Mandatory excess
If you incur healthcare costs that are covered by your basic insurance plan, you will be responsible for paying the first portion, which is called the (mandatory) excess. You will pay up to € 385 per year before we reimburse the costs from basic insurance. There is no excess for children up to the age of 18.
In addition to the excess, a statutory personal contribution or maximum reimbursement applies. In some cases, we may reimburse the costs in full, you may have to pay the costs in full or we may both pay part of the costs. Watch the video: ‘What you pay: What we pay’ (Wat betaal je zelf en wat betalen wij). Available in Dutch only.
How much excess do I have left?
It’s easy to find out how much of your excess you have left this year, or how much you’ve used up to 5 years ago.
log in mijn zilveren kruis met digid Check my excess
This is how the excess works
If you incur healthcare costs that are covered by your basic insurance plan, you will have to pay the first portion. We will reimburse healthcare costs once you have reached the full amount of your excess.
- The mandatory excess applies to everyone over the age of 18, but not to children.
- You will have to pay up to € 385 per year. The amount of the mandatory excess is set by the government.
- Your excess applies to a full calendar year (from the 1st of January up to the 31st of December).
- The excess only applies to healthcare costs covered by basic insurance, never to costs covered by supplementary insurance.
- There are a few exceptions where the excess doesn’t apply, such as maternity care or a visit to your GP.
Why do I have to pay excess?
The excess was invented by the government to make us think twice before rushing to a care provider for things that will go away on their own. This helps to keep healthcare and premiums affordable.
You can increase your excess: voluntary excess
The advantage of having a higher excess is that you pay less premium, but the disadvantage is that you will pay a higher portion of the healthcare costs you incur. If you expect have care covered by basic insurance, then it’s never a good idee to increase your excess, as you’ll almost always end up paying more.
Good to know
If you have been treated in hospital, you will receive a late bill for your excess. Hospitals and independent treatment centres (zbc’s) are only allowed to claim for the costs after the end of the treatment period. A treatment period lasts a minimum of 42 days and a maximum of 120 days. Zilveren Kruis will only be able to calculate whether you will have to pay an excess once it has received the bill.
No. You’ll pay the excess from the 1st of the month following your 18th birthday. The amount will be adjusted accordingly. For example: if your birthday is on the 4th of June, you will pay the excess from the 1st of July and for the rest of the year it will be €192.50.
If you start treatment (dbc-care product) in 2023, the costs will be settled with your 2023 excess. Even if you stop treatment in 2024.
Hospitals bill you every 120 days because a dbc-care product (treatment) lasts up to 120 days. After that, the hospital will start a new dbc for the same treatment. This will continue until your treatment is completed. You will pay the excess for each bill until you reach your excess amount.
Yes, as in the Netherlands, you’ll have to pay an excess for treatment that is reimbursed by your basic insurance. The excess doesn’t apply to medical treatment reimbursed on the basis of S2 form. However, the statutory personal contribution may apply.
Are you an administrator, curator or budget manager?
Request an overview of your client’s excess using the online form. Further information in Dutch.