Non-occupational health insurance contracts may have their premiums, excesses and/or cover indexed.
One method of indexing is the use of medical indices. Unlike the consumer price index, these indices take changes in medical costs into account. Using them allows for a more linear adaptation of pricing conditions to the evolution of health care costs.
These indices are compiled annually by the FPS Economy, which publishes them on 1 July.
They concern:
- "private room" cover;
- "double and shared room" cover;
- "ambulatory care" cover;
- "dental care" cover.
The cover with the most weighting in the annual premium determines how the insurance contract is linked to this cover.
It is also envisaged that the insurer may assign each insured party to an age category. The age categories are laid down by Royal Decree:
- from 0 to 19 years old;
- from 20 to 34 years old;
- from 35 to 49 years old;
- from 50 to 64 years old;
- from 50 to 64 years old;
- 65 years old and over.
What are the conditions for applying the medical indices?
- There must be an indexation clause in the health insurance contract not linked to the professional activity and;
- the medical index is higher than the consumer price index.
What can the insurer index and to what extent?
The insurer has the option of indexing:
- the premium and/or;
- the excess and/or;
- the cover.
However, the medical index is a maximum. It means that your insurer can make smaller increases.
When can the medical index be applied?
The medical index applies to the annual expiry date and the insurer must inform the policyholder of the modified indexation method and its terms and conditions by means of a notation on the expiry notice.