WHAT YOU SHOULD KNOW ABOUT physioINSURANCE AND
WHICH PACKAGE GIVES YOU THE BEST COVERAGE WITH US!
For most people December and January are full of ‘gezellige’ get-togethers with family and friends with way too much food and drinks.
It is also the time to change your physioinsurance. With increasing prices and limited coverage, it’s definetly worth reviewing your physioinsurance.
As a consumer this can be quite unclear as there are a lot of options and a lot of fine print to choose from.
Towards the end of the year we always advise to check if your current physioinsurance package still matches your current wishes and situation.
As we are a contract free clinic, your choice of insurance can have a huge impact on your coverage. Because we have no direct contracts with health insurance companies, it is extra important to learn more about the different options. More about non-contracted healthcare below.
Biggest change compared to 2023.
- Restitutie policies are going out (for the most part)
- To cut back on care, most health insurers will stop offering restitution policies. Instead, they offer a combination policy
- Physical therapy increasingly under pressure
- Young physical therapists are leaving the profession because of too high a workload, too low salaries and a lack of future perspective. Aging also among physical therapists.
Rates that health insurers reimburse for physical therapy are about €15 below the cost price. More and more physical therapists are going to work contract-free.
- Young physical therapists are leaving the profession because of too high a workload, too low salaries and a lack of future perspective. Aging also among physical therapists.
Here is what you need to know.
Let’s start with the basics.
For everyone living in the Netherlands it is mandatory to have a “basis” health insurance. You can add supplementary insurance for dental, glasses, physiotherapy, etc of your choice.
Also, there is a government set mandatory excess of €385. You are free to increase your excess voluntarily. A higher excess will lower your monthly premium for your basic insurance.
Keep in mind that physiotherapy care and other things covered by your supplementary insurance packages don’t impact your excess.
Back to the different basic insurance packages.
There are 3 basic insurance options. You can choose between ‘restitutie’, ’natura’, ‘combination’ or ‘budget’.
If you want to visit a non-contracted healthcare provider like us, the ‘restitutie’ or reimbursement package is the one to go for. Please make sure the extra package is also a restitutie package. It is the most complete and gets you the best reimbursement across the board. However, it is usually also the most expensive one. With us, they generally cover €40 to €50 per session.
With the ‘natura’ or arranged care package you can still choose which healthcare provider you want to visit. However, when you visit a non-contracted healthcare provider they will only reimburse part of your sessions. They generally cover about 75% of an average contracted rate. With us, that means about 20 and 30 euros per session.
The combination policy is a combination between a natura and a reimbursement policy. With some healthcare providers you will receive a refund, while with others you will receive a natura refund. The terms and conditions of this policy vary by health insurance provider, so be sure to read the fine print carefully.
The ‘budget’ or ‘arranged care insurance with selective contracting’ package is the cheapest insurance you can get. Great for the wallet, not so great when it comes to reimbursement with us. Often they only cover a small amount of our sessions.
Reimbursements not only affect physical therapy, but can also affect hospitals, home health care and other medical services. So do your homework!
Great info, but which do I choose?
Our advice is to choose one of the smaller health insurers rather than the large ones.
The big insurers; Zilveren Kruis, VGZ, CZ, Zorg & Zekerheid and Menzis often have stricter conditions and lower reimbursements with us. The smaller health insurers are more personal, demands less and often reimburse a larger portion of our treatments.
Our top 3 recommendations for healthinsurance companies are:
- ONVZ
- DSW
- VvAA
Whichever package you choose, just make sure it is a restitutie / reimbursement or a combination package! If you have any questions about it, reach out to us and we’ll happily answer all your questions!
Additional physioinsurance
Which supplementary package suits you best depends on your situation. Our advice is to consider your current physical state. Are you healthy with no issues whatsoever? Then you might consider not having an extra package and pay yourself when you need it. When you have some ongoing issues or you train a lot, consider having at least a few session covered. That lowers the threshold to go and find a solution to your issue.
What if you don’t have a supplementary package for physiotherapy?
When you just have basic insurance and no supplementary package for physiotherapy, you’ll need to pay the physiotherapy sessions yourself.
There is one exception. With certain pathologies (like surgeries, broken bones) your basic insurance covers physiotherapy from the 21st treatment session onwards. The first 20 sessions you still need to pay yourself.
You mentioned contract free healthcare before, what it that all about?
It means we don’t have direct contracts with insurance companies.
At Art of Physio we strive to learn every day and we invest a lot of time, effort and money in our training and professional development. The rates reimbursed by a health insurance company in contracts is well over €15 below cost and gives very little room for this.
By working contract-free, we can do just that and remain innovative!
For you as a client this means that you have to advance the cost of treatment to claim back from your insurance company. This can be done very easily through your health insurance company’s app these days.
We understand that this can cause more hassle, but consider this….Where would you rather go?
A well-trained and motivated therapist who takes the time to listen, analyze and provide first-rate service?
Or an overworked and jaded therapist who does treatments on the assembly line and has to spend your precious treatment time on excessive paperwork.
How do I know how much is covered?
As we mentioned before, the level of coverage is determined by your basic insurance package and your supplementary package.
Your supplementary package determines how many sessions are covered and your basic insurance package determines how much per session is covered.
Restitutie or reimbursement packages give the highest coverage while budget packages give the lowest.
You can find the exact amount covered in your insurance policy. Please don’t hesitate to reach out and ask your questions! In our system we can check your insurance package and give you an indication!
You can also look for more information at zorgwijzer.nl
