Optifit
As of 1 January 2021, part of the benefits included in Optifit will change. We make these changes to better match the coverage of Benfit with the wishes of our insureds. As a result, we were able to lower the premium for this plan.
What will change for you?
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The maximum reimbursement limits for acne treatment will be lowered. The coverage will also apply to the treatment of cured acne scars.
What does this mean for you?
Optifit will offer a maximum reimbursement of €300 per calendar year for insureds up to the age of 21 instead of a 100% coverage.
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The coverage of alternative medicine will change. Alternative movement-related care (chiropractic, osteopathy, and manual therapy E.S.) will be covered under alternative medicine and movement-related care (in 2020, this was covered under posture, movement, and sport). A reimbursement limit will apply.
The following applies to all supplementary plans:
- we will no longer reimburse (laboratory) tests
- we will reimburse a maximum amount per day instead of per treatment
What does this mean for you?
Optifit will reimburse €50 per day, up to a maximum of €550 per calendar year.
ount per day instead of per treatment
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Optifit will cover exercise programmes for up to €250 instead of €500 per calendar year.
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From 1 January 2021, Optifit will reimburse consultations with a breastfeeding specialist up to a maximum amount per calendar year, instead of a maximum number of sessions.
What does this mean for you?
Optifit will reimburse up to a maximum of €300 instead of 4 sessions per calendar year.
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The maximum coverage for glasses, lenses and laser eye treatment has been reduced. Optifit will reimburse a maximum of €150 instead of €175 per 2 consecutive calendar years.
What does this mean for you?
If you have Optifit in 2020 and 2021 and used €100 of the maximum reimbursement in 2020, you will have €50 left to spend in 2021, instead of €75.
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The reimbursement limits will change per 1 January 2021.
The Oedema and scar therapy coverage will be combined with the Physiotherapy and remedial therapy coverage. As a result, the maximum number of treatments also apply to oedema or scar therapy from a skin therapist.
What does this mean for you?
Optifit will cover 30 instead of 35 treatments per calendar year, of which up to 9 manual therapy sessions will be reimbursed.
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Since 2020, general remedial educationalists are listed in the register of the Wet BIG (Dutch Individual Health-Care Professions Act). Therefore, a general remedial educationalist no longer needs to be listed in the registers of NVO / SKJ to be eligible for reimbursement.
What does this mean for you?
If you plan on consulting a general remedial educationalist, you do not need to check whether he or she is registered with NVO or SKJ. A BIG registration is sufficient.
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From 1 January 2021, the maximum coverage will be reduced All supplementary plans will only allow you to use a maximum amount of the medicine coverage to cover statutory personal contributions.
What does this mean for you?
Optifit will cover up to €300 instead of €4,540 per calendar year, of which €250 may be used to cover personal contributions.
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The cover for personal contributions for medical appliances and the cover for the personal contribution for wigs have been merged. This means the total reimbursement limits have been lowered.
What does this mean for you?
Optifit covers €250 per calendar year for all personal contributions for medical aids combined. This also applies to the personal contribution for wigs.
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Optifit will no longer reimburse the costs of membership of a patients’ association or advocacy group.
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Optifit will cover a maximum of €1,000 in the first 12 months from the start of the treatment and a maximum of €1,000 in the 12 months following that. There is no more coverage for a 3rd year of treatment.
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Optifit will reimburse the costs of menopause consultations up to a maximum of €200 instead of €250 per calendar year.
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Our prior permission is no longer needed for reimbursement of surgery to correct the position of the ears.
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Per 1 January, the coverage for Preventive health-related courses and Quitting smoking will be combined. For Optifit, the coverage limit for this care will be reduced.
What does this mean for you?
Optifit will reimburse the costs of preventive health-related courses:
• 75% for first aid courses
• 100% for other courses
Combined up to €150 per calendar year. -
Optifit covers preventive (medical, sports medical and pharmacogenetic) examinations. The maximum reimbursement limits have been changed.
Care from a sports doctor will not be reimbursed separately anymore (the benefit Posture, movemebt and sport will be part of other reimbursements with effect from 1 January 2021).
What does this mean for you?
Optifit covers:
• sports medical examination (50%)
• preventive medical examination (50%)
• pharmacogenetic testing (100%)Together up to a maximum of €200 per calendar year.
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Optifit will no longer reimburse travel costs for visiting ill people.
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From 1 January 2021, the benefits arch supports supplied by an orthopaedic technician, podiatry and chiropody have been combined into a single benefit: Foot care.
What does this mean for you?
Optifit will cover up to €200 for specialist foot care and arch supports, instead of €200 for chiropody and full coverage for arch supports and podiatry.
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Optifit will no longer reimburse seated medical transportation.
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From 1 January, for all supplementary insurance policies, previous reimbursements received from one ONVZ brand will count towards the maximum reimbursement limits if you switch to another ONVZ brand.
What does this mean for you?
If you had a supplementary insurance with ONVZ, PNOzorg or VvAA and switch to another supplementary pland under one of those brands in 2021, reimbursement received in 2020 will count towards the maximum reimbursement of multi-year coverages.
Back to all changes in your health insurance for 2021
