Health insurance letters: eigen risico and the bill that arrives a year late

Health insurance letters surprise people in two places: they arrive long after the treatment, and having insurance does not mean paying nothing.

Why does the bill come so late?

The hospital or the specialist closes the treatment as a whole and declares it to your insurer. The insurer first deducts what is left of your annual excess (eigen risicoannual excess · The yearly amount you pay yourself before the insurer starts paying), pays the rest and sends you a statement. That chain can take months, so getting a letter this year about last year's treatment is odd but normal.

For that reason, look at the treatment date, not the date of the letter. The year of the treatment decides which year's excess it comes out of.

Eigen risicoannual excess · The yearly amount you pay yourself before the insurer starts paying: what counts and what does not

It is a compulsory amount that resets every year; it changes over time and the exact figure is in your policy. Until it is used up, you pay most of the costs in the basic package yourself.

Counts	Does not count
Specialists and hospital treatment	Visits to the huisartsfamily doctor
Blood tests, X-rays, laboratory work	Most maternity and postnatal care
Most prescription medicines	Care for children under 18
Ambulance and emergency care	Some programmes your insurer points you to

If you chose a voluntary extra excess to lower your premium, the amount you pay yourself in a year when you fall ill goes up accordingly. And eigen bijdragepersonal contribution · An extra share on some medicines and services; not the same as eigen risico is a different thing: a share you pay on certain medicines and services regardless of your excess.

Dentistry, glasses and physiotherapy are not in the basic package; those need supplementary insurance (aanvullende verzekeringsupplementary insurance · For dentistry, physiotherapy and other things outside the basic package). Reading the policy conditions (polisvoorwaardenpolicy conditions) once a year takes most of the surprise out of the bills that follow.

What happens if you cannot pay the premium

The order is always the same, and each step costs more:

1. A reminder letter. Settled here, nothing follows.
2. A few months of arrears. The insurer warns you and offers a payment plan (betalingsregelingpayment plan). Accepting that offer stops the next step completely.
3. Your file moves to the CAKgovernment collection body · Where your file goes if the premium stays unpaid for a long time. If the arrears run on, collection passes to the state and the monthly amount you pay becomes higher than the normal premium. The old debt keeps standing as well.

So the cheapest moment to deal with this is the first letter. Cancelling your insurance is not a way out: being uninsured carries its own penalty.

The allowance people miss: zorgtoeslaghealthcare allowance

If your income is under a certain level, the state pays part of your premium through zorgtoeslaghealthcare allowance. Nobody applies on your behalf. It is recalculated every year, and reporting a change in income when it happens is the easiest way to avoid a reclaim letter later.

November and December: the months for switching

Insurers publish next year's premium in the autumn, and the policy letter arrives in December. If you want to switch, you cancel the current policy at the end of the year and move to the new insurer within the period allowed in early January. Do not put that letter aside as advertising; it is one of the most valuable envelopes of the year.

If the letter is in front of you and you cannot read it

Photograph it with Letrin: see in your own language whether this is a bill, a reminder or a change of policy, which year it belongs to and when it has to be paid.

Check the amounts against the paper. If premium arrears have grown, the municipality's free debt service can talk to the insurer for you.