OHRA Zorgverzekering 2014

Arranging it yourself
is so easy!
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Arranging it yourself is so easy! 4
The OHRA Zorgverzekering 5

Which supplementary insurance can
you choose? 8
Dental insurance 9
What is covered? 10
OHRA Coverage Guide 11
Mijn OHRA Zorgverzekering 14
Extra Advantages 16
What will it cost you? 17
Arranging your healthcare insurance
immediately? 18
Contents
When it comes to healthcare insurance, you know what
you want and what you dont want. Thats why you want to
choose your own insurance coverage. Only then will you have
an insurance policy that really benets you. This brochure
contains everything you need to know about our healthcare
insurance. The OHRA Zorgverzekering offers excellent service,
easy conditions and a competitive premium. Simply arrange
your insurance by phone or online.
Arranging it yourself is so easy!
You can arrange much more online with OHRA, such as Mijn
OHRA Zorgverzekering; your own online policy folder. You
will always have a clear overview of your insurance, your
healthcare costs, your coverage and more. Together with the
Coverage Guide, you will see exactly what is covered
and whether an excess applies.
New: declarations via your mobile phone
In most cases, your healthcare provider will send your invoice
directly to OHRA. Have you received an invoice? You can
declare it the easy way via your mobile with the OHRA app.
Our healthcare insurance
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With OHRA, your healthcare insurance is arranged well. With
the OHRA Zorgverzekering, you have basic insurance with
which you are insured, for example, for your general
practitioner, the hospital, medication and maternity care.
Additionally, you can choose from
various types of supplementary insurance, including sup-
plementary dental insurance. The OHRA Zorgverzekering is
a non-contracted care policy. This means that you yourself
choose which doctor, which hospital or which
physical therapist you want to treat you. In most cases, your
healthcare provider will send your invoice directly to OHRA.
Basic insurance
The basic insurance is the same for all healthcare insurers.
The government has decided what basic insurance must
cover. Below are the costs that we cover if you choose OHRA
Zorgverzekering:
General practitioner.
Hospital.
Physiotherapy for complaints that are included on a list drawn
up by the government.
Visit www.ohra.nl/vergoedingenwijzer
Medication. The rules on the reimbursement of medication
can be found in our policy conditions.
Maternity care. You must pay a personal contribution.
Medical aids, for example hearing aids. You must pay a
personal contribution for some medical aids.
What costs are not paid under basic insurance?
The OHRA Zorgverzekering
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Physiotherapy for complaints that are not included on the list
drawn up by the government.
Personal contribution for maternity care.
Spectacles, contact lenses and eye laser treatment for persons
aged 18 and above.
Alternative therapies, such as acupuncture.
The costs of dental treatment for persons aged 18 and above.
Orthodontics.
Better cover for costs made outside the Netherlands.
Contraceptives (pill/coil/pessary) from the age of 21.
Courses and exercise programmes (e.g. rst aid, weight
management in the event of obesity, etc)
Excess
Everyone from the age of 18 has a mandatory excess of 360 per
year. This amount is determined by the government. This means
that you must pay the rst 360 yourself. The excess only applies
to those costs covered under the basic health insurance scheme.
The excess does not apply to the following care:
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Care provided by a general practitioner.
Obstetric care.
Maternity care.
Healthcare costs and dental treatment costs for children up to
the age of 18.
Integrated care (a concept where various care providers work
together to agree on the best care for you).
A check-up for kidney or liver donors.
Medical aids on loan.
The excess does not apply to supplementary insurance
policies. You can also choose to increase your excess. Your
premium will then be reduced. You can increase your excess
by 100, 200, 300, 400 or 500. Visit
www.ohra.nl/zorg and calculate how much your premium
will be with a higher excess.
Paying your excess in instalments
Are you expecting healthcare costs and would you rather not
pay this amount all at once? OHRA offers you the opportunity
to pay the statutory excess of 360 in ten monthly instalments
of 36 in advance. If you have not used all your excess during
a calendar year, we will refund the amount overpaid.
Visit www.ohra.nl/zorg for further information.
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Which supplementary insurance can
you choose?
Basic insurance covers a large percentage of care, but not everything.
That is why OHRA has various types of supplementary insurance.
There is always a supplementary insurance to suit your situation.
OHRA has four supplementary insurance packages:
OHRA Sterk (OHRA Strong)
OHRA Aanvullend (OHRA Supplementary)
OHRA Extra aanvullend (OHRA Extra Supplementary)
OHRA Uitgebreid (OHRA Comprehensive)
All these supplementary insurance packages include cover for
physiotherapy, spectacles and contact lenses, alternative medicines,
care abroad, maternity care and orthodontics. You will receive
supplementary insurance coverage on top of your basic insurance.
For a complete summary of all supplementary insurance coverage,
see our package comparer on www.ohra.nl/zorg.
OHRA Growth Service
As your lifestyle changes, you may want to adapt your insurance
to your needs. OHRA takes this into account. Our growth service
enables you to adapt your supplementary insurance once a year, for
example if you and your partner decide to live together or if you are
having a baby. There are no additional conditions for this service.
Choose the right package
You will always make the right choice with OHRA when it comes to
healthcare insurance.
Visit www.ohra.nl/zorg for the OHRA Selection Guide. Here you can
specify which coverage is important for you. Based on your input,
you will immediately see which supplementary package the majority
of people chose. You will immediately know where you stand.
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A large percentage of dental costs is covered for children
and adolescents up to 18 years of age. This is included in the
basic insurance package. Would you like dental coverage for
people above the age of 18? Choose OHRA TandenGaaf or
Tand Sterk supplementary dental insurance.
OHRA TandenGaaf dental insurance
OHRA TandenGaaf insurance covers all kinds of treatments
by the dentist, dental hygienist and prosthodontist. This
includes crowns, bridges, implants and technical costs. Teeth
whitening treatments and subscription fees for the dentist are
not covered by this insurance.
OHRA TandenGaaf enables you to set the maximum
coverage that we pay for your dental costs each year yourself.
You can choose a coverage of 250 or 500. A higher
coverage means a higher premium. We cover your dental
expenses until your maximum coverage has been reached.
OHRA Tand Sterk
OHRA Tand Sterk covers 75% to a maximum amount of 250.
The coverage applies to the following treatments by a dentist
and/or dental hygienist:
Consultations
Fillings
Teeth cleaning
X-rays
Root canal treatment
Anaesthetic
No coverage for, among other things, teeth whitening,
orthodontics, crowns and bridges.
Dental insurance
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What treatments do we pay for you?
It is good to know which dental treatments are covered.
Would you like to know which treatments we pay for you
under OHRA TandenGaaf and OHRA Tand Sterk? Use the
OHRA Coverage Guide on the internet. Enter a search term,
such as teeth extraction or plaque removal.
You will quickly receive answers to questions such as:
What exactly does OHRA cover and what not?
Where can I go?
Do I need prior permission from OHRA?
You will then know where you stand and will be able to
prevent unexpected surprises. The OHRA Coverage Guide
can be found on www.ohra.nl/vergoedingenwijzer.
What treatments do we not pay for you?
OHRA TandenGaaf and OHRA Tand Sterk do not cover
treatments by an orthodontist. Would you like us to pay
treatments by an orthodontist for you? If so, you will need
supplementary insurance. For more information, please visit
www.ohra.nl/zorg.
No excess
OHRA TandenGaaf and OHRA Tand Sterk do not have an
excess. This means that we always fully reimburse the dental
costs for which you are insured up to the annual amount that
you choose.
What is covered?
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Would you like to know what OHRA Zorgverzekering covers?
The OHRA Coverage Guide gives you quick and clear
answers to important questions, such as:
What exactly is covered and what not?
Do I have to pay a personal contribution?
Do the costs count for the statutory excess?
Which care provider can I go to?
Do I need permission from OHRA prior to treatment?

How does it work?
Go to www.ohra.nl/vergoedingenwijzer. Then select the
Coverage Guide. Enter a search term, such as acupuncture,
or search in alphabetical order. You will then see the
amount that we cover. You will also see whether you need
to ask OHRA for prior permission. This is how you can avoid
unexpected surprises.
What should a treatment cost?
How do we determine what a medical examination or
treatment should cost? Or what the cost of transport should
be? There are three possibilities:
The government has established the cost. This applies to
most situations.
We have agreements with care providers.
We have determined ourselves what a reasonable amount
is for a treatment, a medical examination or transport. These
are what are known as market rates.

OHRA Coverage Guide
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In all cases the person providing treatment and/or the care
institution must comply with the conditions of OHRA.
Sometimes exceptional rules apply where it concerns
reimbursements. Below are the main rules:
Do we pay for your physiotherapy?
Are you receiving physiotherapy or remedial therapy? If so,
you must pay the rst 20 treatments yourself. We will pay the
21st treatment and any subsequent treatments. However,
your complaint must be included on the list drawn up by the
government. In that case, the costs will be covered under the
basic insurance package. You can nd the list on
www.ohra.nl/zorg. Is your complaint not included on the list
drawn up by the government? In that case we will only pay
the costs if you have taken out supplementary insurance.
For children up to the age of 18 we will pay the rst nine
treatments. This is included in the basic insurance package.
If the complaints have not subsided after treatment, we will
pay a maximum of nine further treatments. If the complaints
are included on the list drawn up by the government, OHRA
will reimburse all the costs. Would you like more coverage
for physiotherapy and remedial therapy? You can take out
supplementary insurance that is tailored to your needs.
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Do we pay for your medication?
This is often the case. For some medication you will have
to pay a personal contribution, or you will have to ask
prior permission from OHRA. Sometimes we only pay for
medication from certain manufacturers. For example, this
applies to medication to reduce cholesterol. OHRA has
established some rules in this regard.
The government has liberalised the price of all medication.
This means that pharmacists may determine what rates to
ask for medicine or for personal advice themselves. If you go
to a pharmacist with whom we have an agreement, OHRA
will reimburse the amount that the pharmacist charges. If you
go to another pharmacist, we will reimburse the market rate.
Will we reimburse you for care abroad?
Do you need care abroad? If so, we will pay the maximum
amount of care that it would have cost in the Netherlands.
Do you know in advance that you will be admitted to a
hospital abroad? For example because you are planning to
have treatment abroad? In that case you will need our prior
permission or you will not receive any reimbursement.
Do you wish to be insured for emergency assistance abroad?
Then it would be wise to take out supplementary insurance.
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Mijn OHRA Zorgverzekering
OHRA Zorgverzekering administration is easily arranged via
Mijn OHRA Zorgverzekering. This is an online policy where
your details are conveniently organised. You can submit
changes, declare invoices from your care provider electro-
nically, track the status of your claims and see what is reim-
bursed at a single glance, wherever and whenever you wish.
You can even order your medication from the pharmacist
online.
Electronic declarations
OHRA enables you to submit your declarations online. Simply
ll in a declaration form on Mijn OHRA Zorgverzekering, make
a copy or scan your invoice and send everything to OHRA
online. No more hassle with receipts and postage stamps
and no more paperwork.
Status of your declaration
Mijn OHRA Zorgverzekering gives you immediate access
to the status of your declaration. Has OHRA received your
declaration? Will the declaration be reimbursed? Mijn OHRA
Zorgverzekering gives you an answer immediately.
Wherever and whenever you wish!
Status of maximum reimbursements
Do you wish to know how many reimbursements you still
have? You can check the status of your maximum reimbur-
sements in Mijn OHRA Zorgverzekering. You will nd a sum-
mary of your reimbursements for physiotherapy, spectacles
and contact lenses, alternative care, orthodontic and dental
treatment.
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Submitting changes
You can quickly and easily change your personal details and
those of your family. Do you wish to co-insure a member of
your family? Will you be moving house shortly? Or do you
wish to submit another bank account number? Changes can
be submitted via Mijn OHRA Zorgverzekering, even outside
ofce hours.
Simply ordering medication online
As an extra service, OHRA Zorgverzekering enables you to
order your medication online. You no longer need to leave the
house to go to the pharmacist. Neither do you need to stay at
home to await delivery of your medicines, because most of
them t through the letter box and are packaged as
childproof and pet-friendly. The medicines are delivered to
any address in the Netherlands. Do you need a prescription
for your medicines? Your general practitioner or specialist can
send this by e-mail. If that is not possible, you can send the
prescription by post. Your order will then be delivered to your
home free of charge.
Would you already like to experience the online convenience
of Mijn OHRA Zorgverzekering yourself?
Visit www.ohra.nl/zorg for a demonstration.
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OHRA Zorgverzekering offers you a discount on products
and services that help you remain healthy and t. All care
advantages are offered directly by our partners. Therefore,
they have no inuence on the amount of your premium. The full
customer benets programme can be found on
www.ohra.nl/korting.
Mobility
Discount at almost 500 tness centres in the Netherlands.
Discount on Tulp bicycles.
Free running schedule.
Discount on sports clothes at Aktiesport.
Prevention
25% discount on Euro - Codicil lifesaving card.
20% discount on UV-resistant childrens clothing.
Treatments and medical aids
Discount on spectacles and contact lenses at Het Huis Eyewish
Opticians and Specsavers.
Discount on travel vaccinations.
Relaxation
Discount at saunas.
Discount on a oating session.
Discount on various magazines.
Extra Advantages
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The amount of your premium depends on the type of insurance
that you choose. Calculate your premium on www.ohra.nl/zorg.
OHRA Zorgverzekering does not charge administration or policy
costs. Additionally, you can receive discounts on your premium in
various ways. How? Read all about it below.
Group discount
We have agreements with many employers, associations, senior
citizens associations, housing corporations, retailers and other
organisations. As a result, you will receive a discount on your
OHRA Zorgverzekering. For more information, please visit
www.ohracollectief.nl.
Discount when you pay per quarter or per year
As a rule, the premium for your healthcare insurance is paid
each month. Would you rather pay per quarter? If so, you will
receive a discount of 0.75%. Do you wish to pay per year? You
will receive a discount of 3%.
Take advantage of the OHRA Package Discount
On our already low premiums, you can in addition get a
package discount. The principle is simple: the more insurance
you take out, the higher your discount. If you take out three
insurance policies, you will receive a discount of 3%, four
insurance policies 4% discount, and so on. The discount can run
up to no less than 10%. OHRA does not give package discounts
on life insurance policies, temporary travel and cancellation
insurances or the OHRA Zorgverzekering basic package. Does
your employer or association have a group contract with OHRA?
In that case other discount percentages may apply.
What will it cost you?
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Do you wish to take out healthcare insurance immediately?
Visit www.ohra.nl/zorg. You can also immediately calculate
your premium and take out your OHRA Zorgverzekering.
Arranging your healthcare insurance
immediately?
This brochure has been compiled with the utmost care. However,
the text in the brochure does not give you any rights. Neither can
you derive any rights from the OHRA Coverage Guide: the policy
conditions and regulations shall prevail. The policy conditions state
precisely what your and our rights and obligations are. At the time of
printing of this brochure, the changes were not nal. These changes
are the changes proposed by the government. Until such time as
the government makes a nal decision on these changes, the policy
conditions may still be subject to change. For the most recent version
of the reimbursements, please read the policy conditions at
www.ohra.nl/zorg.
OHRA Schadeverzekeringen is a trade name of Delta Lloyd
Schadeverzekering N.V. in Amsterdam - CoC 33052073, PO Box
40000 - 6803 GA Arnhem - the Netherlands - Rijksweg West 2 -
www.ohra.nl - Tel +31 (0)26 400 40 40
OHRA Schadeverzekeringen is the intermediary for OHRA
Zorgverzekeringen N.V. and OHRA Ziektekostenverzekeringen N.V.,
both part of CZ.
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For more information
please visit
www.ohra.nl/zorg
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