Package Comparer OHRA Zorgverzekering 2014

Basic insurance
OHRA
Zorgverzekering
(Health insurance)
Excess
Personal
contribution
OHRA
Strong
OHRA
Supplementary
OHRA
Extra
Supplementary
OHRA
Comprehensive
Alternative healing and remedies
Total compensation alternative healing and remedies 250 500 750
Alternative healing 45 per day 45 per day 45 per day
Alternative remedies (registered as homeopathic or anthroposophic medication) full cover full cover full cover
Delivery and maternity care
Hospital delivery on medical grounds
Hospital delivery or maternity care without medical grounds
yes, personal contribution
formaternity care
Use of delivery room
Obstetric care by a midwife, general practitioner or specialist
Statutory personal contribution for hospital delivery full cover
Maternity care
Tip: request maternity care at the latest five months before the expected delivery date through
Mijn OHRA orgverzekering
Maternity care in maternity centre or hospital without medical grounds
16.50 per day. If your care provider
declares more than 116.50 per
day, the excess amount is paid by
you as personal contribution.
Maternity care at home. You must apply by the 4th month of pregnancy at the latest. maximumof 10 days 4.10 per hour
Birth kit service
Personal contribution for maternity care full cover
Incubator aftercare 15 hours
Breastfeeding advice 200
Maternity care following hospitalisation 15 hours
Additional maternity care (only on medical grounds) Prior consent required. 5 x 3 hours
Maternity care for adopted child younger than 6 months. Prior consent required. 3 x 3 hours
Fertility treatments
IVF/ICSI for women up to the age of 43 (at a government-improved institution) and associated hormonal
preparations
attempts 1, 2 and 3 yes
Other fertility treatments yes
Prenatal screening
Prenatal screening on medical grounds
Prenatal screening without medical grounds for women older than the age of 36
Prenatal screening without medical grounds for women younger than the age of 36
Other
Monitoring equipment to prevent cot death. Prior consent required.
Courses on childbirth 200
GeboorteTENS (equipment to combat pain). Prior consent required.
Spectacles/contact lenses/eye laser treatment
Spectacles/contact lenses/eye laser treatment, per 2 calendar years 50 50 75
Abroad
Area of cover world world world world
Non-emergency assistance abroad. Prior consent required for hospitalisation.
100% according to standard rates
in the Netherlands
yes
Emergency assistance abroad
100% according to standard rates in
the Netherlands
yes full cover full cover full cover full cover
Helpline:
- Travel physician service service service service
- Repatriation of patients/injured persons service service service service
- Repatriation of deceased service service service service
- Sending medicines service service service service
- Telecommunication costs 350 350 350
Emergency dental treatment from the age of 18 250 250 250 250
Travel inoculations 250 250 250
This package comparer enables you to
see at a glance which coverage is inclu-
ded under which insurance package. It
is an easy way to compare the different
types of health insurance provided by
OHRA. Eligibility for compensation is sub-
ject to a number of conditions, which you
will find in the General Terms & Conditions
and in the compensation overview pertai-
ning to your insurance.
Basic insurance
The government determines the compensation under the basic insu-
rance. These amounts, which are included in this overview, are valid
per insured person per calendar year, unless otherwise stated. Under
the excess column you can see whether a compensation falls under
the excess. The excess is only applicable to insured persons aged 18
and older. Under the personal contribution column you will see the
amount that all insured persons must pay. The personal contribution
has been established by the government and is a separate matter
from your excess.
Supplementary & dental insurance
Would you like more coverage than your basic insurance
allows? Supplementary insurance, including dental
coverage, is available. All amounts in this package com-
parer are maximum amounts and are valid per insured
person per calendar year, unless stated otherwise. In all
cases, the care provider and/or institution must be appro-
ved and recognised by OHRA. The maximum compensa-
tion is based on the standard market rates.
Standard market rates
When you see the symbol in the package com-
parer, it means that this type of care is insured.
OHRA usually agrees on the rates with care
providers in advance. In those cases, OHRA will
apply the agreed rates. If you visit a care provider
with whom OHRA does not have an agreement,
you will receive the maximum compensation
based on the standard market rates in the
Netherlands.
Basic insurance
OHRA
Zorgverzekering
(Health insurance)
Excess
Personal
contribution
OHRA
Strong
OHRA
Supplementary
OHRA
Extra
Supplementary
OHRA
Comprehensive
Pharmaceutical care
Dietary preparation (for certain medical conditions) yes
Medicines such as antibiotics
according to drug
compensation system
yes
possible (in the drug compensation
systemyou will nd the maximum
compensation and exceptional
personal contribution)
Contraceptives (pill/coil/pessary) up to the age of 21
according to drug
compensation system
yes
possible (in the drug compensation
system you will find the maximum
compensation and exceptional
personal contribution)
Contraceptives (pill/coil/pessary) from the age of 21 200 200 200
Compensation of statutory personal contribution drug compensation system 25 50 150
Compensation of statutory personal contribution for contraception up to the age of 21 full cover full cover full cover
Recovery, accommodation and aftercare
Convalescent homes. Prior consent required. 250 500 1,000
Recovery and Balance programme for ex-cancer patients (per treatment programme) 250 500
Therapeutic (holiday) camp for children (for certain indications) 200
Childcare during hospitalisation 200
Accommodation costs for 1 room at the guest house rate (e.g. Ronald McDonald house) 200
Health resorts (for certain indications) Prior consent required. 500 1,000
Trauma processing
Assistance with recovery service
Hospice
Personal contribution hospice 500 1,000
Skin therapy (prescribed by a physician)
Acne treatment 50 100 150
Camouflage therapy 50 100 150
Depilation or laser treatment (facial/neck hair removal) for female insured persons 250 500 1,000
UV-B light therapy equipment (purchase or rental costs). Prior consent required. yes 500 1,000
General practitioner
Care provided by general practitioner
Preventive foot care for diabetic patients
Medical care aids
Medical aids (such as wigs, hearing aids)
see OHRAs Medical Aids
Regulations
yes, except when on loan
possible (in the Medical Aids
Regulations you will find the maxi-
mum compensation and exceptional
personal contribution per aid)
Personal contribution medical aids basic insurance 500 1,000
Head cover other than a wig 75 75
Personal alarms 150
Epilepsy alarms
Bed-wetting alarm for insured persons aged 7-18
(purchase cost or rental cost for a maximum of 90 days for insured persons aged between 7 and 18)

Cranial helmets (for certain indications)
Support soles 100 150
Therapeutic sports braces 150 150 150
Medical specialist care
Hospital care maximum of 365 days yes
Day-care nursing, hospitalisation and care several days maximum class 3 yes
Specialist costs during hospitalisation. The following treatments are excluded: sterilisation, reversal of sterilisation,
circumcision, snoring treatment, upper eyelid correction when the eyelid covers at least half of the pupil causing
severe visual impairment, correction of the ear position and breast prosthesis unless a mastectomy has been car-
ried out. Look under the heading other for compensation of these medical conditions.
yes
Additional costs (costs during hospitalisation):
- use of operating theatre yes
- medicines and dressings, X-rays, laboratory, physiotherapy in the hospital yes
Outpatient specialist care
Specialist costs during hospitalisation. The following treatments are excluded: sterilisation, reversal of sterilisation,
circumcision, snoring treatment, upper eyelid correction when the eyelid covers at least half of the pupil causing
severe visual impairment, correction of the ear position and breast prosthesis unless a mastectomy has been car-
ried out. Look under the heading other for compensation of these medical conditions.
yes
Use of operating theatre yes
X-rays, laboratory tests and medicine and dressings yes
Radiotherapy yes
Kidney dialysis in hospital (outpatient) or at home yes
Thrombosis service yes
Sperm freezing or storage in the event of impending fertility reduction as a result of oncological treatments. yes
Obesity, outpatient (once for the entire insurance period) 500
Admission and/or treatment in connection with transplantation of specified organs
Heart, bone, kidney, liver, skin, cornea, bone marrow, lung, heart/lung and kidney/pancreas
yes, except for check-ups after a
kidney/liver donation.
Tissue type tests. Prior consent required. yes
Aftercare costs if you have received a donor organ (transport, operation and donor care) 13 weeks yes
Basic insurance
OHRA
Zorgverzekering
(Health insurance)
Excess
Personal
contribution
OHRA
Strong
OHRA
Supplementary
OHRA
Extra
Supplementary
OHRA
Comprehensive
Other
Costs of Independent Treatment Centre. The following treatments are excluded: sterilisation, reversal of sterilisation,
circumcision, snoring treatment, eyelid correction, correction of the ear position and breast prosthesis unless a
mastectomy has been carried out. Look below for the amount of reimbursement of these medical conditions.
yes
Audiological care (by an approved audiological centre) yes
Genetic testing (by an approved centre) yes
Medically necessary cosmetic surgery (excluding the number of treatments
not covered under the policy conditions). Prior consent required.
yes
Cosmetic surgery (breast prosthesis replacement other than after a mastectomy,
correction of protruding ears and upper eyelids when the eyelid covers at least
half of the pupil causing severe visual impairment). Prior consent required.

Non-medically necessary circumcision for insured male persons 250 250

Medically necessary circumcision for insured male persons
Male sterilisation 400
Female sterilisation 1,250
Reversal of sterilisation (m/f).
Second opinion by a physician (not a dentist or an oral surgeon) yes
Revalidation yes
Surgical treatment for snoring
Artificial respiration yes
Help during the treatment of children with cancer (SKION)
Sports medical consultations
Courses and exercise programmes (incl. First Aid, diet and weight management in the event of overweight,
how to stop drinking alcohol and reanimation)
100 150 200
Sports medical examination 100 100 100
Dental care
Dental care up to the age of 18
Check-ups (as indicated by the dentist, several times a year possible) 1x per year
Fluoride treatment 2x per year
Other dental care (excluding crowns, bridges, inlays, dental bleaching and orthodontics).
Crowns and bridges 500 500 500
Dental care from the age of 18
Complete dentures (upper and/or lower) 75%, 1 x 5 years yes 25%
Repairs and rebasing (filling) complete dentures (upper and/or lower) yes
Compensation personal contribution complete dentures (upper and/or lower) 200
Dental care in exceptional cases
For certain indications/disability. Prior consent required. yes
Orthodontics
Orthodontics up to the age of 18 (once for the entire insurance period) 1,000 2,000
Orthodontics from the age of 18 (once for the entire insurance period) 250 250
Orthodontist in exceptional cases (for certain indications). Prior consent required. yes
Implants (for certain indications). Prior consent required.
Compensation dentist and oral surgeon yes
Polyclinic and clinical additional costs (hospital) yes
Suprastructure yes
Upper or lower dentures on implant yes 125
Upper and lower dentures on implant yes 250
Therapies
Physiotherapy up to the age of 18
Physiotherapy and Cesar/Mensendieck exercise therapy, per indication. Prior consent required if you visit a care
provider with whom OHRA does not have an agreement.
max 9 treatments (if unsatisfactory
result a further
9 treatments at maximum)
Physiotherapy for indications that are included on the list of disorders, as determined by the
government. See www.ohra.nl. Prior consent required.

Physiotherapy from the age of 18

From the 21st treatment for indications that are included on the list of disorders, as
determined by the government. See www.ohra.nl. Prior consent required.
yes
Physiotherapy for all ages
Physiotherapy and Cesar/Mensendieck exercise therapy
9
treatments
4
treatments
9
treatments
18
treatments
Screening physiotherapy
Ergotherapy 10 hours yes
Ergotherapy up to 18 years of age, in addition to the basic insurance coverage 2 hours 2 hours 2 hours
Instruction and supervision care providers of the insured persons receiving ergotherapy 2 hours 2 hours 2 hours
Other
Pelvic therapy through urinary incontinence 9 treatments yes
Speech therapy yes
Dyslexia: diagnosis and treatment of severe dyslexia for 7-year-olds to 12-year-olds.
Phototherapy (rental/purchase price of the unit) 100 150 250
Foot treatment and counselling for medical indication rheumatoid arthritis or severe vascular problems in the legs.
Prior consent required.
50 100 150
Foot treatment other situations (by chiropodist or podiatrist, prescribed by a physician) 50 100 150
Stutter therapy. Prior consent required.
Dietary advice 3 hours yes 100 150
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Basic insurance
OHRA
Zorgverzekering
(Health insurance)
Excess
Personal
contribution
OHRA
Strong
OHRA
Supplementary
OHRA
Extra
Supplementary
OHRA
Comprehensive
Preventive care
Stop Smoking programme (combined with medicines), dealing with depressive symptoms and alcohol abuse yes
Influenza immunisation 1 x per year
General preventive and work-related examinations, 1 x per year 50 100 150
Psychological care
Primary psychological care
Primary psychological care (including internet treatment process) yes
Secondary psychological care
Psychiatric help with admission 365 days yes
Psychiatric help without admission yes
Psychotherapy (for personality disorders per indication and other disorders) yes
Other
Consultations and counselling for women (including menopause counsellors, carefree pregnancy advice and
cancer prevention advice)
200
Transport
Ambulance transport service (one way) maximum of 200 kilometres yes
Seated patient transport (one way) in the following situations: maximum of 200 kilometres 96 per year
- Own car. Prior consent required. 0.31 per kilometre yes
- Taxi. Prior consent required. yes
Seated patient transport is only reimbursed in the following instances:
- For renal dialysis treatments
- For radiotherapy or chemotherapy treatments
- If you are blind or visually impaired
- If you are wheelchair dependent
- In the case of long-term illness or a disorder and you have a certificate from your physician that you have to rely
on transport long-term.
Travel expenses of parents (0.19 per kilometre) 200
Transport of the patient by own car (per kilometre). Prior consent required. 0.19 0.19
Transport of the patient by taxi. Prior consent required. 100% for contracted care, maximum rate per kilometre for
non-contracted care.

Waiting list mediation service
Dental insurance for insured persons of 18 and above
Tand Sterk TandenGaaf 250 TandenGaaf 500
Dental treatment by a dentist or oral hygienist for maintenance of the teeth:
- consultations
- fillings
- teeth cleaning
- dental extractions
- X-ray
- root canal treatment
- anaesthetics
75% up to 250 100% up to 250 100% up to 500
Crowns, bridges, implants, dentures and inlays. 100% up to 250 100% up to 500