| Definition of cover | Standard cover | Extensive cover |
| Including cover for war and kindred risk *) (on a mutual basis) | Cost price (if there are sufficient funds) | Cost price (if there are sufficient funds) |
| Clinical costs: | | |
| Hospital nursing costs (max of 365 days per occurrence) | Cost price | Cost price |
| Costs specialist | Cost price | Cost price |
| Additional costs hospital | Cost price | Cost price |
| Patients' transport | Cost price, own transport max of € 0.20 per km | Cost price, own transport max of € 0.20 per km |
| Transplantation, haemodialysis, plastic surgeon | Cost price | Cost price |
| Non-clinical costs: | | |
| Specialist | Cost price | Cost price |
| Laboratory tests | Cost price | Cost price |
| General practitioner | Cost price | Cost price |
| Medicines | Cost price | Cost price |
| Oral contraceptives | - | Cost price |
| Patients' transport | Cost price, own transport max of € 0.20 per km | Cost price, own transport max of € 0.20 per km |
| Physiotherapist, remedial therapist, speech therapist | Max of 25 treatments per insured per insurance year | Max of 25 treatments per insured per insurance year |
| Rehabilitation/outpatients' treatment | Cost price | Cost price |
Dental treatment | Exclusively as a result of an accident: max of € 350 per insurance year | Irrespective of its cause: max of € 350 per insured per insurance year |
| Orthodontic treatment | - | Max of € 1,200 per insured up to age 21 during entire period of insurance with the company |
| Second opinion | - | Cost price |
| Psychotherapy (by psychotherapist or psychiatrist) | - | Max of € 700 per insured per insurance year |
| Preventative medicine | Cost price of vaccinations and immunoglobinen against rabies and tetanus (only after an injury) | Cost price of child health care, Dutch vaccination program, influenza vaccination, investigation of heart and bloodvessels, cerfical and breastcancer (limited in age and number) |
| Artificial limbs and aids | - | According to the Regulation of Artificial Aids of the company |
| Alternative treatments | - | Max of € 500 per insured per insurance year |
| Fertility: | | |
| Genetic tests | - | Cost price |
| Fertility treatments: AI (after a waiting period of 12 months) | - | Cost price : max of 3 treatments for 1st child only |
| Fertility treatments: IVF/ICSI (after a waiting period of 12 months) | - | Max. of € 3,000 in total for max of 3 treatments for 1st child only |
| Pregnancy and delivery: unforseen emergency situations | Cost price | Cost price |
| Pregnancy and delivery (after a waiting period of 12 months) | - | Cost price if the OOM Emergency center is called in in time. If not: max of 65%. |
| Maternity care | - | Maximum of € 1,500 |
| Induced abortion | - | Cost price |
| Sterilization man (outpatients' treatment) and woman | - | Cost price |
| SOS: | | |
| Repatriation, including transport of the dead body | Cost price, for special costs maximum amounts | Cost price, for special costs maximum amounts |
| Tracing and rescue costs | Max of € 10,000 per occurrence | Max of € 10,000 per occurrence |
| Other cover: | | |
Cover upon temporary stay outside the Netherlands | Max of 30 days | Max of 30 days |
| Cover upon temporary stay outside the Netherlands for childbirth | Max of 90 days prior to and 90 days after the delivery | Max of 90 days prior to and 90 days after the delivery |
Accommodation expenses in connection with medical treatment outside place of residence (not being the land of which insured was a resident before coming to the Netherlands and not being the land of nationality) | Max of € 100 per day up to a max of € 2,000 | Max of € 100 per day up to a max of € 2,000 |