Dental care aged 18 and older
Reimbursement HollandZorg healthcare insurance 2020
- What is dental care?
- When will you qualify for reimbursement?
- A referral will be required sometimes
- Reimbursement public healthcare insurance in 2020
- Reimbursement dental insurance 2020
- Statutory personal contribution
- Policy excess
- Who may provide this type of care?
- Request permission
Please note: the information provided on this page is a summary of the reimbursement applicable. You will only be able to derive rights from the HollandZorg Conditions of Insurance (pdf).
Dental care involves caring for and correcting teeth. A dentist, dental prosthetitist, prosthodontist or oral hygienist will be able to provide dental care.
Do you have a special affliction to your mouth, jaws and/or teeth (the tooth-jaw-mouth system)? If so, you will qualify for special dental care.
Which reimbursement you receive will largely depend on your age. The public healthcare insurance distinguishes between insured parties up to the age of 18 and insured parties aged 18 and older. On this page, we will inform you about the reimbursement of dental care to insured parties aged 18 and older. See the reimbursement of dental care for insured parties up to the age of 18.
Under the HollandZorg dental insurance, you will be able to obtain supplementary insurance for dental costs.
- For dental care by virtue of the public healthcare insurance provided by a dental surgeon, you will need a referral from a general practitioner, dentist or orthodontist.
- You will need a referral from a dentist for fitting, making, fitting and placing removable (full) prosthetic devices on dental implants by a dental prosthetician.
- For the care provided in a centre for special dentistry, you need a referral from a general practitioner, dentist or orthodontist. The referring dentist or orthodontist may not be affiliated to a centre for special dentistry.
If you are 18 or older, the public healthcare insurance will reimburse you for the costs of:
- surgical dental care provided by a dental surgeon and the accompanying x-rays, with the exception of periodontal surgery and fitting a dental implant and uncomplicated extractions;
- a removable complete prosthesis for the upper and/or lower jaw (dentures) whether or not secured on dental implants;
- special dental care.
Younger than 23
If you are younger than 23 and the care does not fall under the heading 'dental care for all ages', you are entitled to tooth replacement with non-plastic materials and fitting dental implants if this concerns the replacement of one or more missing permanent incisors or canines which have not grown or a tooth or teeth missing as the direct result of an accident. This is subject to the condition that the necessity of the care is established before you reached the age of 18.
Under our dental insurance, you qualify for reimbursement for dental care upto the insured amount for the different treatments taken together:
|TandExtra||75% up to a maximum of € 250,- per calendar year|
|TandPlus||75% up to a maximum of € 500,- per calendar year|
You are entitled to reimbursement of following treatments taken together:
- general dental care
- technical costs
- statutory personal contributions for dentures
- urgent dental treatment outside the Netherlands
- orthodontic treatment if you are younger than 18
Reimbursement general dental care
The reimbursement applies to the various elements mentioned above jointly. Codes are shown after each type of treatment. These have been formulated by the Dutch Healthcare Authority (Nederlandse Zorgautoriteit). You can view them and download the list at www.nza.nl. You are only entitled to reimbursement of the costs of care with those service codes. You are not entitled to reimbursement based on your dental care insurance if the treatment concerned is covered by the public healthcare insurance. In that case, the costs will be reimbursed under the conditions of the public healthcare insurance.
|Type of treatment||Service code|
|Consultation and diagnostics||All C-codes|
|Taking and evaluating photos||All X-codes|
|Preventive oral care||All M-codes|
|Anaesthesia (light anaesthetic)||All B-codes|
|Root canal treatments||All E-codes|
|Crowns and bridges||All R-codes|
|Jaw treatments||All G-codes|
|Gum treatments||All T-codes|
Reimbursement of technology costs
Technology costs are the costs incurred to make a workpiece (or to have a workpiece made), such as a crown or dentures. You are entitled to reimbursement of (a part of) the technical costs for the aforementioned treatments. You can view the maximum of the amount included for the treatment in question in the List of maximum reimbursements of technical costs. The reimbursement to which you are entitled is 75% of the maximum technology costs up to the insured amount per calendar year in accordance with your supplementary policy conditions.
Reimbursement of the statutory personal contribution for dentures
You will qualify for the reimbursement of costs for your statutory personal contribution for a removable complete prosthesis. Is this prosthesis secured on dental implants? Then you can get a reimbursement up to a maximum of € 275,- (TandExtra: up to a maximum of € 250,-).
Reimbursement of urgent oral care abroad
With the HollandZorg dental insurance, you qualify for the reimbursement of urgent oral care abroad. Cover is limited to the treatments included in the Urgent Oral Care List (pdf).
What is not reimbursed?
Have you failed to attend an appointment and have now received an invoice? We will not reimburse the costs charged for non-attendance of an appointment.
There may be a statutory personal contribution for dental care under the public healthcare insurance. If you are 18 years or older, you will be required to pay a personal contribution for:
- care that falls under special dental care if that care is not directly related to the indication for special dental care;
- a removable full denture for the upper or lower jaw. You pay 25% of the costs of the prosthesis.
- a removable full denture for the upper or lower jaw on dental implants. You pay 10% of the costs if it concerns a dental prosthesis for the lower jaw. For an upper jaw prosthesis you pay 8% of the costs.
- repairs or transfer of a removable full denture. You pay 10% of the costs yourself.
Do you need removable full prostheses for your upper or lower jaw (whether or not fitted to dental implants)? Do your dentures need repairing or want to improve their fit (rebasing)? Want to know the exact extent of your statutory personal contribution? If so, we will refer you to your care provider first. Your care provider can tell you exactly what the treatment entails, which treatment codes apply to you and what the costs involved are. The reimbursement overview for dental prostheses explains what reimbursement you are entitled to for each treatment code and which statutory personal contribution applies.
Under the HollandZorg dental insurance, you will be able to receive reimbursement for (part of) the statutory personal contribution for dentures.
Are you 18 or older? The costs incurred for dental care under the public healthcare insurance will count towards your compulsory policy excess and any voluntary policy excess.
You may obtain dental care from a dentist (whether or not working in a centre for special dentistry). You may also obtain certain dental care from the following care providers:
- a dental surgeon for surgical dental assistance of a specialist nature.
- a dental prosthetitist to make and fit removable (complete) dentures;
- an orthodontist for orthodontia;
- a dental surgeon for implantology.
An oral hygienist may only provide the following care: preventive oral care (all M codes), non-complex periodontal assistance (T11, T12, T22, T31 to T33, T41 to T43, T60, T61, T91 to T93, T96), performing simple fillings (V30, V35, V40, V50, V71, V72, V81, V82, V91, V92) and anaesthetic (A10 and A15).
An anti-snoring device (MRD) may only be measured up, made and fitted by a dentist or dental surgeon who is registered with the Dutch Society of Dental Sleep Medicine (Nederlandse Vereniging voor Tandheelkundige Slaapgeneeskunde (NVTS).
Use our Care Guide to find a (contracted) care provider near you.
You will require our prior written permission for the following treatments:
- all care that falls under special dentistry;
- dental replacement care with non-plastic materials if you are under 23 years old;
- treatments under anaesthetic;
- surgical jaw correction (osteotomy) and combined orthodontic and osteotomy treatment;
- making and fitting a Mandibular Repositioning Device (MRD anti-snoring device) and the related diagnosis and after-care by a dental surgeon;
- fitting a dental implant;
- surgical dental assistance of a specialist nature if it requires hospitalisation;
- making, fitting and rebasing of removable (full) prostheses for the upper or lower jaw, whether or not secured on dental implants;
- care provided by a centre for special dentistry.
Include a written and reasoned treatment plan from the care provider with your request. This plan will include the medical diagnosis (or diagnoses) and the care codes, supplemented by x-rays and any dental models.
Please send requests for permission to:
7400 VB Deventer
No stamp is necessary.