You pay monthly for the health insurance (these costs depend on the insurance package you chose). On top of that, if you’re an adult and you receive special care, you will pay for ‘own risk’ (eigen risico). This means that you pay the first €385,- of special care costs yourself.
Most insurances offer to insure also this amount or pay it in advance in smaller parts per month. In this way you prevent unexpected high bills.
The basic health insurance pays for the basic costs; all visits to the family doctor (huisarts) are covered, as well as the costs for care for children. However, as an adult receiving special care (for example a visit to the hospital, a therapist or for medicines) you have to pay for the first €385,- of these costs yourself. This is called own risk (in Dutch: eigen risico).
This own risk, is …
⇒ €385,- for every person older than 18 years
⇒ counts each calendar year; every year, starting January 1st, you have to pay the first €385,- of special care yourself
The own risk, does NOT count for …
⇒ kids, their basic care costs are always covered by the basic insurance
⇒ the costs to go to the family doctor (huisarts) are also covered by the basic insurance
⇒ the care costs which are covered by your extra health insurance (aanvullende zorgverzekering). This only applies when you have an extra health insurance contract
How do you pay for Own Risk?
In most cases, the insurance first pays the bills directly to the pharmacy or hospital. You will later pay the first €385,- (or a part of it, if the bills are not that high) back to your health insurance, after you receive bills for that. Note: sometimes it takes long before you receive and have to pay these bills, after the full year.
Spread Own Risk Costs! You can ask your insurance to pay your own risk in parts, before or after something happens, spread over several months. Ask your insurance company for this option BEFORE January 1st. This way you will prevent paying €385,- at once. By spreading payments you can prevent financial problems.
Why is there ‘Own Risk’?
⇒ To make people more aware of care costs, because they are paying part of it themselves
⇒ The care costs are partly payed by the people that need care. This way the basic health insurance remains affordable for everyone.
If your family doctor prescribes medicines, contraceptives and/or further research: check if you have to pay for them later as part of your own risk. Also check if you reached the maximum coverage for a year. It can be smart to wait or cluster care treatments.