Claim medical expenses
Insured persons do not have to pay in advance for services provided by contracted care providers, such as your GP, local hospital or pharmacy.Services by care providers are reimbursed by ZJCN. However, you must have your sedula with you at all times for identification purposes. Note: keep an eye on the expiration date of your sedula. You are not entitled to free care when your sedula is expired. When you receive your new sedula, it is important to visit the ZJCN office.
Have you incurred medical costs abroad?
Which medical costs will ZJCN reimburse?
- emergency assistance; accident, acute life-threatening condition, hospital admissions,- provided ZJCN is contacted.
- medical costs related to Article 10, paragraph 4, based on a referral by your doctor and only after ZJCN’s prior permission;
When can I claim?
Best is: as soon as possible.
- Take note!: invoices older than 12 months will not be processed.
- ZJCN assesses your claim and makes the payment to you. You pay the medical bills yourself.
- With ZJCN approval, Article 10, paragraph 4, medical costs are reimbursed afterwards only, so you must pay your chosen care provider yourself.
- The sooner you submit a claim, the sooner we can respond.
Which documents do I need?
Each claim must include the following documents:
- a fully filled in and signed claims form;
- an explanation in your own words;
- guarantee letters, or the reason why you don’t have them;
- in the event of illness abroad: a medical statement from the foreign doctor and proof of contact with ZJCN;
- the original medical bills;
- Additionally, with Article 10, paragraph 4, the original payment receipts and the letter of referral from the doctor or GP.
What are the criteria for medical claims?
- you were registered with the healthcare office (ZJCN) when the costs were incurred;
- in the event of illness, an accident or a hospital admission abroad, you did contact ZJCN and submit proof of this with your claim;
- separate claims are required for each family member;
- Incomplete or unsigned claim forms will not be processed.
- For Article 10, paragraph 4: medical costs are only reimbursed if ZJCN gave prior permission.
What other things do I have to bear in mind?
Review your details!
Are your name, address, telephone number and bank account number correct? This is important for money transfer and contact by ZJCN about your claim.
Make an appointment with your healthcare office to submit your claim.
Your processed bills and receipts will be returned to you right away.
You will receive your reimbursement!
In some cases, you may have to pay the expenses associated with your care in advance. You can claim these expenses from ZJCN by following these three steps:
Step 1: Download the claims form and fill in the details.
Step 2: Scan your bills and corresponding receipts.
Step 3: E-mail the claims with the attachments to firstname.lastname@example.org