As hearing care professionals, we find that many clients do not know exactly how their health insurance works, especially when it comes to hearing aid reimbursement. It is important to understand the difference between a natura policy and a restitution policy, as this affects your freedom of choice and the costs you may have to pay yourself. In this blog, we explain what these policies entail, how they affect hearing aid reimbursement, and why it may be advantageous to choose a restitution policy in 2025, given the minimal price difference.
What is a natura policy?
A naturapolis is a health insurance policy in which the insurer contracts with specific health care providers, such as audiologists. If you choose a contracted audicien, the cost of your hearing aid will be reimbursed in full, except for the statutory co-payment of 25%. However, if you choose a non-contracted audicien, you will only receive partial reimbursement, often between 70% and 80% of the market rate.
Important to know:
- Limited Choice: You are bound to the health care providers with whom your insurer has a contract.
- Lower premium: A natura policy usually has a lower monthly premium than a restitution policy.
- Direct Billing: Contracted health care providers bill directly to the insurer, so you do not have to advance costs.
What is a restitution policy?
A restitution policy offers you complete freedom in choosing your health care provider. You can go to any audicien, regardless of whether they have a contract with your insurer. Costs are fully reimbursed up to the market rate, except for the statutory co-payment of 25%. This means that you will have no unexpected extra costs if you choose a non-contracted audicien.
Important to know:
- Full freedom of choice: You can decide which audiologist to go to.
- Higher premium: A restitution policy often has a higher monthly premium than an in-kind policy.
- Billing Process: Sometimes you must first pay the bill yourself and then bill your insurer. Horend Goed submits the bill for you if it involves hearing care.
Why is this important for hearing care?
When purchasing a hearing aid, it is essential that you feel comfortable with your audiologist and have confidence in the care provided. Your choice of an in-kind or restitution policy affects your options:
- Naturapolis: If your audicien does not have a contract with your insurer, you will receive only partial reimbursement, which can lead to higher deductibles.
- Refund Policy: You have complete freedom of choice and are reimbursed up to the market rate, regardless of whether there is a contract.
What will change in 2025?
In 2025, the price difference between natura and restitution policies will be minimal. For just a few extra euros a month, you can opt for a restitution policy and thus gain full freedom of choice. This can be especially advantageous if you would like to stay with a specific audiologist, regardless of whether there is a contract.
Overview of basic insurance and premiums in 2025
Below is an overview of some common basic insurance policies in the Netherlands for 2025, including premiums:
| Insurer | Policy name | Policy type | Premium per month |
|---|---|---|---|
| DSW | Health Insurance | Refund | € 158,50 |
| Silver Cross | Basic Sure | Natura | € 156,25 |
| Silver Cross | Basic Exclusive | Refund | € 172,75 |
| CZ | Care-on-demand policy | Natura | € 159,99 |
| CZ | Care Aware Policy | Natura | € 156,95 |
| VGZ | Wide Choice | Natura | € 157,30 |
| VGZ | Own Choice | Combination | € 171,65 |
| Univé | Care Select | Natura | € 149,90 |
| Univé | Care Arranged | Natura | € 157,70 |
| Bewuzt | Bewuzt Basic | Natura | € 149,90 |
| Menzis | Basic Advantageous | Natura | € 151,25 |
| Menzis | Basic | Natura | € 156,25 |
| Menzis | Basic Free | Refund | € 173,50 |
Note: Premiums may vary based on personal circumstances and additional insurance policies.
Conclusion
It is important to know what health insurance policy you have and what this means for hearing aid reimbursement. With a naturopathic policy, you may face limited freedom of choice and additional costs if your audiologist does not have a contract with your insurer. A restitution policy offers complete freedom of choice and avoids unexpected costs, and in 2025 the price difference with a natura policy is minimal. Therefore, when choosing your health insurance, consider which policy best suits your hearing care needs and desires.
