and the Collectief van Zelfstandige Opticiens (CvZO).
Contraception for female insured parties (aged 21 and over)
100% and the statutory personal contribution up to € 500
(for all medicines together).
Anticonceptie voor vrouwelijke verzekerden (21 jaar en ouder)
100% and the statutory personal contribution.
Eye laser treatment
A one-off reimbursement of up to € 500 and a discount
scheme at VisionClinics.
Eye laser treatment
A one-off reimbursement of up to € 750 and a discount
scheme at VisionClinics.
Medicines and dietary preparations
Reimbursement of statutory personal contribution up to € 500.
Medicines and dietary preparations
100% reimbursement and statutory personal
Cosmetic surgery A reimbursement for cosmetic surgery
(without medical grounds): 100% for the correction of the
ear position. A reimbursement for other forms of treatment
of up to € 500 per calendar year.
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Our dental insurance policies
For people who do not want any nasty surprises
Even people who take care of their teeth sometimes need dental treatment they did not expect. Examples are the replacing
of fillings or the fitting of a crown. You can take out supplementary dental insurance to cover you for the sometimes high
costs of visits to the dentist, dental hygienist and dental prosthetician. We offer you a choice of four packages: T Start,
T Extra, T Royaal and T Excellent.
T Start
100% reimbursement
• dental appointment, second opinion
• oral hygiene, fillings, extractions of teeth and molars
75% reimbursement
• other forms of treatment, such as the fitting of crowns
and bridges
The maximum reimbursement per year is € 250.
T Extra
T Extra offers the same cover as T Start, but the
maximum reimbursement is € 500 per year.
T Royaal
T Royaal offers the same cover as T Start, but the
maximum reimbursement is € 1,000 per year.
T Excellent
T Excellent means 100% of all forms of treatment are
reimbursed, up to a maximum of € 1,250 per year.
Medical acceptance
Generally speaking our insurance policies are not subject to medical
acceptance. Only in the case of the Excellent supplementary insurance
policy and the T Royaal and T Excellent dental insurance policies are
you required to answer a few questions in advance.
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Juist Voor Jou [Right for You]
For students and young people aged up to 30
When you are young you want to conquer the world. For
these people we have ‘Juist Voor Jou’: a basic insurance with
Juist Voor Jou [Right For You]
supplementary insurance and a dental package. Juist voor
Tailor-made cover for students and young people aged
Jou links up perfectly with the world and life experiences of
up to 30.
students and young people aged up to 30. For example,
100% of the costs of vaccinations for trips abroad are
The complete basic insurance, plus:
reimbursed, just as emergency assistance when abroad.
• Vaccinations and consultations in connection with
This also includes: 12 appointments for physiotherapy and
travelling abroad (100%).
a reimbursement for alternative forms of treatment and
• Emergency assistance when abroad (100%).
medicines.
• Alternative forms of treatment and medicines (up to
€ 250 per year).
• Sport-medical examination (€ 100 per two years).
• Physiotherapy (12 appointments).
• Glasses and lenses (up to € 100, 1x per 3 years).
• Dental costs (up to € 250 per year).
• Contraception for women 100% (with the exception
of the statutory personal contribution).
The complete summary of cover can be found at
www.averoachmea.nl/juistvoorjou
“We do not want cover for absolutely everything. However, if you often travel around in
far-off countries, knowing that you have the best international cover available in the
Netherlands gives you a certain peace of mind. It covers everything, even vaccinations.
This is yet another example of how the people at Avéro Achmea are there for you, no
matter what your age.”
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Beter Voor Nu [Better for Now]
For people who are still enjoying life to the full after the age of 50
Beter Voor Nu has been specially developed for people aged around 50 and older who still want to enjoy life to the full and
without any worries. Hopefully, whether single or in a relationship, you now have more time for hobbies and other fun
things, such as trips in the Netherlands or abroad. You may well also have time for sport or exercise. Beter Voor Nu offers
cover which fits in completely with this kind of lifestyle. The cover includes, for example, a generous reimbursement for,
among other things, (reading) glasses, vaccinations and physiotherapy.
Beter Voor Nu [Better for Now]
Treatment
Reimbursement
Physiotherapy
27 appointments
Flu jab
fully reimbursed
Glasses or lenses
€ 250 (per 3 years)
Vaccinations (holiday)
fully reimbursed
International cover
fully reimbursed
Health Check
fully reimbursed
Preventive courses
partially reimbursed
Eye laser treatment
€ 500 on a one off basis
Alternative forms of treatment
up to € 1,500
Medicines and
statutory personal
dietary preparationscontribution up to € 500
The complete summary of cover can be found at
www.averoachmea.nl/betervoornu
“We go away on trips more than we used to. Hiking in the
countryside and things like that. It is then reassuring to
know that you are guaranteed the same quality of care
when abroad that you are used to at home. What’s more
you can always contact Achmea to discuss medical issues.
Not just when you break your leg, but also if you just want
to check something with a Dutch doctor.”
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Disclaimer
Your privacy - why do we ask for your details?
We ask for your personal details and other details if you apply to us for an
insurance policy or a financial service. We use your details within the
Achmea Groep to conclude and execute agreements. We also provide you
with information about products and services which may be important to
you.
What else do we use your details for? We also use your details:
• to manage our customer database;
• to prevent and combat fraud;
• to perform statistical analyses;
• to meet our legal requirements.
Whenever we use your personal data, we observe the applicable rules, such as:
• the Wet Bescherming Persoonsgegevens [Personal Data Protection Act];
•the Gedragscode Verwerking Persoonsgegevens Financiële Instellingen
[Code of Conduct for the Processing of Personal Data by Financial
Institutions];
•the Gedragscode Verwerking Persoonsgegevens Zorgverzekeraars [Code
of Conduct for the Processing of Personal Data by Health Insurers].
If you would prefer not to receive any information about our products and
services,
or do you not want us to use your e-mail address, please send a letter or
e-mail to:
Avéro Achmea
Postbus 101
7300 AC Apeldoorn
www.averoachmea.nl
We are there for you
With the very best in health insurance policies
• The best value for money (Rolls comparison).
• The best cover when abroad (Consumentenbond [Consumers’
Association]).
• The highest score, for the past 5 years already, for our Excellent
Information about the Stichting Centraal Informatie Systeem [Central
Information System Board] (CIS)
We may request your details from, or have them included in, the files of the
Stichting CIS in The Hague. This is the central information system used by
insurance companies that operate in the Netherlands. We may do so if you
have failed to submit important information and we want to terminate the
insurance. It is a way for us to manage risks and prevent fraud.
More information can be found at www.stichtingcis.nl. There, you can also
read what the Board actually does with your details.
Applicable law and complaints procedure
The insurance policies are exclusively subject to Dutch law. It goes without
saying that we do our very best to provide you with an optimal service at all
times. Nevertheless, you may still be unhappy about some aspect of the
services we provide. In such instances, you should first contact your adviser
or contact person. If you still feel it is necessary to submit a complaint, you
can do so by e-mail via our website www.averoachmea.nl (under the
section klacht doorgeven [‘submit complaint’]) or in writing to Avéro
Achmea, Centrale Klachtencoördinatie, Antwoordnummer 2241, 8000 VB
Zwolle. If, in your opinion, we do not manage to solve the problem
satisfactorily and if you are a natural person that is not involved in running
a business or engaged in a profession, you can submit your complaint to the
authorised complaints board to which we are affiliated: Stichting Klachten
en Geschillen Zorgverzekeringen (SKGZ), Postbus 291,3700 AG Zeist, tel.
+31 (0)30 698 83 60, www.skgz.nl
What do we do and who are we?
We offer insurance policies and other financial services. We do not sell
our products and solutions to our clients ourselves. Instead we work
together with advisers. Our advisers can give you independent advice.
This means you will always have insurance that is appropriate.
We are a brand of Achmea, Avéro Achmea Zorgverzekeringen N.V. in Leiden.
Achmea is the largest insurer in the Netherlands. Avéro Achmea
Zorgverzekeringen N.V is registered with the Chamber of Commerce under
number 30208633 and with the AFM (Stichting Autoriteit Financiële
Markten [Netherlands Authority for the Financial Markets]) under number
12001023.
The office addresses of Avéro Achmea are:
Dellaertweg 1
2316 WZ Leiden
package (MoneyView).
• Behandelinformatie-Plus [Treatment Info Plus]: unique help
choosing a type of treatment.
• The Zorgversneller [Care Accelerator]: rapid access to the best
Lange Marktstraat 26
8911 AD Leeuwarden
www.averoachmea.nl
care at all times.
• Second Opinion Service via the worldwide network of Best
Doctors.
• Eurocross Assistance: always available to arrange emergency
assistance when abroad.
• Vakantiedokter [Holiday Doctor]: can always be contacted for
advice when you are abroad.
• Your own Personal Care Overview. In digital or paper form.
• Including valuable advice from your insurance adviser.
Avéro Achmea has acquired the Klantgericht Verzekeren [Customeroriented Insurance] quality mark
Confidence and certainty are essential for the quality of services provided
in the insurance sector. The Klantgericht Verzekeren quality mark is issued
by the independent Stichting toetsing verzekeraars [Insurers Assessment
Foundation] (Stv). The quality mark is only awarded to insurers that provide
honest information and dynamic services, are easy to contact, assess
customer satisfaction and use the ensuing results to improve services, and
pursue, and pursue a consistent quality policy.
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We are there for you. With a clear choice of health insurance policies.
Basic insurance policies Select Zorg Plan and Keuze Zorg Plan
Supplementary insurance policies Dental insurance policies Start, Extra, Royaal, Excellent
T Start, T Extra, T Royaal, T Excellent
Specially for young people and students 75(4293F)-14-11
Specially for 50+
Juist Voor Jou [Right for You]
Beter Voor Nu [Better for Now]

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