Health care insurance diabetes
In the Netherlands, the basic Dutch health insurance covers diabetes. This means that all necessary care and materials are reimbursed in accordance with Dutch healthcare guidelines. However, there is an own-risk fee of €385,- so you have to pay the first part of the medical costs yourself. After that the rest will be covered. Then you will be reimbursed for your visits to the specialist and for your diabetes aids.
Diabeter: contracts with all health care insurers
Since its foundation, Diabeter has concluded annual contracts with all health care insurers. Based on our results, outcomes and mutual trust, we now have long-term contracts and agreements with two health care insurers in which improvement of care play a central role.
We have a 10 year agreement with Zilveren Kruis and we are discussing the extension of the contract of recent years with CZ. These insurers recognize the added value of Diabeter and the need to keep improving health care. We work closely with them on our mission to move towards a future without diabetes complications.
We are also discussing long-term agreements with VGZ, with special attention to the added value of Diabeter.
Differences in insurance policies?
In general: the different policies and brands try to distinguish themselves mainly on price, but sometimes there are substantive differences. In the case of cheaper insurance policies, this usually concerns so-called ‘in-natura’ insurance policies. With an ‘in-natura’ policy you can only opt for care providers who have a contract with the health insurer. If you turn to a non-contracted care provider, you pay part of the costs yourself. With the refund insurance policy you usually pay more, but then you get a full reimbursement and more freedom of choice in health care provider. Since we aim to have contracts with all insurance companies, this is usually not a concern.
Switch only possible in the month of December
There are many health care insurance companies in the Netherlands with quite a number of labels. You can switch to another health care insurance only in the month of December each year. Choosing starts with a good comparison of the different policies. This is possible with various 'decision aids' on the internet. (They are in Dutch).
Reimbursement of Real Time Continuous Glucose Monitoring
In The Netherlands not all patients with type 1 diabetes are eligible for reimbursement of Continuous Glucose Monitoring (RT CGM) or Automated Insulin Delivery (AID).
At the moment the RT-CGM is only reimbursed for:
- Children with type 1 diabetes.
- Adults with poorly controlled type 1 diabetes (continuously high HbA1c >8% or >64 mmol/mol despite standard monitoring).
- Patients with type 1 diabetes, who suffer from repeated severe hypoglycaemia and/or who are insensitive to detect hypoglycaemia (hypoglycemia unawareness).
- Pregnant women with existing diabetes (type 1 and 2).
- Women who wish to become pregnant with preconceptional diabetes (type 1 and type 2).
At Diabeter, we have long recognized the importance of the use of diabetes technology such as Continuous Glucose Monitoring and Hybrid Closed Loop for the outcomes and life expectancy of people with type 1 diabetes. We are therefore very much in favor of a broader reimbursement and this is an important element in our negotiations with health care insurers.
Zorginstituut Nederland advises the Minister of Health Care on the criteria for reimbursement of CGM.
As in previous years, all insurers have indicated that they want to conclude a contract with Diabeter. We are still having negotiations with a few insurers.
(scroll down) shows the progress of the contract negotiations as of 10 January 2023. The agreements are expected to be finalized in early 2023.
For the delivery of medical aids and insulin via Diabstore, all contract are concluded for 2023.