• Home
  • dutch healthcare insurance

Dental care aged 18 and older

Reimbursement HollandZorg healthcare insurance 2019

  1. What is dental care?
  2. When will you qualify for reimbursement?
  3. A referral will be required sometimes
  4. Reimbursement public healthcare insurance in 2019
  5. Reimbursement dental insurance 2019
  6. Statutory personal contribution
  7. Policy excess
  8. Who may provide this type of care?
  9. 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).

1. What is dental care?

Dental care involves caring for and correcting teeth. A dentist, dental prosthetitist 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.

2. When will you qualify for reimbursement?

Which reimbursement you receive will largely depend on your age. The public healthcare insurance distinguishes between insured parties up to the age of 23 and insured parties aged 23 and older. On this page, we will inform you about the reimbursement of dental care to insured parties aged 23 and older. See the reimbursement of dental care for insured parties up to the age of 23.

 

Under the HollandZorg dental insurance, you will be able to obtain supplementary insurance for dental costs.

3. Referral required sometimes

For dental care provided by a dental surgeon, you will need a referral from a general practitioner, dentist or orthodontist. For care provided by a dental prosthetitist (removable dentures), you need a referral from a dentist. 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.

4. Reimbursement under the public healthcare insurance in 2019

If you are 23 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); To a removable full prosthetic supply to post on dental implants, is also applying the fixed part of the superstructure (the click-System);
  • special dental care.

5. Reimbursement under dental insurance in 2019

Under our dental insurance, you qualify for reimbursement for dental care upto the insured amount for the different treatments taken together:

 

Dental insurances Reimbursement 2019
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

We offer the following cover for dental care. The reimbursement applies to the various elements 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 All A-codes
Anaesthesia (light anaesthetic)  All B-codes
Fillings  All V-codes
Root canal treatments  All E-codes
Crowns and bridges  All R-codes
Jaw treatments  All G-codes
Surgery All H-codes
Dentures  All P-codes
Gum treatments  All T-codes
Implants All J-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 via www.hollandzorg.com/nl. We can also send it to you if you wish. 

 

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.

 

6. Statutory personal contribution

There may be a statutory personal contribution for dental care under the public healthcare insurance. You will be required to pay a personal contribution for:

  • for a removable full dental prosthesis for the upper or lower jaw, if you are aged 18 or older and the care does not fall under the heading 'All ages'. In that case, the statutory personal contribution amounts to 25% of the costs of that dental prosthesis. Contrary to the above, the statutory personal contribution for a removable full dental prosthesis secured on dental implants amounts to:
    a. 10% of the costs of that dental prosthesis, if it is a denture for the lower jaw;
    b. 8% of the costs of that dental prosthesis, if it is a denture for the upper jaw.
  • for repairs or rebasing of a removable full dental prosthesis. In that case, the statutory personal
    contribution amounts to 10% of the costs of the repair or rebasing.
  • special dental care. The height of the statutory contribution is in that case the amount that the healthcare provider had brought in account as there was no right to reimbursement of the costs under the heading ' all ages '. That means that you are actually entitled to reimbursement of only the extra costs involved with that care.

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.

7. Policy excess

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.

8. Who may provide this type of care?

You may obtain dental care from a dentist or 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. For care by a dental prosthetitist you need a referral from a dentist.

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.

9. Request permission

You will require our prior written permission for the following treatments:

  • all care that falls under special dentistry;
  • 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:

HollandZorg
Medical Advisor
Antwoordnummer 30
7400 VB Deventer

No stamp is necessary.


< Back to the reimbursement overview for healthcare insurance