Resident and/or Insured in a Foreign Country

A resident of the European Union

As an EU resident, you will most likely have one of the most common insurance certificates. Below are a few insurance situations that might apply to you. We recommend contacting your insurer to see whether they can issue one of these insurance certificates.

1. European Health Insurance Card (EHIC)
   The EHIC is an insurance card that enables you to prove your residence in the EU or another treaty state*. In many cases, the EHIC is only valid for emergency care, unless you are insured through the Centraal Administratie Kantoor (CAK) in the Netherlands. In that case, you are entitled to more extensive medical care in the Netherlands. Read more about the EHIC.
   
   * The other treaty states are Norway, Iceland, Liechtenstein, and Switzerland.


2. CZ-AOK card
   This is an insurance card that you might have if you are resident in Germany. This card enables you to attend for planned care. With it, we can submit the care invoice to CZ Buitenland. Read more about the AOK CZ card.


3. S2 or E-112 form
   With this form, your insurer grants permission for planned medical care in the Netherlands. Read more about the S2 or E-112 form.

If you have private insurance or no insurance, you can still receive treatment at Radboudumc. Other conditions apply in this case.

If you don’t see your situation here or have another query, please contact the Costs of Care information point.

• E kostenvanzorg@radboudumc.nl
• T +31(0) 243613393, available Monday to Friday from 9 am to 1 pm.

Not a resident of the European Union

Letter of Guarantee

In some cases, we may be able to accept letters of guarantee from foreign or private insurers. It is important that they satisfy our conditions. It is important to note that the costs of care are calculated differently in the Netherlands compared with other countries, and that the care invoice may, in some cases, be sent several months later.

Always contact us beforehand to discuss this.

You can read more about how the costs of care are calculated in Dutch hospitals here.

If you are resident in Norway, Iceland, Liechtenstein, or Switzerland, you may have an insurance document that is also valid for residents of the EU.

Advance invoice

If you are unable to supply a letter of guarantee, perhaps because you are uninsured, your appointment can still go ahead if you pay an advance invoice first.
In that case, please contact the Costs of Care information point.

• E kostenvanzorg@radboudumc.nl
• T +31(0) 243613393, available Monday to Friday from 9 am to 1 pm.

European Health Insurance Card (EHIC)

The EHIC is an insurance card that enables you to prove your residence in the EU or another treaty state*. In many cases, the EHIC is only valid for emergency care, unless you are insured through the Centraal Administratie Kantoor (CAK) in the Netherlands. In that case, you are entitled to more extensive medical care in the Netherlands.

* The other treaty states are Norway, Iceland, Liechtenstein, and Switzerland.

You can recognize an EHIC by its blue back and European Union logo. The logo contains the country code, as shown below. The white bars contain your personal information and the validity date of the card.

If you see “NL” inside the logo, you are insured in accordance with basic insurance conditions in the Netherlands. In that case, please send us a copy of your card.

If there is a different country code inside the logo, it means that the card is valid solely for emergency care. For planned care, you can request an E-112 or S2 letter of guarantee from your insurer abroad.

If you send us a copy of your card, we will declare the care invoices through intermediate insurance for you. You can upload your copy securely via www.radboudumc.nl/en/secureupload, e-mail it to kostenvanzorg@radboudumc.nl, or mail it to:

CZ-AOK card

This card allows you to receive both emergency care and most planned care.

If you send us a copy of your card, we will declare the care invoices through CZ intermediate insurance for you.

E kostenvanzorg@radboudumc.nl
T +31(0) 243613393, available Monday to Friday from 9 am to 5 pm.

Explanation of healthcare costs in the Netherlands

Foreign insurers often request a statement that itemizes the costs of care for each activity. In other words: a cost breakdown. In addition, the care invoice often needs to be submitted quickly. Unfortunately, Radboudumc is unable to satisfy either of these conditions. As hospital care is arranged differently in the Netherlands, we would be happy to explain this to you.

One Price Per Treatment Period

If you are treated in hospital, the hospital will not charge for every scan, injection, or treatment separately. You will pay for your hospital care through what are known as DBC care products. DBC stands for Diagnose Behandeling Combinatie, or in English, Diagnosis Treatment Combination (your care path). DBC healthcare products form the basis of Dutch hospital care finance. This means that you do not settle each component of your examination or treatment separately, but pay one price for the entire care path.

A DBC healthcare product has a maximum duration of 120 days. If a patient has a chronic illness and undergoes long-term treatment, consecutive DBC healthcare products are registered over the years. 
DBC healthcare products are a type of care path that are usual for a certain kind of treatment, such as a broken arm. The price for this care product is an average of all costs associated with this form of break.
The scope of the treatment is important – there is a difference between a patient staying overnight in hospital or returning home immediately. Whether or not a patient needs an operation also makes a difference. The number of visits to the medical specialist can also play a role.

The final price

The DBC healthcare product is officially determined at the end of the treatment. The Dutch Healthcare Authority (NZA) is the supervisory body for all the healthcare markets in the Netherlands and determines which DBC healthcare products hospitals can declare. The NZA also determines the rules regarding start and end dates of a healthcare product. It is possible for a patient to have more than one healthcare product at once if he/she is being treated for more than one ailment by different specialists

Why can it sometimes take several months for you or your insurer to receive a care invoice?

Treatments take different amounts of time. Even if you have just one visit, your DBC (care path) often lasts for many more months. This is because of the way that the system in the Netherlands is structured.

Large Bill for Small Amount of Care?

The costs of a treatment, or a DBC care product, are based on the average costs for the respective treatment. It is not a total of the costs for the activities, but is based on the average costs that are incurred when treating a patient.

DBC care products are care packages that are usual for a certain kind of treatment, such as a broken arm. The price for this care product is an average of all costs associated with this form of break. Consequently, it makes no difference if one or five X-rays are taken. If the patient feels that very little treatment was provided by the hospital, the care invoice may seem expensive. But the opposite can also be true.

If you would like to receive further information after reading this page, please contact the Costs of Care information point.

• E kostenvanzorg@radboudumc.nl
• T +31(0) 243613393, available Monday to Friday from 9 am to 1 pm

Price indication

A price indication is based on the costs of care anticipated on the basis of your information. The actual costs are based on the examinations that you need, the diagnosis that the medical specialist gives you, and the treatment that you undergo. In some cases, you may need to be seen by a doctor before a price indication can be provided.

Standard prices

You can look up the standard prices yourself. To do this, you need the care product code or declaration code for the anticipated treatment. You can find the standard price lists here.

Requests

You can request a price indication using the price indication request form. You can expect to receive a response within one to two weeks.
 

Conditions for Letters of Guarantee

• Your name and date of birth must be provided;
• The guarantee must be issued for a specific amount (where applicable, based on an advance invoice issued by us) or the guarantee must be issued for the entire treatment within the specialism in question;
• A description of the treatment or the specialism to which the letter of guarantee relates must be provided;
• The letter of guarantee must be in Dutch, English, or German;
• The treatment must be invoiced in accordance with Dutch law. This means that:
  • A price per activity cannot be provided;
  • No deadline may be specified by which the care invoice is declared;
  • The care invoice is provided in Dutch only;
• For privacy reasons, you are responsible for requesting medical information from the respective department if the insurer requests it;
• Care invoices will only be sent to you. It is possible to have care invoices sent to your insurer (as well), provided that you have given your consent for this to happen. You remain ultimately responsible for payment.