Financial matters reimbursement of medical costs for (international) patients coming from abroad

Planned medical care

Prior to your treatment or appointment, consultation (by video or telephone), we will ask you to provide documentation that the healthcare expenses for medical healthcare you will receive, can be paid for. 

You can do so by either sending us a valid ‘prior authorization’ from your health insurer/health authority, also known as a letter of guarantee, or you can make an advance payment. 

Valid letters of consent/guarantee

Depending on your situation, there are a number of different letters of guarantee (within the EE/EEA) that you can provide. You should request a letter of guarantee from your health insurer or health authority. Our Finances Department (Costs of Care) will check after receipt whether your letter of guarantee is in order. Before sending us your letter, it is important that you check whether all information has been filled in.

• Overview of valid letters of guarantee accepted at Radboudumc 

Advance payment

If you cannot obtain a letter of guarantee, your appointment can still proceed, but we will ask you to make an advance payment before your appointment. An advance payment is based on an indication of what your treatment will cost.

After completing your treatment, the advance payment will be set off against the final invoices. These invoices will be sent to your home address. 

Please note: PIN payments and/or cash payments for medical healthcare are not accepted at Radboudumc.

Outpatient visit, video call or telephone appointment & fees

In some situations, you do not need to come to the hospital for an appointment and you might be offered a video call or an appointment via telephone. 

This appointment must meet the following conditions:

• The telephone or video appointment is a substitute for an outpatient appointment
• The healthcare professional has discussed medical healthcare content with you

The invoice for an appointment via telephone or video is the same as an appointment in the hospital. 
In the Netherlands, this form of care falls under nationwide agreements between healthcare providers, health insurers and the Dutch Healthcare Authority (NZa). 

Emergency medical healthcare

European Health Insurance Card (EHIC)

The European Health Insurance Card (EHIC)* is an insurance card that shows that you are insured in the EU/EEA or in another treaty country. 
This card provides access to emergency healthcare only during a temporary stay abroad, and is accepted within Radboudumc for emergency healthcare.

The EHIC cannot be used for planned medical healthcare abroad, nor is it an alternative to travel insurance. 
If you have a valid EHIC, you will not have to advance the medical healthcare expenses to Radboudumc yourself. The invoice will be charged to your health insurer through the national and/or European platform.

We recommend that you check whether your health insurer/authority makes use of the EHIC before going abroad. 

If you would like to know whether the medical healthcare expenses to be incurred will be reimbursed to you in full or in part, we advise you to contact your healthcare insurer or healthcare authority. This may vary per individual, depending on the country or policy. 

UK Global Health Insurance Card (GHIC)

The GHIC was introduced for residents of the United Kingdom following Brexit. The GHIC replaces the EHIC and provides access to emergency healthcare while temporarily abroad. The GHIC card is accepted within Radboudumc for emergency healthcare.

The GHIC cannot be used for planned medical healthcare while abroad, nor is it an alternative to travel insurance.

* In Germany, the EHIC is called EKVK (= Europaische Krankenversicherungskarte).

No valid EHIC/EKVK/GHIC

If you do not have a valid EHIC/EKVK/GHIC card, we will ask you to pay the invoices yourself.
The invoices will be sent to your home address. 

If you would like to know whether the medical healthcare expenses incurred will be reimbursed to you in full or in part, we recommend that you contact your health insurer or health authority. This may vary per individual, depending on the country, health insurer or policy.

Please note: PIN payments and/or cash payments for medical care are not accepted at Radboudumc.

Healthcare costs and invoices in the Netherlands

Healthcare expenses in the Netherlands may differ from what you are used to in your home country. 
Non-Dutch healthcare insurers often require a statement that breaks down the costs of healthcare by intervention. Also, the invoice must often be submitted within a short period of time. Radboudumc can not meet these conditions because hospital healthcare in the Netherlands is structured differently, and we have to comply with national laws and regulations on the subject. 

If you receive an invoice from Radboudumc you will see that it lists DBC care products. DBC stands for 'diagnose behandel combinatie' (diagnosis treatment combination). This means that instead of paying for each examination or treatment separately, you pay one price for the entire DBC. 

See for more information the video from the Dutch Healthcare Authority (NZa) 

How does Radboudumc determine your DBC care product?

The combination of all the activities (including appointments, treatments and testes) you undergo and your diagnosis determine the DBC care product. The DBC care product is what is billed. 
This means that you will always receive a healthcare invoice for a standard DBC care product.

Why does it sometimes take months for you or your healthcare insurance company to receive an invoice?

Treatments have different lead times. Even if you only have one visit, your DBC (care path) often goes on for months. That is a consequence of the Dutch DBC system.

Where to find information on reimbursement for medical healthcare abroad?

• Within EU/EEA countries

  Each country has its own healthcare system. Every EU/EEA country is required to inform citizens about reimbursement for medical healthcare abroad. Information about this can be found through the National Contact Point (NCP), among others. 

  You can contact the NCP for questions like the following:

  • Am I entitled to full or partial reimbursement of the medical expenses?
  • What treatments are covered and what reimbursement can I expect?
  • Do I need prior authorization and if so, how can I apply for it? 
  • What can I do if my rights are not respected?

  More information about National Contact Points
   

• Caribbean Islands

  If you are a resident of the Caribbean islands, you can request information from:

  • Transcaring: Transnational healthcare provider
  • Zorg en Jeugd Caribisch Nederland (Healthcare and Youth of the Caribbean Netherlands, ZJCN)
  • See Valid Forms of Guarantee

Travel insurance and medical healthcare expenses

Travel insurance is not the same as a letter of guarantee for planned and/or emergency medical healthcare abroad. Therefore, travel insurance is not accepted as a letter of guarantee for medical expenses. 

If you have travel insurance, check with your travel insurer to see if you will be reimbursed for any additional expenses to be incurred (think of hotel accommodation, travel expenses, etc.).

Refugees reimbursement of healthcare

Are you a refugee and do you work in the Netherlands?

If you are refugee who is working in the Netherlands, the Uninsured Subsidy regulation cannot be applied and therefore you will need to take a Dutch healthcare Insurance. 

Refugees from Ukraine

The Ministry of Health has decided that the provision of medical healthcare in the Netherlands to refugees from Ukraine will be fully reimbursed through the national Medically Necessary Care for the Uninsured Subsidy Regulation.