Example letter AL3
You received an athorisation letter in Dutch. Find the translation of the letter below to help you understand what the letter is about.
Request for dental care treatment
Dear Mr./Mrs. [Name] ,
This letter concerns your request for dental care treatment. In this letter we will explain what we reimburse and what you have to pay.
Your request for dental care treatment is approved
Your treatment is reimbursed from the basic insurance.
You pay the following costs:
- The difference between the requested amount and the amount we approved. Find the maximum tariffs on zk.nl/vergoedingen/tanden.
- The statutory personal contributions that applies to removable click-tight dentures, removable dentures and repairs or rebased. Read the policy terms, article B. 10 of care covered by the basic insurance policies.
- Your excess of the year treatment takes place. On zk.nl/mijnzilerenkruis you can find your outstanding excess.
Find a calculation example on zk.nl/rekenvoorbeeldklikgebit.
The authorisation for your treatment has number [number
The authorisation is valid from [date] to [date].
| Requested performance code | Requested treatment | Number |
| [performance code] | [name requested treatment] | [number] |
| [performance code] | [name requested treatment] | [number] |
In the following cases your right to reimbursements expires if:
- your health insurance stops with us and treatment has not yet started
- the insurance policy terms and conditions change
- your treatment changes
- your treatments starts after [date]
- you have treatment somewhere else. Your new care providers must then submit a new request.
Let us know if you have any questions.
A lot of information can be found on zk.nl. Can’t find the answer to your question? Or would you rather speak to us in person? No problem. You can chat with us, send us a WhatsApp or give us a call. Our opening hours and contact information are listed at zk.nl/contact-english.
Best regards,
| What will you pay? |
|
| Statutory personal contribution | These are the costs you have to pay. This is determined by law. We will only know the level of your statutory personal contribution after receiving the invoice. We will let you know the amount we will reimburse and the amount you will pay. Want to know more about the possible statutory contribution? Find out on zk.nl/eigenbijdrage. |
| Excess | The excess applies to many costs from the basic insurance. Everyone in the Netherlands over the age of 18 has a mandatory excess. Each year the government determines the level of the excess. Dental care treatments are also included. Please this into account. |
| Technician services and materials | Your care providers calculates the technician services and materials. A maximum tariff as been agreed to. Your care provider is aware of these tariffs. Are the costs higher, then you will pay the difference. Information about the maximum tariffs are on zk.nl/vergoedingen/tanden. |