Tips and Guidelines for Health Care Providers whose Patients have a Global Traveler or Young Global Traveler insurance
How can I confirm whether my patient’s insurance is valid?
You can check the validity of your patient’s insurance with OOM Verzekeringen. This can be done by phone during our office hours (8.30 a.m. – 5 p.m. CET), or by e-mail.
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What kind of information do I need to provide to your company to be able to file my claim?
- policy number
- patient’s name
- patient’s date of birth
- diagnosis and/or symptoms
- in case of hospitalisation: the expected duration, the daily nursing charge and an estimate of the medical expenses
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When is it necessary to contact the OOM Emergency Centre?
It is necessary to contact the OOM Emergency Centre in the following cases:
- Hospitalisation outside the Netherlands
- Specialist treatment in the United States of America or in Canada
- Death
- Repatriation or a necessary premature return to the Netherlands or home country
- Pregnancy and delivery
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When is repatriation warranted?
If medical treatment is not possible within the insured person’s country of residence and the treatment cannot be postponed until a temporary or permanent return to the Netherlands (when insured for Region A or B) or to the home country (when insured for the Netherlands).
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What pregnancy and childbirth coverage exists?
Standard coverage
The costs of pregnancy and delivery will not be reimbursed except in an unforeseen emergency that requires critical medical intervention, in the view of OOM Verzekeringen’s medical consultant. If this is the case, please contact the OOM Emergency Centre as soon as possible.
Extensive coverage
During the first 12 months of the insurance, the coverage is the same as for the Standard coverage. After the waiting time of 12 months, the costs of pregnancy and delivery - regardless of whether the delivery takes place in a hospital (as a medical necessity or otherwise), an outpatients’ department or at home - will be fully reimbursed provided the OOM Emergency Centre was notified as soon as the insured person became aware she was pregnant. If the OOM Emergency Centre is not contacted on time, reimbursement will be restricted to a maximum of 65% of the insured costs. The costs of maternity care at home will be reimbursed up to a maximum amount of € 1,500, over a period of up to 10 days. In case of hospitalisation, € 150 will be deducted for each day of admission.
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Is it possible to bill OOM directly and is an excess payable?
We prefer that you bill your patient. The patient should pay directly to you and will then claim reimbursement from us. We will determine whether the claimed medical expenses are covered by the insurance. If not, we will not reimburse or otherwise not fully reimburse our client. An excess is due in all cases. Depending on the choice of the insured person, the excess is € 250, € 500 or € 1,000 per insured person, per year (or per insurance period if that is shorter than a year). You can check the excess amount with your patient or with OOM Verzekeringen. We will deduct the excess from the claim and reimburse our client.
If a bill is too high for the patient to pay upfront, please contact OOM Verzekeringen. We will determine whether the medical treatment is covered by the insurance and, if so, will make arrangements with you and your patient regarding payment.
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Do any exclusions apply to this insurance?
Yes, there are different exclusions on the policy depending on whether your patient has the standard or extensive coverage. We recommend that you check the policy terms and conditions.
Please note that special conditions may apply to your patient’s policy. You can check this (and the policy terms and conditions) with your patient or with OOM Verzekeringen.
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How does the cover apply in the Netherlands or the insured person's country of origin?
If insured for Region A or B
Upon the insured person’s temporary return to the Netherlands, the coverage of this insurance will remain effective as long as there is no obligation to take out Dutch national health insurance. Upon a permanent return to the Netherlands, this insurance will lapse immediately.
If insured for the Netherlands
Upon the insured person’s temporary return to his/her country of origin, the coverage of this insurance will remain effective for 30 days after the date of temporary return. After that period, this insurance will lapse. Upon a permanent return to the country of origin, this insurance will lapse immediately.
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