Choosing health insurance for your (expected) fertility treatment

Changing or switching your health insurance?

If you are considering fertility treatment, it is advisable to look into the various health insurers and the policies they offer. Health insurers usually announce their premiums and cover from mid-November.

We are happy to help you list the most important points to consider if you are already undergoing fertility treatment or are thinking about starting a fertility journey. 

The Dutch government (Rijksoverheid) has put together a useful list of points to take into account when choosing a health insurance policy. In addition to this list, we would like to give you some tips and questions to help you choose.

Questions to help you choose

Are you currently receiving treatment with us?

1. What treatment are you currently receiving, and what will this look like in the next calendar year if you do not become pregnant with your current type of treatment?
2. If you are given an indication for a different treatment and therefore switch treatment, for example from IUI to IVF, will your health insurer cover this and how much is the reimbursement?
3. Have you reached the maximum number of covered treatments, and is there perhaps a (supplementary) insurance policy that covers more, for example a 4^th/5^th IVF treatment?

Tip: The outcome of fertility treatment is difficult to predict. Make sure you include any expected and possible unexpected situations in your list of care needs for next year.

Is your current treatment covered by your health insurer?

If you are receiving treatment with us this year, your current health insurer may cover the costs in full or in part. Sometimes you have to pay the invoices yourself first and then submit them to your health insurer. In other cases, you will not see the bill at all, because we have a contract with your health insurer and invoice the costs directly to them. 

Please note: 

• Treatments without a medical indication, such as KID and egg freezing, are not covered by health insurers. 
• Consider how important it is to you that the costs are paid directly by your health insurer. 

Direct reimbursement or submitting claims yourself?

Direct invoicing
Would you prefer the treatment to be paid directly by your health insurer? Then ideally choose a health insurer we have a contract with. On our page about health insurance, you will find an overview of the insurers we have a care contract with.

Submitting claims yourself
Do you not mind paying our invoices yourself first and then claiming them from your health insurer? Then you can also choose a health insurer that does not have a contract with us. This can make sense if you have other specific care needs that are better matched by the cover of certain policies.

Tip: Reimbursement for care from a non-contracted provider can vary greatly from policy to policy. So check in advance exactly how much you will get back if you are treated by a non-contracted provider.

How do you decide on your compulsory deductible?

As the Dutch government points out, you can consider increasing your compulsory deductible (eigen risico) in exchange for a lower monthly premium. This can be financially attractive, but it is important to know how this works out in combination with fertility treatment.

At Nij Clinics too, your compulsory deductible is used first for the care you receive. Only once this amount has been used up in full will your health insurer start reimbursing costs.

Personal contribution
In addition to the compulsory deductible, a personal contribution (eigen bijdrage) may apply to certain treatments. This applies in particular to treatments without a medical indication, such as KID, as these are not covered by health insurers.

Tip: Work out carefully in advance whether a higher compulsory deductible is sensible in your situation, especially in relation to the premium you save.

Ongoing DBC but a new health insurer?

If your treatment started this year, you may receive follow-up treatment in the new year within the same open DBC (diagnosis-treatment combination). This depends on the duration of the DBC in question. In many cases, this means that the costs will still be covered by your current health insurer, even if you switch to a different health insurer on 1 January.

Tip: In specific cases like this, we recommend that you contact our patient billing department  and ask when your new DBC will be opened.

DISCLAIMER: Please consult your health insurer for complete and up-to-date information about policy conditions and reimbursements.