A breast prosthesis is an exterior aid that fully or partially replaces the breast. Ready-to-use breast prostheses are available, but you can also have one customised for you. The breast prosthesis falls under medical aids.
Prescription required for breast prosthesis
You need a prescription from a general practitioner or mamma care nurse for a breast prosthesis. If you need a customised breast prosthesis, you will need a statement, along with the prescription, that a ready-to-use breast prosthesis is not possible or safe in your case.
On loan or owner?You will be the owner of the breast prosthesis. The minimum useful life of a breast prosthesis is 24 months. Read the Medical Aids Regulations (PDF) for more information about replacing a breast prosthesis.
|Public Healthcare Insurance||Reimbursement|
|HollandZorg public healthcare insurance||100% in the case of contracted care|
Maximum rates non-contracted provider
If the medical aids are available from a contracted care provider in time, but you prefer to go to a non-contracted care provider, we will apply a maximum reimbursement. The non-contracted provider has to comply with the conditions set out in the Medical Aids Regulations (PDF).
A medical aid that we sell to you is reimbursed up to a maximum of 75% of the costs we would incur if you would have received the care from a contracted care provider. In that case, we also reimburse a maximum of 75% of any repair costs in connection with the medical aid.
No statutory personal contribution
A breast prosthesis is not subject to a statutory personal contribution.
The costs of a breast prosthesis count towards the compulsory and, if applicable voluntary excess.
Who can you go to?
If you need a breast prosthesis, you can go to a contracted provider of medical aids. A non-contracted provider has to be an S.E.M.H-recognised provider of medical aids. Our Care Guide helps you find a (contracted) provider near you. You do not need our prior consent when visiting a contracted provider.
Apply for consent
Do you want to use a provider with whom we have not concluded an agreement? In that case, you need our prior consent. Send your prescription and offer to:
7400 VB Deventer
No stamp required.
Also view the Reimbursements 2021.
The information on this page is a brief outline of the reimbursement. You can only derive rights from our insurance conditions (PDF).