zem.nl

ZEM Policy basic health insurance

The ZEM Policy is a combination policy

Under this combination policy, your employee is entitled to 100% reimbursement for care from contracted care providers. We have contracts with all GPs and hospitals in the Netherlands. Reimbursement for care from non-contracted providers is limited. However, in the case of oral care and paramedical care, the policy will fully reimburse care from any provider (both contracted and non-contracted).

The premium of the basic health insurance ZEM Policy is € 148.95 per month.

Contracted care

  • 100% reimbursement

  • Agreements on the quality of the care provided, prices and availability

Non-contracted care

  • 75% reimbursement (100% for oral and paramedical care)

  • No agreements on the quality of the care provided, prices and availability

  • The insured party first pays the invoice, and then submits it to ZEM for reimbursement

There are two exceptions where reimbursement of care from a non-contracted provider is lower than 75%:

  • Mental healthcare, 70% max.

  • District nursing, 70% max.

Find a contracted care provider

View all reimbursements in the Reimbursement Overview

Excess and AV-ZEM supplementary insurance

If your employee receives care covered by the basic healthcare insurance policy, they must pay their excess towards the costs of the care. The amount of the compulsory excess is set by the government. In 2024, the excess is € 385.

The AV-ZEM policy also covers the compulsory excess of € 385. This means that your employee will not have to pay any invoices for their excess. In other words, no uncertainty, no hidden costs. This supplementary insurance is only available for employees who participate in group insurance via employment agencies that have a contract with ZEM.

More information excess

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