Specialists in custom made expat health insurances

LOONZORG, SPECIALISTS IN
EXPAT HEALTH INSURANCES

LOONZORG OFFERS THE BEST PRICED
HEALTH INSURANCE PACKAGE IN THE NETHERLANDS

LOONZORG, CUSTOM MADE HEALTH INSURANCE
PACKAGES FOR YOU AND YOUR FAMILY

Students

LoonZorg offers 2 Student Insurance Policies that will cover most of your unforeseen care expenses:
The main difference between these policies are based upon the number of treatments or the maximum of coverage. Please find next document to compare the coverage of both the policies together with the policy conditions:

Scope of coverage student policies

Please be aware that as soon as you start working (even part time) besides your study you will be obliged to take out the Dutch Public Health Insurance. In this case please inform us and we will direct you to the best priced policies. Also please be informed that if you start working (part time) in The Netherlands you might be entitled to receive health care benefit from the Dutch Government. More information can be found at next page

REGISTRATION FORM STUDENTS

PARTICULARS POLICYHOLDER
Surname/Family name*
Given name*
Date of birth*
Gender*
- Male
- Female
BSN
Phone number*
Email address*
Nationality*
Country
Insurance Package*
- Package A (29,50 p/m)
- Package B (37,50 p/m)
Effective date (from when you want the new insurance to start)*
ADDRESS DETAILS (YOUR ADDRESS IN THE NETHERLANDS)
Street*
House No.*
Postal Code*
City of residence*
Country*
Country
BANK ACCOUNT DETAILS
IBAN (Account)
Account holder's name*
By signing this mandate form, you authorise LoonZorg B.V. to send recurrent collection instructions to your bank to debit your account concerning the monthly premium and your bank to debit your account on a recurrent basis in accordance with the instructions from LoonZorg B.V. Premiums will be taken from the account around the last working day of the month. As part of your rights, you are entitled to a refund from your bank under the terms and conditions of your agreement with your bank. A refund must be claimed within 8 weeks starting from the date on which your account was debited. Ask your bank for the conditions.
Place*
Date*
Please print your full name*
How did you first hear about LoonZorg*
By sending this form to LoonZorg B.V., applicant authorises LoonZorg B.V. to register the person stated above for the Student Insurance policy A or B. The policy will be effective after receipt of the first monthly premium. LoonZorg has the right to retroactively terminate the insurance policy as from the date the insured stopped paying for the premiums. LoonZorg will only use your personal details for policy purposes and will not share these details with third parties. For more information please find following privacy statement

Our Partners

Students

REGISTRATION FORM STUDENTS

PARTICULARS POLICYHOLDER

ADDRESS DETAILS (YOUR ADDRESS IN THE NETHERLANDS)

BANK ACCOUNT DETAILS