Additions to this from the LVVP (www.lvvp.info): Supreme Court ruling from December 2022: what if the health insurer reimburses less than 75%?

If the insurer reimburses less than 75%, there is a chance that the patient is still entitled to a higher reimbursement; the aforementioned obstacle criterion applies here. This means that the reimbursement for an in-kind policy may not be so low that it prevents the patient from going to this care provider. In that case, the patient can press the health insurer for a higher reimbursement. Do this in writing, so that a commitment is also recorded in black and white. 

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In case of a long waiting time, different rules apply to the reimbursement. The NZa states that there is no scope for limiting the reimbursement of non-contracted care if the health insurer has purchased too little care or if the purchased care does not meet the standards for timeliness, accessibility and/or quality. If an insured person cannot gain timely access to a contracted alternative, the health insurer will not be fulfilling its duty of care. In that case, the reimbursement percentage for the insured may not fall below 100%. If you have a waiting time of more than 14 weeks with a comparable contracted care provider (Treek standard) and you can come to me more quickly, this rule applies. For this, the patient must contact his health insurer himself and submit this request in writing again.