Mandatory Excess in Leiden
In the Netherlands, including for residents of Leiden, the **mandatory excess** is the amount policyholders must pay themselves for basic healthcare before their insurer covers the costs. For 2024, this amount is **€385 per person**. This mechanism encourages mindful healthcare decisions, with exemptions for services like general practitioner visits. This article explains how it works, your rights, and practical tips—including local support from the **Municipality of Leiden**.
What Does the Mandatory Excess Mean for Leiden?
The **mandatory excess** is an annual fixed amount that adult policyholders in Leiden and surrounding areas pay for treatments and aids under the basic insurance. It promotes responsible healthcare use, while children under 18 and services like GP consultations or postnatal care are exempt. For Leiden residents receiving care at institutions like the **LUMC**, this applies fully.
The excess resets annually on **January 1st**. If you don’t use relevant care, you pay nothing. However, costs for hospital admissions or prescriptions from Leiden pharmacies—such as those in the city center—will reduce your excess. The government adjusts the amount based on inflation and healthcare developments, setting it at **€385 for 2024**.
Legal Basis of the Mandatory Excess
The **Dutch Health Insurance Act (Zorgverzekeringswet, Zvw)**, particularly **Article 2.5**, mandates this excess for all Dutch residents, including Leideners. Insurers must include it in basic coverage, with the amount determined by the **Ministry of Health, Welfare and Sport (VWS)**. The increase from **€355 in 2023 to €385 in 2024** reflects this adjustment.
The law prohibits exceeding the mandatory excess through voluntary excess for premium discounts. Insurers must clearly communicate reimbursement details via your policy or app. EU regulations ensure equal treatment, even for expats in Leiden.
How the Mandatory Excess Works in Leiden
Your insurer handles reimbursement. Healthcare providers in Leiden—such as specialists at **Alrijne Hospital**—submit claims to your insurer, and you’ll receive an invoice or deduction if costs fall under your excess.
Example 1: Hospital Admission in Leiden
Suppose a **40-year-old Leiden resident** undergoes appendectomy surgery at the **LUMC** costing **€5,000**. You pay **€385** (mandatory excess), with the remainder covered by your insurer, minus any prior contributions. If you’d already paid **€200** for medications, your remaining excess is **€185**.
Example 2: Medications and Specialists in Leiden
You purchase **€150** in prescription drugs at a Leiden pharmacy and consult a specialist for **€250**. Both count toward your excess, totaling **€400**—meaning your excess is fully utilized, and no further out-of-pocket payments apply for basic care that year. **GP visits in neighborhoods like Stevenshof remain exempt**.
**Note:** Assistive devices like hearing aids may incur additional contributions. Check your insurer’s calculator for your balance.
Rights and Obligations Regarding the Mandatory Excess in Leiden
As a Leiden resident, you have **rights** and **obligations** concerning this excess:
- Right to information: Annual updates on your excess via your insurer’s letter or portal.
- Right to exemption: Low-income individuals or those in medical emergencies can apply for waivers through **healthcare allowance (zorgtoeslag)** or **special relief (bijzondere bijstand)** via the **Municipality of Leiden**.
- Obligation to pay: Non-payment risks collection or policy suspension.
- Right to dispute: Challenge costs within **180 days** with your insurer.
Chronically ill Leiden residents may qualify for additional protections under the **Long-Term Care Act (Wet langdurige zorg, Wlz)**.
Comparison: Mandatory vs. Voluntary Excess
| Aspect | Mandatory Excess | Voluntary Excess |
|---|---|---|
| Amount | €385 (2024, for all Leiden residents) | Additional €100–€500, chosen for premium reduction |
| Application | Applies to all basic care | First voluntary, then mandatory |
| Advantages | Encourages cost-conscious care | Lowers premiums |
| Disadvantages | Financial burden | Higher risk in illness |
Frequently Asked Questions for Leiden Residents
What if I can’t afford the mandatory excess?
Contact your insurer for payment arrangements. Low-income individuals can apply for **special relief** via the **Municipality of Leiden**. For legal advice, consult the **Leiden Legal Aid Office (Het Juridisch Loket Leiden)**.
Do all medications fall under the excess?
No—only **prescription drugs** under basic insurance. Over-the-counter medications are excluded. Ask your **Leiden pharmacy** or **Leiden Legal Aid Office** for details.