zem.nl

General practitioner care - Reimbursements and conditions


What reimbursement will you receive?

The ZEM Polis offers full (100%) reimbursement of all the costs incurred, provided you see a contracted GP. General practitioner care is not subject to your excess.

However, if your GP orders blood, urine or stool laboratory tests or X-rays, those costs do count towards your excess.

Which GP costs qualify for reimbursement?

Under basic healthcare insurance, you qualify for reimbursement of:

  • consultations and treatment by a GP

  • care provided by a medical practice assistant (POH), such as mental POH healthcare

  • the quarterly costs of your registration with the GP

What is not reimbursed?

  • flu jabs other than for persons in risk categories

  • medical examinations

  • a second opinion from a different GP

  • a hand-written or printed doctor's certificate

  • several consumables (including syringes, needles, band-aids)

  • a smear (at your own request)

  • a pregnancy test without medical necessity

You are able to go to a contracted GP

Find a contracted GP

 

  • You go to a non-contacted care provider
    • The registration fee and a visit to a non-contracted GP qualify for 100% reimbursement.
    • For other procedures you will receive up to 75% of the prevailing Dutch market rate.

We strive to inform you about our reimbursements and conditions as accurately as possible on our website.
The Policy Conditions and Regulations determine the reimbursement you will receive.