What reimbursement will you receive?

The ZEM Polis offers full (100%) reimbursement of all the costs incurred, provided that you see a contracted care provider. Hospital care is subject to excess.

Which hospital costs qualify for reimbursement?

Hospital care is defined as care provided by medical specialists. This includes the costs of consulting medical specialists, examinations, nursing and most other types of hospital care.

• View all specialisms here

  • Cardiology
  • Ophthalmology
  • Radiology
  • Dermatology and venereology
  • Anaesthesiology
  • Cardiothoracic surgery
  • Gastroenterology (diseases of the stomach, intestines or liver)
  • Gynaecology and obstetrics
  • Surgery
  • Internal medicine
  • Paediatrics
  • Clinical biology
  • Clinical genetics
  • Clinical geriatrics
  • Medical microbiology
  • Neurosurgery
  • Neurology
  • Nuclear physics
  • Orthopaedics
  • Otorhinolaryngology (ear, nose and throat conditions)
  • Pathology
  • Plastic surgery
  • Pneumology (lung diseases and tuberculosis)
  • Psychiatry
  • Radiotherapy
  • Rheumatology
  • Rehabilitation medicine
  • Emergency medicine
  • Nuclear medicine
  • Urology
• Examples of hospital care

  • a stay in a hospital or independent treatment centre on medical grounds
  • nursing and care
  • medicines, physiotherapy, aids and band-aids associated with the treatment
  • X-rays, MRI scans or exploratory surgery
  • cancer treatment including surgery, radiation therapy or chemotherapy
  • treatment in the case of a brain haemorrhage or cerebrovascular event
  • treatment for cardiovascular diseases, including catheterisation, percutaneous angioplasty, stent placement, bypass surgery
  • treatment of varicose veins
  • knee or hip operation
  • bariatric surgery (gastric bypass, gastric sleeve, stomach reduction)
  • plastic surgery on medical grounds
  • second opinion; ask the Care Advice & Mediation Team for advice
  • fertility treatment; ask the Care Advice & Mediation Team for advice
  • cataract operation
  • tonsillectomy
  • abortion

What is not reimbursed?

• anti-snore treatment
• circumcision on religious grounds
• experimental treatments whose effects have not yet been scientifically proven
• plastic surgery for strictly cosmetic purposes
• sterilisation or reversal
• a fourth (or subsequent) IVF treatment

• What are the costs of hospital treatment?

  Check here to find out about the costs of a hospital treatment.

To qualify for hospital care, you will need a referral from a:

• GP
• corporate physician
• paediatrician
• Regional Health Service doctor
• medical specialist
• obstetrician (for obstetric care)

You may need to obtain permission

For some treatments you need our prior permission. Your specialist will apply for our permission on your behalf.

You are able to go to a contracted hospital or independent treatment centre

Find a contracted care provider

• You go to a non-contacted care provider

  The reimbursement amounts to 75% max. of the prevailing Dutch market rate.

Read more

• Diagnosis-Treatment Package
• Costs of hospital treatment