The deductible is the amount you must pay yourself before your health insurance starts to reimburse you for healthcare you have received. You will have to pay the deductible if you are over 18 years of age and need healthcare covered by the general insurance policy. The compulsory deductible for 2019 is €385 and it is determined by the government. On top of the compulsory deductible, you can opt to have a voluntary deductible.
A statutory personal contribution means that you cover part of the costs of certain healthcare yourself. The government determines the amount of this personal contribution and the type of medical care this applies to. Things such as other medical transport, obstetric care and some medicines are subject to a personal contribution.
In some cases, you will have to pay both a personal contribution and the deductible
For certain healthcare, you will have to pay the deductible and a personal contribution. In that case, you will have to pay the personal contribution first and the remaining amount will subsequently be set off against your deductible.
Mieke needs a hearing aid. She has general insurance with CZ with a €385 deductible and the ‘50+’ additional insurance package. Here is how much will she have to pay for her hearing aid.
- Mieke buys a €1,200 hearing aid.
- The personal contribution is 25%, i.e. €300. Mieke will have to pay that out of her own pocket. This leaves an amount of €900.
- Given that the hearing aid is covered by Mieke’s general insurance policy, it is subject to the deductible.
- In total, she will have to pay the €300 personal contribution + €385 deductible = €685.
- Her additional insurance package reimburses her for the €300 personal contribution.
- In total, CZ pays €815 for the hearing aid, and Mieke has no further deductible left to pay for any healthcare she receives in 2019.