31 October 2023
Health insurance companies purchase a certain amount of care from a hospital or healthcare provider. This determines the maximumbudget and number of treatments. When this turnover ceiling is reached, this hospital can reject care for the insured.
In the broadcast, Bastiaan Wallage notes that no health insurer is transparent about this turnover ceiling when a consumer joins the health insurance. The information is not actively shared. This makes it unclear to the insured what has been purchased by the insurer, what turnover ceiling has been agreed on with the hospital and when this turnover ceiling might be reached.
Looking at how it works now, the insured is insufficiently informed. The insured does not know where they stand and the moment you are then confronted with the situation 'budget is finished,' there is insufficient clarity about where you can go then, whether there are waiting lists then and how to proceed.Bastiaan Wallage on Radar