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Table 1 Key elements of the health insurance schemes in the old insurance system compared with the new insurance system

From: Free choice of healthcare providers in the Netherlands is both a goal in itself and a precondition: modelling the policy assumptions underlying the promotion of patient choice through documentary analysis and interviews

 

Old system

New system

 

Social health insurance (ZFW)

Alternative private health insurance (PHI)

Private social health insurance

Insured people

People under a certain income ceiling (two-thirds of the population)

People above a certain income ceiling (one-third of the population)

The whole population

Mandatory/voluntary

Mandatory primary healthcare package and voluntary additional healthcare package

Voluntary

Mandatory primary healthcare package and voluntary additional healthcare package

Premium rating

Income-dependent (85%) and community rating (15%)

Dependent on the risk profile of the person requesting the insurance

Income-dependent (50%) and community rating (50%)

Benefits in kind/ benefits in cash

Benefits in kind

Benefits in cash

Insurers are allowed to offer both

Voluntary policy excess

No

Yes

Yes

Insurer choice

Those insured could change insurer and additional insurance product yearly, but in practice choice options were limited

Those insured could change insurer and insurance product yearly

Those insured can change insurer and additional insurance product yearly

Provider choice

Free choice among contracted providers

Free choice among all providers, but may receive only partial reimbursement

Free choice among all providers, but may receive only partial reimbursement