Summary of health insurance reimbursements for 2011

All the things you can expect from More Care

Table of contents

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4 4 5 6 7 7 8 8 9 10 15 16 18 30 31 31 31

More Care. For you to make the most of Faster assistance thanks to care mediation! The Seven Certainties of good care The deductible excess No deductible excess thanks to care mediation On paying bills and their reimbursement When permission is required for treatment What happens when things change? Awareness and healthy living! Some useful information A cheap way to get fit Your health insurance What can you find where in the summary of reimbursements? Summary of reimbursements 2011 Summary of the health insurance policies Privacy Applicable law and complaints procedure Information about Avro Achmea

Avro Achmea Postbus 1717 3800 BS Amersfoort General telephone number: 0900 - 9590 (local rate) Travel Line: 0900 - 23 02 340 ( 0.10 p/m) Nursing articles line: 0900 - 20 08 010 ( 0.10 p/m) Holiday doctor: +31 71 36 41 802 Emergency Centre: +31 71 36 41 850 www.averoachmea.nl/zorgverzekeringen

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More Care For you to make the most of

Avro Achmea offers excellent care, in every sense. We help you make all the right arrangements to ensure excellent cover for an attractive price. As far as we are concerned, no-one should have to wait for care. We also believe that good care should be a matter-of-course. You can always be sure of our Seven Certainties of Good Care: 1. Care and waiting time mediation for everyone. 2. A care guarantee for all insured parties. operations. 4. Recourse assistance. 5. GP and dentist mediation. 6. Help when on holiday abroad. 7. Health programme. You can find out more about the benefits of Avro Achmea on the following pages. They also contain practical information on paying bills and submitting claims. In the summary of reimbursements you can find out exactly what is reimbursed via the various (supplementary) insurance policies. We hope you live a long and healthy life, but if you need more care, Avro Achmea will always be there to help. 3. No obligatory deductible excess in the case of certain

Faster assistance thanks to care mediation!

The fastest referrals

If you have medical problems, you will want rapid and good quality assistance. Your GP will usually refer you to the nearest hospital. You may then be added to a waiting list. Care mediation helps to ensure that you receive assistance more quickly. All you need to do is call the care mediation department and we will start looking for hospitals that are specialised in certain forms of medical treatment. The main focus is on the speed and quality of the care. Our care mediators are in contact with all hospitals in the Netherlands and even some in Belgium and Germany. If you agree to the care advice they provide, our care mediator will make all the necessary arrangements. Thanks to our guarantee agreements you can often get an appointment within two weeks. The sooner your problem is dealt with, the sooner your life can get back to normal. Call 0900 - 9590 (local rate) or surf to www.averoachmea.nl/zorgbemiddeling to arrange assistance.

The Seven Certainties of good care

We believe that good care should be a matter of course. After all, nothing is more important than your health. It is for this reason that we have made a number of key arrangements. You can always be sure of the following Seven Certainties: 1. Care and waiting time mediation

department and you will soon have an appointment with a doctor or specialist. 2. Care guarantee

Care guarantee means you are guaranteed follow-up assistance for 65 common forms of treatment within 10 working days. 3. No obligatory deductible excess in the case of certain operations You do not pay any obligatory deductible excess for a number of common operations if you make the necessary arrangements via our care mediation service. The great thing about this is that we also ensure that you are provided with good quality care at the earliest opportunity.

If you have medical problems, you will want good quality assistance at the earliest opportunity. It is our job to provide it. All you have to do is call the Avro Achmea care mediation

The deductible excess

What you have to pay and what not

Everyone who has to pay a premium for the basic insurance policy also has an obligatory deductible excess. In 2011 this is 170.00 per insured party per calendar year. This deductible excess is set by the government to keep care affordable. This means you have to pay the first 170.00 of the medical costs incurred yourself. The costs on top of this are then eligible for reimbursement. Avro Achmea allows you to opt for a voluntary deductible excess in addition to the obligatory deductible excess. The higher your voluntary deductible excess, the lower your premium will be. There are several ways in which you can increase your deductible excess. The details can be found on the back of your policy document. From all reimbursements of care expenses which we issue during the course of the year, we first deduct the obligatory deductible excess of 170.00 and then any self-selected voluntary deductible excess. If you want to adjust your voluntary deductible excess, you can do so every year by calling 0900 - 9590 (local rate). The deductible excess does not apply to: Sample calculation 2: obligatory and voluntary deductible excess Mrs Smith has opted for a voluntary deductible excess of 200.00 over and above the obligatory deductible excess. Her hospital submits a claim directly to us for treatment costing 700.00. We pay the hospital directly. We then additionally charge Mrs Smith her obligatory deductible excess ( 170.00), followed by her voluntary deductible excess ( 200.00). Mrs Smith therefore has to pay a total of 370.00. After that Mrs Smith will pay no more deductible excess for the rest of the year. Any treatment she undergoes in that year will, therefore, be reimbursed. Sample calculation 1: obligatory deductible excess alone Mr Jones only has the deductible excess required by law of 170.00. He pays a bill of 190.00 to the care provider himself and then submits the invoice to us as a claim. The first 170.00 of this invoice are charged to his deductible excess as required by law. We then reimburse the rest ( 20.00). Mr Jones will then pay no more deductible excess for the rest of the year. Any treatment he undergoes in that year will, therefore, be reimbursed. Your bills are always set off against the obligatory deductible excess and lastly the voluntary deductible excess (if you have opted for one).

GP visits (with the exception of subcontracted laboratory tests). Care which is reimbursed via your supplementary (dental) insurance policy. Care and dental care for children aged up to 18. Articles on loan (such as VDU spectacles). Maternity care and obstetrical assistance. Chain-based care and follow-up checks of the donor.

4.

Recourse assistance

6.

Help when abroad

If you have suffered bodily injury as a consequence of an accident, or wish to make a claim for compensation as a consequence of a medical activity, we will help you recover the costs.

It is nice to know that, when you are abroad, Avro Achmea is there for you 24 hours a day. All you have to do is call our Emergency Centre or our Holiday Doctor. 7. Health-programme

5.

GP and dentist mediation

Health is a unique service which helps you improve your health and develop a healthy lifestyle. For example, it offers you a discount on a Health Check, so that you can find out exactly how healthy you are. You also get a discount at the Achmea Health Centers, and you will be eligible for the regular special offers which can be found at www.averoachmea.nl/health. We even reimburse the majority of the costs of, for example, a first aid course.

If you are going to move house, we will help you find a new GP or dentist. We will find out which practices are able to accept new patients and will make the necessary arrangements so that your registration is completed within two weeks.

No deductible excess thanks to care mediation

In the case of a number of forms of specialist medical treatment

We want to help you find the best possible care as quickly as possible. We want to do this on the basis of consultation with you because the Dutch healthcare system really offers you a number of choices. One example is the useful information which is available on the quality of various forms of specialist medical treatment. If you ask us for advice regarding which hospital offers the best treatment you can, in a number of cases, even become eligible for exemption from the obligatory deductible excess. All you have to do is contact us on 0900 - 9590 (local rate) or surf to www.averoachmea.nl/ zorgbemiddeling to find out which forms of treatment this exemption applies to.

On paying bills and their reimbursement

How to submit bills

As an insured party you often do not receive any bills at all. In fact, most care providers submit bills to us directly. This is handy and relieves you of the worry! If you do receive a bill, this may be because we do not have agreements with all care providers regarding direct payments. You have to pay the bill yourself and then claim the costs from us.

Good to know Please let us know if the bill you have submitted is the consequence of an accident.

Step 1 Find the original bill. Step 2 Check whether your name, address, place of residence and date of birth are referred to on the bill. Step 3 Write down the client number of the person who has received the treatment in the top right-hand corner of the bill. You can find the client number of the care card.

Step 4 Make a copy of the bill for your own records. Step 5 Send the original bill without* any accompanying letter or claims form* to: Avro Achmea Afdeling Declaratieservice Postbus 59005 1040 KA Amsterdam The bill will be processed within 10 days.

* In the case of medical expenses incurred abroad, travel expenses incurred using your own or public transport and visiting or accommodation costs, you have to complete a claims form and submit it with the original bill. The forms can be downloaded via www.averoachmea.nl/zorgverzekeringen under Meer informatie [More Information] and then Declareren [Claims].

When permission is required for treatment

How to get authorisation?

In some cases you will need permission beforehand in order for treatment, medicines or travel costs to be reimbursed. We refer to this approval as an authorisation. Dental implants and an insulin pump are examples of treatment or a nursing article for which you need authorisation. You can find details of the types of treatment for which you need an authorisation in our summary of reimbursements and policy conditions. You or your care provider can apply for authorisation using the

special form which can be found at www.averoachmea.nl/zorgverzekeringen. You can also telephone our Customer Services on: 0900 - 9590 (local rate). Travel costs Insured parties who have to undergo certain forms of treatment or who are wheelchair-dependent can receive a reimbursement of (part of) the travel costs from and to the hospital. For this you need an authorisation for travel costs. You can apply for this via the special Travel Line: 0900 - 23 02 340 ( 0.10 p/m).

Nursing articles without authorisation For some nursing articles, for example hearing aids, incontinence materials and ortheses, you can simply contact the supplier we have contracted using the referral from your GP or specialist without any authorisation. Details on all our contracted suppliers can be found at Find your care provider at www.averoachmea.nl/zorgverzekeringen. Alternatively you can call our nursing articles line: 0900 - 20 08 010 ( 0.10 p/m).

When things change

How do you change your personal details?

Sometimes things in life change. The same applies to the details we have on you. If you want to change your policy and opt for another health insurance, please contact your insurance adviser. You can also use the change form at www.averoachmea. nl/zorgverzekeringen

We receive notification about you moving house within the Netherlands, a change in initial(s), additional name details or surname, a marriage or registered partnership, a divorce (except in the event of a policyholder change) or death via the municipal records database. There is therefore no need for you to inform us of these changes yourself. Neither do you need to inform us of any change in dentist, GP or pharmacy.

For administrative changes relating to a birth, moving house abroad (in that case you should check whether you retain your right to basic insurance in the Netherlands), a different telephone number, e-mail address, account number or payment method, you can simply call our Customer Services on 0900 - 9590 (local rate) or use the change form at www.averoachmea.nl/zorgverzekeringen.

Awareness and healthy living!

The Avro Achmea Health programme

Our health client benefit product is ideal for all our healthconscious policyholders. It is a unique service which helps you improve your health and develop a healthy lifestyle. It includes things like the Health Check and various discounts. For example you get a discount on participation in a first aid course or a course on coping with heart problems. Information on the special offers with which you can get even more

out of your health insurance can be found further on in this booklet. We can make a real difference to your state of health.

Some useful information

Useful addresses and numbers

Care allowance The care allowance is a financial contribution by the Tax Authorities intended to keep the basic insurance affordable for everyone. Whether you are eligible depends on your personal situation. The Tax Authorities determine the amount of the care allowance on the basis of your income and that of your partner if you have one. If you have received care allowance this year and your situation has not changed, you do not need to apply for it again for next year. If you have not received any care allowance this calendar year and you think you are entitled to it in the coming year, you can submit an appropriate application to the Tax Authorities. Surf to www.toeslagen.nl or call the BelastingTelefoon on 0800 - 0543.

own health insurance does not reimburse your care expenses you can, in some cases, claim via the AWBZ. The Wet maatschappelijke ondersteuning [Social Support Act] (Wmo) offers local authority assistance if you need help and are unable to fall back on volunteer carers in your community (family, friends, neighbours, volunteers). For care issues related to the AWBZ and Wmo, you or your carer can use our Care Regulator. Via the supplementary health insurance we reimburse a number of hours of support relating to complex care issues relating to the AWBZ and the Wmo and the accompanying regulatory tasks in the field of care, work, welfare, living and finances. If you would like to be eligible for this support, please

Complaints We do our level best to resolve any problems you may encounter. Nevertheless, you may still be unhappy about some aspect of the services we provide. You should then contact your insurance adviser. If you wish to submit a complaint, please do so via www.averoachmea.nl/zorgverzekeringen or by post: Avro Achmea, Centrale Klachtencordinatie Achmea Zorg, Antwoordnummer 93200, 2200 XA Noordwijk. The Care Regulator The Algemene Wet Bijzondere Ziektekosten [Exceptional Medical Expenses Act] (AWBZ) is a national medical expenses scheme, for example for long-term home care and care for handicapped people. It is an obligatory insurance for everyone who lives and works in the Netherlands. If your

contact our Customer Services on 0900 - 9590 (local rate). A carefree holiday Start your trip in a stress-free way. After all, you can always turn to us for advice or assistance if you have a medical query or in the event of an emergency. Make sure you have the following numbers in your mobile telephone:

The holiday doctor: +31 71 36 41 802

For medical queries, not emergencies.

The Achmea Emergency Centre: +31 71 36 41 850

The Achmea Emergency Centre can be contacted in emergencies 24 hours a day.

A cheap way to get fit

Get more out of your health insurance with Avro Achmeas Health programme

Getting fit makes you feel better. Its something we all want. That is why we are making it as attractive as possible. We offer all kinds of offers and discounts. For example, there is a discount on a Health Check, help losing weight, a reimbursement for a first aid course and a discount on eye laser treatment. More information can be found on our website www.averoachmea.nl/health

Instructive

Diabetes course
The Diabetesvereniging Nederland [Netherlands Diabetes Association] (DVN) organises basic and follow-up courses for patients with type 2 diabetes or people associated with them. If you have supplementary insurance the costs will be partially reimbursed, or even totally reimbursed in the case of the Excellent variant. www.averoachmea.nl/health

First Aid

First aid for accidents involving children

Accidents and injuries can happen at any time, especially where children are concerned. Doing a first-aid course helps you to know what you should do. You can attend a course in first aid for childrens accidents at a home care institution or the local First Aid association. Alternatively you can do the Internet course on first aid for children offered by Iedereen EHBO. If you have supplementary insurance the costs will be partially reimbursed, or even totally reimbursed in the case of the Excellent variant. www.averoachmea.nl/health

First Aid

Sleeping

First aid courses

It can be very handy to know how to provide first aid in the event of accidents. If you have supplementary insurance the costs will be partially reimbursed, or even totally reimbursed in the case of the Excellent variant. www.averoachmea.nl/health

Sleeping course
Sleeping better makes people healthier and fitter. If you have supplementary insurance the costs will be partially reimbursed, or even totally reimbursed in the case of the Excellent variant. www.averoachmea.nl/health

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Sauna

Instructive

A discount on visits to the sauna

Going to the sauna is a great way to give your body and mind a little break. As an Avro Achmea insured party you are eligible for a discount on visits to the sauna. Details on the special offer can be found at www.averoachmea.nl/health

Coping with heart problems

A preventive course designed to help patients learn to cope with heart problems. You can do this course at a home care institution. If you have supplementary insurance the costs will be partially reimbursed, or even totally reimbursed in the case of the Excellent variant. www.averoachmea.nl/health Welfare
now

Stopping smoking

disCount

10%

If your basic insurance does not grant you eligibility for a stopping smoking programme, you can always do a course. You can choose between Stop smoking with Allen Carr, I Quit Smoking at a home care institution, or laser therapy. If you have supplementary insurance the costs will be partially reimbursed, or even totally reimbursed in the case of the Excellent variant. www.averoachmea.nl/health

Well seen

Eye laser treatment

Wouldnt it be great, if you are short or long sighted, to wake up in the morning and immediately see everything clearly, without first having to put on your glasses or put in your lenses? Having your eyes lasered can make this a reality. If you have supplementary insurance, you will be eligible for an attractive discount if you have your eyes lasered at Vision- Clinics. No reimbursement for eye laser treatment is available in the case of the Start supplementary insurance policy. The Extra and Royaal variants provide a reimbursement of up to 500.00 for eye laser treatment over the entire term of your insurance policy. The Excellent variant provides a reimbursement of up to 750.00 for eye laser treatment over the entire term of your insurance policy. www.averoachmea.nl/health

Exercise

Achmea Health Centers: 20% discount

quality supervision will help you train. www.averoachmea.nl/health

20%
disCount

now

At the Achmea Health Centers, a personal plan and good

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A clear view of things

Reimbursements and discounts for glasses and contact lenses

No-one wants their eyesight to deteriorate and no-one wants to spend a fortune on glasses or lenses. Via the Start supplementary insurance policy we reimburse, per person per 3 calendar years, the costs of glasses and contact lenses up to an amount of 100.00. The reimbursement via the Extra variant is 150.00. Via the Royaal variant, Avro Achmea reimburses, per person per 3 calendar years, 1 set of spectacles (including frame) or a pair of contact lenses for long-term use up to an amount of 250.00. This means new glasses or contact lenses on average once every 3 years! The reimbursement for daily, weekly, monthly, six monthly and yearly lenses is up to 65.00 per calendar year. The amounts reimbursed via the Excellent variant are 350.00 and 75.00 per calendar year respectively. In addition, each supplementary insurance policy offers a discount at Pearle and Eye Wish stores. www.averoachmea.nl/health Health Check

Check your health via the Health Check

The Health Check is a quick and easy way for people to get a good indication of their state of health. By determining the cholesterol and glucose levels in your blood, taking your blood pressure, and measuring the length/body mass ratio and lung function, the Health Check ensures that any increased risk of heart and vascular diseases is detected in good time. Avro Achmea offers an attractive discount on the Health Check. In fact, the Excellent supplementary insurance policy even offers a 100% reimbursement of the Health Check. www.averoachmea.nl/health

Nutrition

A healthy weight in 15 weeks

Help losing weight might be just the boost you need. Depending on your supplementary insurance policy, the reimbursement may be as much as 100%. You can do a course at a home care institution, or a correspondence or online Happy Weight course, or complete the Sportief afslanken [Sports weight loss] programme at one of the Achmea Health Centers. www.averoachmea.nl/health

Health products

Health Shop
products from our Health Shop Internet store. www.averoachmea.nl/health

20%
disCount

now

Discounts are available on the entire range of health

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Summary of reimbursements 2011

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Your health insurance

For which types of care are we insured in the Netherlands? What is the difference between the basic insurance and the supplementary insurance policies? Our care system in a nutshell.

The Dutch care system The government introduced our current care system on 1 January 2006. It consists of a basic insurance policy with an obligatory deductible excess. Everyone in the Netherlands is obliged to be insured for medical expenses and everyone aged 18 or over pays a premium. You may be eligible for a premium costs subsidy. This subsidy is called the care allowance. More information is available at www.toeslagen.nl. What is basic insurance? Basic insurance is for everyone in the Netherlands. The government sets the basic insurance reimbursements every year. Zorg Plan [Care Plan] Zorg Plan means you receive care from care providers with whom we have made agreements. As a result you pay a slightly lower premium. If you use other care providers, the reimbursement will be lower and you may have to pay an additional charge. We pay bills directly (less the statutory personal contributions). Keuze Zorg [Options Care] Plan The Keuze Zorg Plan gives you complete freedom to choose whichever care provider you want. It does not matter whether the care provider has a contract with us or not. You always receive a full reimbursement to the maximum of the statutory amount, or to the maximum of the rate (applica-

ble on the market) in the Netherlands (less the statutory personal contributions). What cover does the (Keuze) Zorg Plan provide? Medical care provided by GPs, hospitals, specialists and midwives. Hospital admissions. Nursing articles. Medicines. Maternity care. Patient transport. Paramedic assistance (limited physiotherapy/remedial therapy, speech and language therapy, occupational therapy and dietary advice). Dental care (up to the age of 18). What cover does a supplementary insurance policy provide? You can take out supplementary insurance in addition to basic insurance. For example for a reimbursement of the statutory personal contributions, or for more comprehensive cover for physiotherapy, dental costs or emergency help when abroad. Avro Achmea allows you to choose from different supplementary insurance policies and separate dental insurance policies. The higher the supplementary insurance policy, the more extensive the cover and the higher the reimbursements.

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What can you find where in the summary of reimbursements?

To find out what is reimbursed, choose the theme in the overview below and then look to see which page it is on. This is a quick way of finding the care you are looking for. Each reimbursement is accompanied by information on what exactly is reimbursed via the (Keuze) Zorg Plan (basic insurance) and via any of the supplementary insurance policies. If you cannot find the care you are looking for, surf to our website www.averoachmea.nl/zorgverzekeringen or call our Customer Services on 0900 - 9590 (local rate).

Alternative
18 18 Alternative remedies and therapies. Homeopathic and anthroposophic medicines

Nursing articles
21 21 21 Nursing articles via the basic insurance Equipment for negative pressure therapy CPM invalid buggy Walking aids Personal alarms Breast prosthesis adhesive strips 21 21 21 21 21 Incontinence alarm Wig Support pessary Support soles Transtherapy to alleviate incontinence 21 21 21

Mouth and teeth (18 and older)

22 23 23 23 23 Dentures (prosthesis) Orthodontics (brace) Orthodontics (brace) 18 - 22 years old Orthodontics (brace) from age 22 onwards Dental costs as a consequence of an accident from age 18 onwards 23 23 Care for handicapped people Exceptional cases

Bones, muscles and joints

19 19 19 19 19 Exercise programmes Exercising in extra heated water for rheumatism sufferers Occupational therapy Orthopaedic medicine Chiropodist care in the case of rheumatism or diabetes

When abroad
19 19 19 19 Repatriation Emergency care Non-emergency care Vaccinations and consultations 22

Mouth and teeth (younger than 18)

23 Any treatment by a dentist, dental hygienist, dental surgeon and dental prosthetician 23 23 Crowns, bridges, inlays and implants Orthodontics (brace)

Medicines
22 22 Contraception Medicines via the basic insurance Flu vaccination Melatonin 22

Skin
20 20 Skin care Psoriasis treatment

Physiotherapy and remedial therapy (18 and older)

20 20 20 Chronic disorder Non-chronic disorder Pelvic physiotherapy

Mouth and teeth (18 and older with supplementary dental insurance)
22 22 22 Dentist, dental hygienist and dental prosthetician Other forms of treatment Treatment which we do not reimburse

Eyes and ears

23 23 23 23 24 24 Audiological centre Prescription glasses and lenses Correction of upper eyelids Correction of ear position Hearing aid Eye laser treatment

Physiotherapy and remedial therapy (younger than 18)

20 20 Chronic disorder Non-chronic disorder

Psychological care
24 24 24 Primary psychological care Second-line mental health care (GGZ) Admission to a psychiatric hospital

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Talking and reading

24 24 24 Dyslexia-related care Speech and language therapy Stutter therapy

(Becoming) pregnant / baby / child

27 Maternity care for adopted children or medical screening in the event of adoption 27 27 27 27 27 27 27 27 27 Circumcision Childbirth Monitoring equipment to prevent cot death GeboorteTENS IVF Maternity pack Maternity care Breastfeeding assistance Oncology examination for children 28 28 28 28 Prenatal screening Therapeutic holiday camps Obstetrical care Fertility-enhancing treatment

28 29 29 29 29 29 29 29 29 29 29

Patient associations (Preventive) courses Rehabilitation Sports doctor Sport-medical examination Stopping smoking programme Therapeutic holiday camps for handicapped people Thrombosis service Payment in the event of a functional loss Holiday hotels or sailing holidays Care Regulator

(Patient) transport
25 25 25 Ambulance Travel costs after care mediation abroad Accommodation and travel costs incurred by family members after care mediation abroad 25 Patient transport

Hospital, treatment and nursing

25 25 25 25 25 26 26 26 26 26 26 26 26 26 26 26 26 Asthma Centre in Davos Treatment, examination and operation in hospital Cosmetic and plastic surgery Dialysis Hereditary research and consultancy Guest house Dental surgery Mechanical respiration Obesity change in behaviour programme Organ transplants Preventive examinations Second opinion Sterilisation Telemonitoring in the event of chronic heart failure Nursing outside hospital Nursing in hospital Independent treatment centre

Extra insurance policies

29 Ziekenhuis Extra [Hospital Extra] Insurance Policies

Other
28 28 28 28 28 28 28 28 Dietary advice and nutritional information Health Check Herstel en Balans [Recovery and Balance] Convalescence home Hospice GP Chain-based care for diabetes and COPD Childcare for children aged up to 12 while their parent(s) is/ are admitted to hospital 28 28 28 Lifestyle training sessions Substitute volunteer care Menopause consultant

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Summary of reimbursements 2011

This overview details the reimbursements via both the (Keuze) Zorg Plan and the supplementary insurance policies. The reimbursements via the Keuze Zorg Plan and Zorg Plan are described in a single column. These reimbursements can be found under the heading (Keuze) Zorg Plan (basic insurance).

What does it mean?

Year A calendar year, which runs from 1 January to 31 December. One-off

Surf to www.averoachmea.nl/zorgverzekeringen for an overview of contracted care providers, the Achmea Reglement Hulpmiddelen [Achmea Nursing Articles Regulations], the Achmea Reglement Farmaceutische Zorg [Achmea Pharmaceutical Care Regulations], our terms and conditions, brochures, forms and information about our insurance policies. No rights can be derived from the summary of reimbursements. A detailed description of the terms and conditions and entitlements can be found in the policy conditions. You should always consult these first before you contact a care provider. You can download the policy terms and conditions from our website or we will send it to you on request.

A reimbursement for the term of the insurance policy. Permission from us You need our permission before you can claim a reimbursement. You can request this permission by telephoning our Customer Services on 0900 - 9590 (local rate).

Alternative A. Alternative remedies and therapies By a practitioner at a professional association recognised by us, for example: acupuncture, homeopathy, chiropractic treatment, osteopathy and manual therapy and other forms of treatment. B. Medicines (anthroposophic and homeopathic) The medicines have to be registered and supplied by a pharmacy. See www.averoachmea.nl/ zorgverzekeringen or call 0900 - 9590 (local rate). A + B added up together

(Keuze) Zorg Plan (basic insurance)

Start 40.00 per day.

Extra

Royaal

Excellent

100%

100%

440.00 per person per year.

640.00 per person per year. 100% 100%

Medicines (anthroposophic and homeopathic) The medicines have to be registered and supplied by a pharmacy. See www.averoachmea.nl/ zorgverzekeringen or call 0900 - 9590 (local rate). Alternative remedies and therapies See www.averoachmea.nl/ zorgverzekeringen or call 0900 - 9590 (local rate).

Specifically referred to doctors (2) 75 per day; specifically referred to nondoctors (3) 40 per day; together 20 consultations.

Doctors who practise alternative medicine 75 per day; specifically referred to non-doctors (3) 50 per day; together 24 consultations.

(2) Alternative doctors are: an acupuncturist doctor, homeopathic doctor, natural medicines doctor, anthroposophic doctor, doctor-enzyme therapist, Sickesz doctor, manual doctor or Moerman doctor established in the Netherlands.

(3) Alternative non-doctors are: an acupuncturist, physiotherapist acupuncturist, classic homeopath, manual therapist, chiropractor, hapto therapist or natural medicine therapist established in the Netherlands.

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Bones, muscles and joints (Keuze) Zorg Plan (basic insurance) Exercise programmes For people with: obesity BMI > 30 previous heart failure type 2 diabetes COPD in Gold 1 and 2 stages with a lung value of FEV1/VC > 60%. Exercising in extra heated water Remedial therapy for rheumatism sufferers.

(Keuze) Zorg Plan (basic insurance)

Start 175.00 per person per year.

Extra 350.00 per person per year.

Royaal

Excellent

150.00 per person per year.

100% 100% reimburseper person per year. ment ( 1), together with other costs up to 500.00.

Occupational therapy Orthopaedic medicine Via the Vereniging van Artsen voor Orthopedische Geneeskunde [Association of Orthopaedic Doctors] (VAOG). Chiropodist care For insured parties with diabetes or rheumatism.

Via (Keuze) Zorg Plan 100% up to 10 hours per person per year. 150.00 per person per year. 300.00 per person per year. 500.00 100% reimbursement (1), together with per person per year. other costs up to 500.00.

21.00 per appointment up to 126.00 per person per year.

100% 100% reimburse ment (1), together with per person per year. other costs up to 500.00. 100% per person per year.

For insured parties with a cerebral infarction (CVA). Podotherapie/podologie/ podoposturale therapie (Stichting LOOP of Omni Podo Genootschap). Foot treatment and the measuring, manufacturing and delivering of podiatric soles and nursing articles, no shoes or shoe adaptations. 100,per person per year.

100% 100% reimbursement (1), together with per person per year. other costs up to 500.00.

When abroad Repatriation of insured party and transport of human remains to the Netherlands Urgent care Care which cannot wait until you are back in the Netherlands. Call Eurocross Assistance for emergency assistance abroad on +31 71 36 41 850. This telephone number can also be found on your care card. Non-emergency care Reimbursement in accordance with the terms and conditions and reimbursements

(Keuze) Zorg Plan (basic insurance)

Start

Extra

Royaal

Excellent

100% after permission from Eurocross Assistance.

100% of the rate in the Netherlands via the (Keuze) Zorg Plan.

100% of the rate in the Netherlands via the (Keuze) Zorg Plan. Via Start, Extra, Royaal and Excellent. Supplement to 100% of the cost price for an uninterrupted stay of up to 12 months. Cost price = usual rate in the country in question.

100% of the rate in the Netherlands via the (Keuze) Zorg Plan. See the policy conditions.

100% of the rate in the Netherlands via the (Keuze) Zorg Plan, see the policy conditions. Via Start, Extra, Royaal and Excellent. In accordance with the reimbursement in the Netherlands with due regard for the conditions and exclusions. Via Meditel and Achmea Vitale Travel Clinics 100%. Via the eFarma Internet pharmacy 100%. Or via another care provider 150.00 per person per year. More information about a location close to where you live can be found at www.meditel.nl and www.achmeavitale.nl. Via Meditel and Achmea Vitale Travel Clinics 100%, via the eFarma Internet pharmacy 100%, or via another care provider 100% per person per year. More information about a location close to where you live can be found at www.meditel.nl and www.achmeavitale.nl.

Vaccinations and consultations DTP, yellow fever, typhoid, cholera, rabies, Lyme disease and hepatitis A/B or medicines against malaria in connection with a trip abroad.

(1) ) For these care activities, insured via Royaal, a total of max. 500 is reimbursed per insured party per calendar year.

19

Skin Skin care By a beautician (ANBOS) or dermatologist: acne treatment camouflage therapy facial depilation for women Psoriasis Hire costs relating to UV B light therapy at home. Treatment in a day treatment centre (skin).

(Keuze) Zorg Plan (basic insurance)

Start

Extra 300.00 per person per year.

Royaal 600.00 per person per year.

Excellent 100% per person per year. For epilation you need permission from us.

Via the (Keuze) Zorg Plan 100% after permission from us.

750.00 per persoon per year.

1.000.00 per person per year.

18 and older Physiotherapy and remedial therapy Chronic disorder Your doctor and/or physiotherapist diagnoses the disorder. You pay for appointments 1 to 12 yourself. You pay for appointments 1 to 12 yourself. Via the (Keuze) Zorg Plan as from appointment 13, 100%. + Via Start 12 appointments per year. 12 appointments per year. You pay for appointments 1 to 12 yourself. Via the (Keuze) Zorg Plan as from appointment 13, 100%. + Via Extra 12 appointments per year. 27 appointments per year. You pay for appointments 1 to 12 yourself. Via the (Keuze) Zorg Plan as from appointment 13, 100%. + Via Royaal 12 appointments per year. 27 appointments per year. You pay for appointments 1 to 12 yourself. Via the (Keuze) Zorg Plan as from appointment 13, 100%. + Via Excellent 12 appointments per year. All appointments. (Keuze) Zorg Plan (basic insurance) Start Extra Royaal Excellent

(Manual lymph drainage in Via the (Keuze) Zorg connection with serious Plan as from appointlymphoedema may also be ment 13, 100%. performed by a dermatologist rather than a physiotherapist or remedial therapist.) Non-chronic disorder Your doctor and/or physiotherapist diagnoses the disorder. Manual lymph drainage in connection with serious lymphoedema may also be performed by a dermatologist rather than a physiotherapist or remedial therapist. Pelvic physiotherapy Via the (Keuze) Zorg Plan appointments 1 to 9.

Via the (Keuze) Zorg Plan appointments 1 to 9. + Via Start 12 appointments per year.

Via the (Keuze) Zorg Plan appointments 1 to 9. + Via Extra 27 appointments per year.

Via the (Keuze) Zorg Plan appointments 1 to 9. + Via Royaal 27 appointments per year.

Via the (Keuze) Zorg Plan appointments 1 to 9. + Via Excellent all appointments.

A number of chronic and non-chronic disorders or pelvic physiotherapy If you have a number of disorders, you should always contact our Customer Services on 0900 - 9590 (local rate). Our staff would be only too pleased to explain what reimbursements you can expect.

Younger than 18 Physiotherapy and remedial therapy (Keuze) Zorg Plan (basic insurance) Start Extra Royaal Excellent

Chronic disorder Via the (Keuze) Zorg Plan 100%. Your doctor and/or physiotherapist diagnoses the disorder. Manual lymph drainage in connection with serious lymphoedema may also be performed by a dermatologist rather than a physiotherapist or remedial therapist. Non-chronic disorder Via the (Keuze) Zorg Your doctor and/or physiotherapist Plan 18 appointments diagnoses the disorder. per diagnosis. Manual lymph drainage in connection with serious lymphoedema may also be performed by a dermatologist rather than a physiotherapist or remedial therapist. Via the (Keuze) Zorg Plan 18 appointments per diagnosis. + Via Start 12 appointments per year. Via the (Keuze) Zorg Plan 18 appointments per diagnosis. + Via Extra 27 appointments per year. Via the (Keuze) Zorg Plan 18 appointments per diagnosis. + Via Royaal 27 appointments per year. Via the (Keuze) Zorg Plan 18 appointments per diagnosis. + Via Excellent all appointments.

20

Nursing articles

(Keuze) Zorg Plan (basic insurance)

Start

Extra

Royaal 250.00 statutory personal contribution for other nursing articles, no wig, hearing aid, orthopaedic shoes and allergy-free shoes.

Excellent 100% statutory personal contribution for other nursing articles, no wig, hearing aid, orthopaedic shoes and allergy-free shoes.

Nursing articles via the basic Via the (Keuze) Zorg Plan 100%. insurance Reimbursement in accordance with Certain nursing articles are subject to prior permission from us, a max. the terms and conditions in the reimbursement or statutory personal contribution. Achmea Reglement Hulpmiddelen (Keuze) Zorg Plan [Achmea (Options) Care Plan Nursing Articles Regulations]. See www.averoachmea.nl/zorgverzekeringen or call 0900 - 9590 (local rate). Call 0900 - 20 08 010 ( 0.10 p/m) for personal alarms, workchairs, chairs adapted for people with disabilities (not stand-up chairs) and nursing beds.

In addition to the above reimbursement, all insured parties with a supplementary insurance policy are eligible, upon production of their care pass at Vegro and Harting-Bank/Ligtvoet, for a discount for rollators, stand-up chairs and ADL nursing articles. Equipment for negative pressure therapy E.g. for the removal of wound discharge. Call the nursing articles line: 0900 - 20 08 010 ( 0.10 p/m) CPM invalid buggy Nursing article used after knee or ankle joint operations. Walking aids Elbow crutches, walking aids and 3 or 4 leg sticks and walking frames. Personal alarms On medical grounds Call the nursing articles line: 0900 - 20 08 010 ( 0.10 p/m) Via the (Keuze) Zorg Plan, requested via the nursing articles line 100% for personal alarm unit. See also the Achmea Reglement (Restitutie) Hulpmiddelen [Achmea Nursing Articles (Restitution) Regulations]. Via the (Keuze) Zorg Plan, requested via the nursing articles line 100% for personal alarm unit Eurocross Assistance alarm system. Via Start, Extra, Royaal and Excellent 100% for alarm system subscription costs Action Line via Eurocross Assistance. Or via an other alarm system provider 35.00 per year for subscription costs after permission from us. Via the (Keuze) Zorg Plan 100%.

Via the (Keuze) Zorg Plan 100%.

Only via suppliers we have selected 100%.

On social grounds.

Via Excellent 100% for alarm system subscription costs Action Line via Eurocross Assistance or via an other alarm system provider 35.00 per year after permission from us. 100% One-off 100.00 per person. 100% 100% reimbursement (1), together with other costs up to 500.00. 486.50 per wig with 386.50 via the (Keuze) Zorg Plan max. 100.00 via Royaal. 486.50 per wig with 386.50 via the (Keuze) Zorg Plan. Extra reimbursement is possible.

Breast prosthesis adhesive strips Incontinence alarm In the event of bedwetting problems.

Wig

Via the (Keuze) Zorg Plan 386.50 per wig. See also the Achmea Reglement (Restitutie) Hulpmiddelen [Achmea Nursing Articles (Restitution) Regulations].

462.00 per wig with 386.50 via the (Keuze) Zorg Plan 75.50 via Extra.

Support pessary In the event of a prolapse of the womb. Support soles No podotherapeutic or podological support soles.

100%

35,per person per year.

100% reimbursement (1), 1 pair, together with other costs up to 500.00.

100%.

Transtherapy to alleviate incontinence Hire of neuromodulator (BioStim). Hire of bio feedback equipment (FemiScan). 100% 100%

(1) For these care activities, insured via Royaal, a total of max. 500 is reimbursed per insured party per calendar year.

21

Medicines Contraception Up to age 21, for example the pill or coil.

(Keuze) Zorg Plan (basic insurance)

Start

Extra

Royaal

Excellent

Via the (Keuze) Zorg Plan in accordance with Achmea Reglement Farmaceutische Zorg [Achmea Pharmaceutical Care Regulations] (Keuze) Zorg Plan. You yourself pay the statutory personal contribution, the Geneesmiddelen Vergoedingen Systeem [Medicine Reimbursements Scheme] (GVS), which differs per medicine. See www.averoachmea.nl/zorgverzekeringen for detailed information.

Via the (Keuze) Zorg Plan in accordance with Achmea Reglement Farmaceutische Zorg [Achmea Pharmaceutical Care Regulations] (Keuze) Zorg Plan. + Via Royaal and Excellent 100% reimbursement of statutory personal contribution (the GVS upper limit price).

From age 21, for example the pill or coil.

100%. No reimbursement personal contributi- 100% on (GVS upper limit price). + Via Royaal and Excellent 100% reimbursement of statutory personal contribution (the GVS upper limit price). Via the (Keuze) Zorg Plan in accordance with Achmea Reglement Farmaceutische Zorg [Achmea Pharmaceutical Care Regulations] (Keuze) Zorg. You yourself pay the statutory personal contribution, the Geneesmiddelen Vergoedingen Systeem [Medicine Reimbursements Scheme] (GVS), which differs per medicine. See www.averoachmea.nl/zorgverzekeringen for detailed information. Via the (Keuze) Zorg Plan in accordance with Achmea Reglement Farmaceutische Zorg [Achmea Pharmaceutical Care Regulations]. + Via Royaal and Excellent 100% reimbursement of statutory personal contribution (the GVS upper limit price). 100% Via the eFarma Internet pharmacy 100% or via another pharmacy 100.00 after permission from us. Via the eFarma Internet pharmacy 100% or via another pharmacy 150.00 after permission from us. 100% after permission from us.

Medicines via the basic insurance

Flu vaccination Melatonin Medication for, among other things, insomnia.

18 and older with supplementary dental insurance Mouth and teeth A. Dentist, dental hygienist and dental prosthetician: consultations (C codes) and second opinion oral hygiene (M codes) fillings (V codes) extraction of teeth/molars (H codes). B. Other forms of treatment A + B added up together (Keuze) Zorg Plan (basic insurance) 100% T Start T Extra T Royaal T Excellent

75% 225.00 per person per year. 450.00 per person per year. 900.00 per person per year.

100% 1.150.00 per person per year.

C. Treatment which we do not reimburse: inspection report (C70 and C75) missed appointments (C90) orthodontics (D codes) subscriptions (Z codes) external bleaching of teeth and molars (E97, E98 and E00) mandibular advancement devices (MRA G71, G72 and G73).

18 and older Mouth and teeth Dentures (prosthesis) The purchase of fully removable dentures made by a dentist or dental prosthetician. Repair or refitting (rebasing) of fully removable dentures made by a dentist or dental prosthetician. Implants for removable dentures, in the case of serious dental, jaw or mouth development or growth disorders, made by a dentist, dental surgeon or centre for special dental treatment. (Keuze) Zorg Plan (basic insurance) Start Extra Royaal Excellent

Via the (Keuze) Zorg Plan 75%. Statutory personal contribution 25%. Costs higher than 600.00 per jaw after permission from us. Replacement within 5 years after permission from us. Via the (Keuze) Zorg Plan 100%.

Via the (Keuze) Zorg Plan 100% after permission from us.

22

18 and older Mond en tanden Dentures (prosthesis) Fully removable complete prosthesis on implants, in the case of serious dental, jaw or mouth development or growth disorders, made by a dentist, dental prosthetician or centre for special dental treatment. Orthodontics (brace) In the case of serious dental, jaw or mouth development or growth disorders. Orthodontics (brace) 18 - 22 years old By dentist/orthodontist. With the exception of repair/replacement after damage/loss due to your own fault/negligence. Orthodontics (brace) from age 22 onwards By dentist/orthodontist. With the exception of repair/replacement after damage/loss due to your own fault/ negligence. Dental costs as a consequence of an accident from age 18 onwards Care for handicapped people Your dentist will know whether you are eligible for the reimbursement. Exceptional cases Uw tandarts weet of u in aanmerking komt voor de vergoeding. (Keuze) Zorg Plan (basic insurance) Start Extra Royaal Excellent

Via the (Keuze) Zorg Plan 100% after permission from us. Statutory personal contribution 125.00 per upper or lower jaw.

Via the (Keuze) Zorg Plan 100% after permission from us.

One-off 90% 100% per person. reimbursement up to 2,500.00 per person.

One-off 70% up to 1,000.00 per person, no score 1 and 2 of the Index for Orthodontic Treatment Need (IOTN).

One-off 70% up to 500.00 per person, no score 1 and 2 of the Index for Orthodontic Treatment Need (IOTN).

75% up to 200.00 per element and up to 2,500.00 per accident per person per year. Via the (Keuze) Zorg Plan 100% in the absence of an entitlement to reimbursement via the AWBZ and after permission from us.

Your dentist will know whether you are eligible for the reimbursement. Via the (Keuze) Zorg Plan 100% after permission from us. In some cases a statutory personal contribution applies.

Younger than 18 Mouth and teeth (Keuze) Zorg Plan (basic insurance) Start Extra Royaal Excellent

Any treatment by a dentist, dental Via the (Keuze) Zorg Plan 100%. hygienist, dental surgeon and dental prosthetician With the exception of cast fillings, crowns, bridges, inlays and implants. Crowns, bridges, inlays and implants By dentist/dental surgeon. Orthodontics (brace) By dentist/orthodontist. With the exception of repair/replacement after damage/loss due to your own fault/negligence. 225.00 per person per year. 450.00 per person per year. 100% per person per year. 100% per person per year.

One-off 90%, One-off 90%, One-off 90%, 100% per person. reimbursement up to reimbursement up to reimbursement up to 1,500.00 per person. 2,000.00 per person. 2,500.00 per person.

23

Eyes and ears Audiological centre Prescription glasses and lenses

(Keuze) Zorg Plan (basic insurance) Via the (Keuze) Zorg Plan 100%.

Start

Extra

Royaal

Excellent

100.00 per person for glasses and lenses together once every 3 years.

150.00 per person for glasses and lenses together once every 3 years.

Glasses or contact lenses for long-term use: 1 pair of glasses or 1 pair of lenses up to 250.00 per 3 years or contact lenses for short-term use, such as daily, weekly, monthly, six monthly and yearly lenses is up to 65.00 per year.

Glasses or contact lenses for long-term use: 1 pair of glasses or 1 pair of lenses up to 350.00 per 3 years or contact lenses for short-term use, such as daily, weekly, monthly, six monthly and yearly lenses is up to 75.00 per year.

In addition to the above reimbursement, all insured parties with a supplementary insurance policy are eligible for a discount upon production of their care pass at Pearle Opticiens - Nederland, Eye Wish or Specsavers. Correction of upper eyelids On medical grounds. Correction of ear position 100% per person per year only via care provider selected by us. 100% per person aged up to 18 per year only via care provider selected by us. 100% per person per year.

100% per person per year.

Eyes and ears Hearing aid From age 16 onwards.

(Keuze) Zorg Plan (basic insurance)

Start

Extra

Royaal

Excellent

683.00 per aid. CROS, BiCROS or bone anchored hearing aids included in a glasses frame: 65.00 extra. See also the Achmea Reglement Hulpmiddelen [Achmea Nursing Articles Regulations]. Via the (Keuze) Zorg Plan. Initial purchase: 501.50. Replacement within 5 years: 501.50. Replacement after 6 to 7 years: 592.00. Replacement after 7 years: 683.00. CROS, BiCROS or bone anchored hearing aids included in a glasses frame: 65.00 extra. See also the Achmea Reglement Hulpmiddelen [Achmea Nursing Articles Regulations]. 185.00 extra per device after permission from us. One-off 500.00 per person.

From age 16.

800.00 per hearing aid with an amount being reimbursed via the (Keuze) Zorg Plan and a supplement to a maximum of 250.00 via Royaal.

800.00 per hearing aid with an amount being reimbursed via the (Keuze) Zorg Plan and the rest via Excellent after permission from us.

With remote control on medical grounds.

Eye laser treatment

One-off 500.00 per person.

One-off 750.00 per person.

In addition to the above reimbursement, all insured parties with a supplementary insurance policy are eligible for a discount upon production of their care pass at VisionClinics.

Psychological care Primary psychological care Primary psychologist, clinical psychologist, primary health care psychologist or general remedial educationalist (generalist).

(Keuze) Zorg Plan (basic insurance) Via the (Keuze) Zorg Plan 8 sessions per person per year. A statutory personal contribution of 10.00 applies per session.

Start Via the (Keuze) Zorg Plan 8 sessions per person per year. A statutory personal contribution of 10.00 applies per session. + Via Start 4 extra sessions per person per year.

Extra Via the (Keuze) Zorg Plan 8 sessions per person per year. A statutory personal contribution of 10.00 applies per session. + Via Extra 6 extra sessions per person per year.

Royaal Via the (Keuze) Zorg Plan 8 sessions per person per year. A statutory personal contribution of 10.00 applies per session. + Via Royaal 8 extra sessions per person per year.

Excellent Via the (Keuze) Zorg Plan 8 sessions per person per year. A statutory personal contribution of 10.00 applies per session. + Via Excellent 8 extra sessions per person per year.

Reimbursement of the statutory personal contribution for primary psychological care. Second-line mental health care (GGZ) Via the (Keuze) Zorg Plan 100%. Psychiatrist, neurologist, mental health institution, clinical psychologist or psychotherapist. Psychiatric hospital admissions Admission to a mental health institution (psychiatric hospital or psychiatric ward of a hospital). Via the (Keuze) Zorg Plan 100%.

Reimbursement of the statutory personal contribution of 10.00 per session up to 80.00 per person per year.

24

Talking and reading Dyslexia care Diagnosis and treatment of serious dyslexia for 7 to 10 year old children. Speech and language therapy No dyslexia and language development disorders. Stutter therapy In various stutter centres. According to the Del Ferro, Hausdrfer and BOMA methods.

(Keuze) Zorg Plan (basic insurance) Via the (Keuze) Zorg Plan 100%.

Start

Extra

Royaal

Excellent

Via the (Keuze) Zorg Plan 100%.

Via the (Keuze) Zorg Plan 100%. One-off 225.00 per person. One-off 450.00 per person. One-off 1,000.00 per person. One-off 1,250.00 per person.

(Patient) transport Ambulance Travel costs in the context of care mediation abroad In Belgium and Germany in the event of care mediation. Call the Travel Line for permission on 0900 - 23 02 340 ( 0.10 p/m). Accommodation and travel costs incurred by family members after care mediation abroad In Belgium and Germany in the event of care mediation as from the 15th day of admission. Patient transport By public transport, own car, hire car or taxi in the event of kidney dialysis, oncological care with radio/chemotherapy, visual handicap and if you are unable to travel or are wheelchair-dependent.

(Keuze) Zorg Plan (basic insurance) Via the (Keuze) Zorg Plan 100%.

Start

Extra

Royaal

Excellent

Via taxi company 100%. Own car 0.27 per kilometre. Public transport (second class) 100%.

Accommodation costs: 35.00 per day for the whole of the family. Own vehicle 0.27 per kilometre for max. 700 kilometres per admission.

Via the (Keuze) Zorg Plan. Up to 200 kilometres one way: Own car 0.27 per kilometre. Public transport (second class) 100%. By taxi 100%.

Call the Travel Line for permission on You pay a statutory personal contribution of 92.00 per person after permission from us. 0900 - 23 02 340 ( 0.10 p/m). By own vehicle or taxi in the event of other medical grounds which mean you cannot use public transport. Call the Travel Line for permission on 0900 - 23 02 340 ( 0.10 p/m). Up to 200 kilometres one way and, if you cross a border, up to 55 kilometres across the border: own vehicle 0.27 per kilometre, by taxi 100%. You pay 92.00 per year, total maximum reimbursement 1,000.00 per person per year after permission from us. If you cross a border up to 55 kilometres across the border: own vehicle 0.27 per kilometre, by taxi 100% per person per year after permission from us. If you cross a border up to 55 kilometres across the border: own vehicle 0.27 per kilometre, by taxi 100% per person per year after permission from us.

Statutory personal contribution for patient transport.

100%

Hospital, treatment and nursing Asthma Centre in Davos Treatment, examination and operation in hospital Cosmetic and plastic surgery Cosmetic surgery, not Botox, fillers, (autologous) lip augmentation, peeling, laser or refraction surgery.

(Keuze) Zorg Plan (basic insurance)

Start

Extra

Royaal

Excellent

Via the (Keuze) Zorg Plan 100% after permission from us. Via the (Keuze) Zorg Plan 100%.

500.00 per person per calendar year.

25

Plastic surgery on medical grounds such as a breast prosthesis after a breast amputation (not a breast enhancement, an operation to remove a breast prosthesis without any medical necessity, liposuction of the abdomen, correction of upper eyelids and ear position). Dialysis Hereditary research and consultancy

Via the (Keuze) Zorg Plan 100% after permission from us.

100% of other forms of treatment with medical necessity after permission from us.

Via the (Keuze) Zorg Plan 100%. Via the (Keuze) Zorg Plan 100%.

Hospital, treatment and nursing Guest house Accommodation in a guest house in the event of a cycle of outpatient treatment.

(Keuze) Zorg Plan (basic insurance)

Start

Extra

Royaal

Excellent

35.00 per person per year.

35.00 per person 35.00 per person per year. per day (1), together with other costs up to 500.00. As from 15th day of admission 100%(1) per year for all family members together. Own car 0.27 per kilometre, together with other costs up to 500.00. As from 15th day of admission 100% per year for all family members together. Own car 0.27 per kilometre.

Accommodation or travel expenses of you or your family members in the event of a hospital admission, not being a psychiatric hospital.

As from 15th day of admission travel between home and hospital is at least 50 kilometres 35.00 per day up to 500.00 per year for all family members together. Own car 0.27 per kilometre or public transport (second class) 100%.

Dental surgery Mechanical respiration Obesity change in behaviour programme BMI greater than 40. Organ transplants Nursing of person who has donated the organ (donor). Preventive examinations: cervical cancer (smear) breast cancer heart and vascular diseases prostate cancer. Not a population screening (is reimbursed via the AWBZ). A periodic general check-up.

Via the (Keuze) Zorg Plan 100%. Via the (Keuze) Zorg Plan 100%. Via NOK: one-off Via NOK: one-off 1,000.00 per person after 750.00 per person af- permission from us. ter permission from us. Via the (Keuze) Zorg Plan 100% in hospital or independent treatment centre. Via the (Keuze) Zorg Plan 3 months, 6 months in the case of liver transplant.

100%

1x per 2 years per person. Rate major general GP check-up. Via the (Keuze) Zorg Plan 100%.

Second opinion For care via the basic insurance by medical specialist. Sterilisation Not a reversal operation. Telemonitoring In the event of chronic heart failure hire and supervision. Nursing (extramural) Outside the hospital at home, not artificial respiration at home or alleviating care for terminal patients (palliative care).

100%

Via the (Keuze) Zorg Plan 100%.

Via the (Keuze) Zorg Plan 100%.

Nursing in hospital Via the (Keuze) Zorg Plan 100%. Care provided by a specialist medical and dental surgeon. Independent treatment centre A clinic certified by the government for specialist medical care at which examinations and outpatient treatment takes place. Via the (Keuze) Zorg Plan 100%. In the case of plastic surgery and dental surgery after we have granted permission.

(1) For these care activities, insured via Royaal, a total of max. 500 is reimbursed per insured party per calendar year.

26

(Becoming) pregnant / baby / child Maternity care for adopted babies (younger than 12 months) or Medical screening in the event of adoption Circumcision On religious grounds. Childbirth Giving birth at home. Outpatient childbirth in hospital at own request (without medical grounds).

(Keuze) Zorg Plan (basic insurance)

Start 3 days up to 3 hours a day or 300.00 per adopted child.

Extra

Royaal

Excellent

Only by care providers we have selected 250.00.

Via the (Keuze) Zorg Plan 100%. Via the (Keuze) Zorg Plan 192.00 for use of delivery room, remaining amount is statutory personal contribution. Via the Keuze Zorg Plan 192.00 for use of delivery room, remaining amount is statutory personal contribution. Via the (Keuze) Zorg Plan 192.00 for use of delivery room, remaining amount is statutory personal contribution. + Via Start and Extra 50% reimbursement of statutory personal contribution. 100% via the (Keuze) Zorg Plan 192.00 for use of delivery room, remaining amount is statutory personal contribution. + Via Royaal and Excellent 100% reimbursement of statutory personal contribution.

Childbirth in birth centre in hospital at own request (without medical grounds).

Via the (Keuze) Zorg Plan 192.00 for use of delivery room, remaining amount is statutory personal contribution. + Via Start, Extra, Royaal and Excellent 100% reimbursement of statutory personal contribution.

Outpatient childbirth with medical grounds. Childbirth in hospital (stay in hospital for several days). Monitoring equipment to prevent cot death Monitoring equipment (hire). Nanny Care sensor mat (purchase). GeboorteTENS On loan. In Vitro Fertilisation (IVF) Fertility-enhancing treatment. Maternity pack Order your maternity pack via www. averoachmea.nl/ zorgverzekeringen or call 0900 - 9590 (local rate). Maternity care At home or in a birth centre.

Via the (Keuze) Zorg Plan 100%.

Via the (Keuze) Zorg Plan 100%.

100% for 12 months after permission from us. 100% after referral by doctor. 100%, you arrange this via your midwife.

Via the (Keuze) Zorg Plan first 3 attempts for each attempted pregnancy. Medicines, in accordance with GVS for first 3 attempts. In Vitro Fertilisation (IVF) abroad after permission from us. 100% (request before the 7th month of the pregnancy).

Via the (Keuze) Zorg Plan 10 days, statutory personal contribution of 3.90 per hour.

Via the (Keuze) Zorg Plan 10 days, statutory personal contribution of 3.90 per hour. + Via Start and Extra, statutory personal contribution for 24 hours.

Via the (Keuze) Zorg Plan 10 days, statutory personal contribution of 3.90 per hour. + Via Royaal and Excellent 100% reimbursement, statutory personal contribution of 3.90 per hour.

In hospital on medical grounds. In hospital without medical grounds.

Via the (Keuze) Zorg Plan 100%. Via the (Keuze) Zorg Plan 10 days. + Statutory personal contribution 15.50 per day of admission and hospital rate amount above 111.50. 100% via the (Keuze) Zorg Plan 10 days statutory personal contribution 15.50 per day of admission and hospital rate amount above 111.50. + Via Royaal and Excellent 100% reimbursement of statutory personal contribution. 15 hours, personal payment 100%.

Postponed on medical grounds (for example in the event of a caesarean section or premature birth). Breastfeeding assistance Help and advice during breastfeeding. Oncology examination Oncology examination for children.

15 hours, personal payment 3.90 per hour.

75% up to 115.00 per person per year.

115.00 per person per year.

Via the (Keuze) Zorg Plan 100% via Stichting Kinderoncologie Nederland (Skion).

27

(Becoming) pregnant / baby / child Prenatal screening Counselling. Structural Echoscopic Examination (20 week scan). Combination test (neck fold measurement in combination with a blood test) up to the age of 36 on medical grounds. Combination test (neck fold measurement in combination with a blood test) 36 years or older. Therapeutic holiday camps for children Via Stichting Gezond Gewicht, Stichting de Luchtballon, Diabetes Jeugdvereniging Nederland, Stichting Kinderoncologische Vakantiekampen, Stichting de Ster, Nederlandse Hartstichting. Obstetrical care Fertility-enhancing treatment and freezing sperm Not IVF.

(Keuze) Zorg Plan (basic insurance)

Start

Extra

Royaal

Excellent

Via the (Keuze) Zorg Plan 100%. Via the (Keuze) Zorg Plan 100%.

Via the (Keuze) Zorg Plan 100%.

Via the (Keuze) Zorg Plan 100%.

150.00 per person per year.

250.00 (1) per person 500.00 per year, together per person per year. with other costs up to 500.00.

Via the (Keuze) Zorg Plan 100%. Via the (Keuze) Zorg Plan 100%. Or abroad after permission from us.

Other Dietary advice and nutritional information Dietary advice via a dietician (on medical grounds). Nutritional information via dietician or weight consultant. Health Check

(Keuze) Zorg Plan (basic insurance)

Start

Extra

Royaal

Excellent

Via the (Keuze) Zorg Plan 100%. Up to 4 hours per person per year.

Via (Keuze) Zorg Plan 100% up to 4 hours per person per year. + Via Extra, Royaal and Excellent 115.00 per person per year. 115,- per person per year.

1x 100% per person per year. 800.00 per person per year. 1,000.00 per person per year. 1,000.00 per person per year. 1,200.00 per person per year.

Herstel en Balans [Recovery and Balance] Aftercare training ex-cancer patients. Convalescence home Not psychosomatic care.

50.00 per day up to 48 days per person 28 days per person per per year after permisyear after permission sion from us. from us. 40.00 per day up to 3,600.00. 50.00 per day up to 4,500.00.

Hospice

General Practitioner Chain-based care for type 2 diabetes mellitus and COPD Childcare for children aged up to 12 while their parent(s) is/are admitted to hospital. Not admissions to a psychiatric hospital. Lifestyle training sessions Basic training for heart patients, whiplash patients and people with stress and burn-out related problems. Substitute volunteer care Care for handicapped and chronically ill people in the absence of care via family/friends (volunteer care). Menopause consultant In the event of menopause-related problems Care for Women or the VVOC. Patient associations

Via the (Keuze) Zorg Plan 100%. Via the (Keuze) Zorg Plan 100% only via contracted care groups.

50 hours per week after we permission from us.

Via Leefstijl Training & Coaching (LTC) in Dalfsen 1,000.00 per person per year.

Via Leefstijl Training & Coaching (LTC) in Dalfsen 1,500.00 per person per year. Via stichting Handenin-huis 100% per person per year.

Via stichting Handen-in-huis 21 days per person per year.

In the event of menopause-related problems Care for Women or the VVOC.

25.00 (1) per mem100% bership, together with other costs up to 500.00.

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Other (Preventieve) cursussen: coping with heart problems lymphoedema awareness and/or self-management course coping with rheumatoid arthritis, arthrosis or Bechterews disease type 2 diabetes patients, basic or follow-up losing weight stopping smoking Vrij van alcohol [Alcohol Free] training course basic resuscitation course First Aid first aid for accidents involving children sleep therapy course and/or training in preventing falls exercise programmes for the elderly memory training. Rehabilitation Sports doctor Injury or repeat consultation. Sport-medical examination Not an obligatory sports examination.

(Keuze) Zorg Plan (basic insurance)

Start

Extra

Royaal

Excellent

75% to 115.00 per course per person per year.

100% per course per 75% up to 115.00 per course (1) per per- person per year. son per year together with other costs up to 500.00.

100% per course per person per year.

Via the (Keuze) Zorg Plan 100%. Via a sports medical institution 2 x per person per year. Check www.sportgeneeskunde.com/fsmi for a location close to your home. Via a sports medical institution 1 x per person per 2 years. Basic Examination 85.00. Basic Examination Plus 100.00. Major Examination 135.00. Check www.sportgeneeskunde.com/fsmi for a location close to your home. Via a sports medical institution 1 x per person per 2 years Basic Examination, Basic Examination Plus, Major Examination. Check www.sportgeneeskunde.com/fsmi for a location close to your home.

Stopping smoking programme Therapeutic holiday camps for handicapped people 150.00 per person per year. 250.00 (1) per person 500.00 per person per year, together per year. with other costs up to 500.00.

Thrombosis service Payment in the event of the functional loss of any part, capacity or organ of the body, due to an accident Holiday hotels (Red Cross) or sailing holidays (Red Cross or Zonnebloem organisation) For handicapped people and the chronically ill. Care Regulator (also for insured carer) Telephone number: 0900 - 9590 (local rate).

Via the (Keuze) Zorg Plan 100%. 250.00 per accident.

25%

3 hours per person per year.

6 hours per person per year.

9 hours per person per year.

Supplementary Ziekenhuis Extra [Hospital Extra] Insurance Policies Extra comfort cover Contracted care. Non-contracted care. Daily monetary payment When abroad: room supplement class room / fee surcharge Contracted care. Non-contracted care. * Reimbursement in the Netherlands and abroad together.
(1) For these care activities, insured via Royaal, a total of max. 500 is reimbursed per insured party per calendar year.

100% 150.00 per day. 70.00 per day up to 4,900.00 * per person per year.

100% 70.00 per day up to 4,900.00 per person per year, no reimbursement of the fee surcharge.

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Summary of the health insurance policies

The basic insurance Should you become ill, our health insurance policies offer you the right care without any nasty financial surprises. However, even if you are in good health, you want to know you can rely on us to be there whenever you need help. You can opt for one of our basic insurance policies. If you have the Avro Achmea basic insurance you are already assured of the Seven Certainties of good care, irrespective of which basic insurance you choose.
This reimbursement policy gives you the freedom to choose your own care providers. With this combination of nonmonetary and reimbursement you receive care from our contracted care providers. Keuze Zorg Plan (basic insurance) Zorg Plan (basic insurance)

Supplementary insurance In addition to the basic insurance policies we also offer four supplementary insurance policies - Start, Extra, Royaal and Excellent. They range from a very competitively priced insurance policy to insurance with very comprehensive cover. The following is a brief overview of the supplementary insurance policies you can choose for.
Types of care 1 Alternative therapies Start 440.00 per year Extra 640.00 per year Royaal 1.500.00 per year Excellent 1.800.00 per year

Contraception

100%

100%

100%

100%

Glasses and lenses

100.00 per 3 calendar years none

150.00 per 3 calendar years 500.00

250.00 per 3 calendar years 500.00

350.00 per 3 calendar years 750.00

Eye laser treatment

Primary psychology

4 extra appointments

A reimbursement of the personal contribution 80.00 + 6 extra appointments. 27 times

A reimbursement of the personal contribution 80.00 + 8 extra appointments. 27 times

A reimbursement of the personal contribution 80.00 + 8 extra appointments. 100%

Physiotherapy and remedial therapy 12 times

Help when abroad including vaccinations Orthodontics

100%

100%

100%

100%

Up to 18 years of age 90% and max. 1,500.00

Up to 18 years of age 90% and max. 2,000.00

Up to 22 years of age 90% to max. 2,500.00, from age 22 onwards 70% to max. 1,000.00

Up to 22 years of age 100%, from age 22 70% to max. 1,500.00

Dental insurance The basic insurance does not cover regular dental care from the age of 18. For that reason it is a good idea to supplement your basic insurance with a dental insurance, for family members aged over 18.
Type of care 9 Dental care T Start A maximum reimbursement of 225.00 per year T Extra A maximum reimbursement of 450.00 per year T Royaal A maximum reimbursement of 900.00 per year T Excellent A maximum reimbursement of 1,150.00 per year

Disclaimer: In the event of contrariety between the English and Dutch versions of this document, the Dutch version will prevail.

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Disclaimer
Privacy We need personal data to process applications for an insurance policy or a financial service. This data is used within the Achmea Group to enter into and implement insurance agreements, to inform you about relevant products and/or services, to guarantee the security and integrity of the financial sector, for statistical analyses, customer relationship management and in order to comply with statutory obligations. The use of your personal details is subject to the Gedragscode Verwerking Persoonsgegevens Financile Instellingen [Code of Conduct for the Processing of Personal Data by Financial Institutions]. Health insurers also have to comply with the Gedragscode Verwerking Persoonsgegevens Zorgverzekeraars [Code of Conduct for the Processing of Personal Data by Health Care Insurers]. If you do not wish to receive information about our products and/or services, or if you wish to withdraw your permission for the use of your e-mail address, please write to us at Avro Achmea, Postbus 1717, 3800 BS Amersfoort. With a view to maintaining a sound acceptance policy, we are allowed, as the Achmea Group, to consult details kept at the Stichting Centraal Informatie Systeem [Central Information System Board] (CIS) in Zeist. Within that framework, those affiliated to the Stichting CIS are also allowed to exchange data among themselves. The aim is to manage the risks and combat fraud. This is subject to the privacy regulations of the Stichting CIS. More information can be found at www.stichtingcis.nl. Applicable law and complaints procedure The insurance policies are exclusively subject to Dutch law. It goes without saying that we do our very best to provide you with an optimal service at all times. Nevertheless, you may still be unhappy about some aspect of the services we provide. In such instances, you should first contact your adviser or contact person. If you still feel it is necessary to submit a complaint, you can do so by e-mail via our website www.averoachmea.nl (under the klacht doorgeven [submit complaint] section) or in writing to Avro Achmea, Centrale Klachtencordinatie, Antwoordnummer 93200, 2200 XA Noordwijk. If, in your opinion, we do not manage to solve the problem satisfactorily and if you are a natural person that is not involved in running a business or engaged in a profession, you can submit your complaint to the authorised complaints board to which we are affiliated, namely: Stichting Klachten en Geschillen Zorgverzekering [Health Care Insurance Complaints and Disputes Foundation] (SKGZ), Postbus 291, 3700 AG Zeist, tel. +31 (0)30 69 88 360, www.skgz.nl. Information about Avro Achmea Avro Achmea is a provider of insurance products and uses independent brokers and advisers. Avro Achmea is a trade name of Achmea Zorgverzekeringen N.V., which is located in Noordwijk and registered with the AFM under number 12000647, and of Avro Achmea Zorgverzekeringen N.V., which is located in Utrecht and registered with the AFM under number 12001023. The office of Avro Achmea is located on the Van Asch van Wijckstraat 55, 3811 LP Amersfoort, the Netherlands.

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Basic insurance policies Supplementary insurance policies Dental insurance policies Comfort nursing

(Keuze) Zorg [(Options) Care] Plan Start, Extra, Royaal, Excellent

T Start, T Extra, T Royaal, T Excellent Ziekenhuis Extra [Hospital Extra]

Avro Achmea has acquired the Klantgericht Verzekeren [Customer-oriented insurance] quality mark. Confidence and certainty are essential for the quality of services provided in the insurance sector. The Klantgericht Verzekeren quality mark is issued by the independent Stichting toetsing verzekeraars [Insurers Assessment Foundation] (Stv). The quality mark is only awarded to insurers that provide honest information and dynamic services, are easy to contact, assess customer satisfaction and use the ensuing results to improve services, and pursue a consistent quality policy.
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