For many patients, it is not entirely clear what care is declared for the health insurance. On this page you will find more information about the excess and what applies with regard to the laboratory diagnostics.
The excess is the amount that the patient himself/herself pays for the care that is compensated by the basic insurance.
In the Netherlands, as of age 18 anyone who receives care under the basic insurance is obliged to pay an excess. The excess is paid in addition to the health insurance premium.
There are two different excesses possible:
Statutory excess Voluntary excess
385 euro 885 euro
The excess applies for an entire calendar year (1 January through 31 December).
General practitioner care and care declared via the general practitioner within sequenced care do not fall under the excess of your patients. This means that this care is fully compensated by the health insurance. The patient does however pay for costs incurred in the hospital, the pharmacy and laboratory costs.
Lisa is 21 years old, still studying and has opted for a voluntary excess of €885 euros, in order to keep her monthly costs low. On the basis of her complaints, you decide to take a swab, so that this can be tested for a number of STD´s.
On the laboratory form you tick Chlamydia trachomatis, Neisseria gonorrhoeae and Mycoplasma genitalium. After the sample is taken, you send it to us in accordance with the instructions. After processing and diagnosis, you receive the results of the requested PCR tests.
Eurofins | NMDL-LCPL then declares the Dutch Healthcare Authority rates for the requested tests to Lisa´s health insurance company. Chlamydia trachomatis €31.52 euros, Neisseria gonorrhoeae €31.52 euros and Mycoplasma genitalium €66.35 euros. A total of €129.39 euros is declared. Lisa hasn´t used any excess yet during this calendar year. This means that she herself pays from her voluntary excess the €129.39 for the incurred laboratory costs.
Mr Jansen is 60 years old and has a statutory excess of €385 euros. On the basis of his complaints, you decide to remove a skin lesion for histological examination. After excision, you fully complete the request form and send it in to the laboratory together with the material for examination. After processing and diagnosis, you receive the pathology report with the test results.
Eurofins | NMDL-LCPL then declares the incurred costs to Mr Jansen´s health insurance company. The invoicing is determined according to the nature of the material, acquisition method, question posed and diagnostic conclusion. The invoicing is based on the examination process, the size of the skin fragment, any extra colourings in case of suspicion of malignancy. To illustrate: a biopsy of a wart or mole (neoplasia) costs an average of €63.35, a complete removal of a wart or mole costs €126.07 and a biopsy (non-neoplasia) costs €161.39, regardless of the number of skin fragments and the acquisition technique.
Mr Jansen hasn´t used any excess yet during this calendar year. This means that he personally pays the invoiced amount, in accordance with the NVVP guidelines, for the incurred laboratory costs from his excess.