Mandatory Excess in The Hague
In The Hague, policyholders must pay a **mandatory excess** for basic healthcare before their insurer covers costs. For 2024, this amount is **€385 per person**. This mechanism encourages responsible healthcare use among residents, with exceptions for services like general practitioner (GP) visits. This article explains how it works, your rights, and practical advice—including local support from the Municipality of The Hague and the **Legal Advice Desk (Juridisch Loket) The Hague**.
What Does the Mandatory Excess Mean for Residents of The Hague?
The **mandatory excess** is a fixed annual amount that adult policyholders in The Hague must pay out-of-pocket for treatments and medical aids under the basic insurance. It incentivizes residents to use healthcare selectively. Children under 18 are exempt, and services like GP consultations or regional midwifery care are excluded.
The excess resets every January 1st. If you don’t use qualifying care in The Hague, you pay nothing. However, for higher costs—such as hospital admissions at **HagaZiekenhuis** or prescription medications from local pharmacies—the excess applies. The government adjusts the amount based on inflation and rising regional healthcare costs.
Legal Basis of the Mandatory Excess
The **Health Insurance Act (Zorgverzekeringswet, Zvw)**, particularly Article 2.5 and related provisions, governs this excess. Insurers must include it in basic coverage. The 2024 amount of **€385** (a €30 increase from 2023) is set in the budget of the **Ministry of Health, Welfare and Sport (VWS)**.
Under the Zvw, the mandatory excess cannot be exceeded by a **voluntary excess**, which you may choose to lower premiums. Insurers in The Hague must clearly explain reimbursement processes via your policy or app. EU free movement rules ensure expats and cross-border workers in the region are not disadvantaged.
How the Mandatory Excess Works for Hague Residents
Your insurer handles reimbursement. After receiving care, the provider submits costs; if they fall under the excess, you’ll receive an invoice or deduction. Here’s how it applies:
Example 1: Hospital Admission in The Hague
Suppose you’re 40 and undergo appendectomy surgery at a Hague hospital, with total costs of **€5,000**. You pay the first **€385** (mandatory excess). Your insurer covers the remainder, excluding any additional copays. If you’d already paid **€200** for prior medications, your remaining excess is **€185**.
Example 2: Medications and Specialists in the Region
You purchase **€150** in prescription drugs at a Hague pharmacy and consult a specialist for **€250**—both count toward the excess (total: **€400**). GP visits do not. Once you exceed **€385**, basic care is free for the year. Assistive devices like hearing aids may incur extra costs; check your insurer’s calculator.
Rights and Obligations Regarding the Excess in The Hague
As a Hague resident, you have specific **rights** and **obligations**:
- Right to information: Your insurer annually updates you via letter or online portal.
- Right to exemption: Low-income residents or those in medical emergencies may apply for waivers through healthcare benefits or special assistance from the **Municipality of The Hague**.
- Obligation to pay: Failure to pay may result in collection actions or policy suspension.
- Right to appeal: Dispute costs within **180 days** with your insurer; the **Legal Advice Desk (Juridisch Loket) The Hague** offers free guidance.
Chronically ill or disabled residents in The Hague may qualify for protections under the **Long-Term Care Act (Wet langdurige zorg, Wlz)**, which can limit excess obligations.
Comparison: Mandatory vs. Voluntary Excess
| Aspect | Mandatory Excess | Voluntary Excess |
|---|---|---|
| Amount | €385 (2024, mandatory) | Additional €100–€500 for premium discounts |
| Application | Applies to all basic care | Deductible first; mandatory excess applies afterward |
| Advantages | Encourages cost-consciousness | Lower premiums |
| Disadvantages | Financial burden | Risk of higher out-of-pocket costs if sick |
Frequently Asked Questions for Hague Residents
What if I can’t afford the mandatory excess?
Contact your insurer for payment arrangements. Low-income residents can apply for **special assistance** via the Municipality of The Hague. The **Legal Advice Desk (Juridisch Loket) The Hague** provides debt-related legal support.
Do all medications fall under the excess?
No—only **prescription drugs** covered by basic insurance. Over-the-counter medications and non-reimbursed drugs are excluded. For specific cases, consult the **Legal Advice Desk (Juridisch Loket) The Hague**.