What is a restitution policy?
A restitution policy is a basic health insurance policy with the most freedom of choice. Think a restitution policy is the right one for you? You will be free to choose from all hospitals and health care providers. This is also called free choice of care. This is where this policy differs from an in-kind policy. With an in-kind policy you will only be reimbursed if you go to a contracted health care provider. Are you going to a non-contracted health care provider? Then you'll probably have to pay some of the costs. This does not apply to a restitution policy. However, a restitution policy is more expensive than an in-kind policy.
Advantages and disadvantages of the restitution policy
The advantage of a restitution policy is that you have complete freedom to choose your health care provider. You are not tied to the list of health care providers contracted with your insurer. In contrast to the combination or in-kind policy, you never have to pay part of the bill yourself, unless it's an unnecessary expense. It is possible that you have to pay an amount in advance.
In summary, these are the points that are good to know:
- You have freedom to choose which healthcare provider you want to go to.
- Your choice of healthcare provider does not affect reimbursement under the basic insurance.
- The premium is often higher than for an in-kind policy.
- Sometimes you will have to pay a bill in advance before you get reimbursed.
How does a restitution policy work?
Restitution means reimbursement. In practice you often won’t have to pay for health care in advance. Health insurers offering restitution policy often have contracts with all hospitals and most health care providers. Are you going to a non-contracted health care provider? Then you may have to pay the bill in advance, for example with a physiotherapist. But at a hospital this will not happen.
Free choice of health care
A refund policy gives you complete freedom to choose the health care you need. This means that you do not have to take into account whether your health insurer has a contract with the health care provider. You always get paid regardless of whether there is a contract. Please note: Does it involve excessively expensive health care? For example, because you went to an expensive private clinic? Sometimes you will have to pay part of the bill yourself.
Full restitution & combination policies
Unfortunately, last year it turned out that some restitution policies did not provide full reimbursement. People were only compensated at the market rate. If your treatment is more expensive than the market rate, then you may have to pay some of the costs. That's why you hear the term 'zuivere restitutiepolis’ (full restitution policy) in the news regularly. This kind of policy always covers the entire treatment. A restitution policy that only reimburses the market rate is now called a combination policy.
The term 'zuivere restitutiepolis’ ‘pure reimbursement policy' is therefore regularly used in the news. This policy always covers the entire treatment and not just at the market rate. On our website, under the heading 'restitution policy', you will only find the so-called zuivere restitutiepolis.
What does a restitution policy reimburse?
The restitution policy is a basic health insurance policy. The reimbursements are the same as for other policies. This means that health care costs covered by the basic insurance will be reimbursed up to the normal rates. Also for non-contracted health care. According to the Dutch Health Care Authority (NZa) the costs of (non-contracted) healthcare will be reimbursed in full with a restitution policy, unless the rate is extremely high.
Note: Do you also have supplemental insurance? In that case, you may not receive reimbursement from all care providers. This is because the restitution policy applies to health care covered by the basic insurance. Check the policy conditions of your health insurer to see which conditions apply.