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Dental care up to the age of 18

Reimbursement HollandZorg healthcare insurance 2019

  1. What is dental care?
  2. Reimbursement dental care up to 23 years
  3. Reimbursement under public healthcare insurance in 2019
  4. No statutory personal contribution
  5. No policy excess
  6. Who can you approach?

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 surgeon, dental prosthetist or an oral hygienist may provide dental care.

 

This page is about dental care for insured up to 23 years. Are you older? If so, then check our page on special dental care.

2. Reimbursement dental care up to 23 years

An insured party who is younger than 18 will qualify for the reimbursement of the costs of the following under the public healthcare insurance:

  • special dental care;
  • an annual dentist's check-up (more check-ups on indication);
  • an occasional dental examination;
  • the removal of tartar;
  • two fluoride treatments per year (more treatments on indication);
  • the application of a thin protective layer to the top of the molars (sealing);
  • treatment of gum problems (parodontal treatment);
  • anaesthetic
  • root canal treatments (and endodontic treatment);
  • restoration of the dental elements with plastic materials (fillings);
  • help with problems with the jaw or teeth grinding (gnathological treatment);
  • removable dental prosthesis (dentures);
  • replacement of one or more missing, adult incisors or canines with non-plastic materials or an implant. The missing teeth have not been fitted or are missing as the result of an accident;
  • surgical dental treatment, with the exception of the fitting of dental implants;
  • x-rays, with the exception of x-rays for orthodontic care;
  • 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.

You need our permission for a number of types of dental care. Read the insurance conditions (pdf) for the full terms and conditions.

3. Reimbursement dental insurance 2019

With a dental insurance the insured party younger than 18 years, is entitled to reimbursement of orthodontic treatment. These are all treatments orthodontics with a F-code (service code). Service codes are codes for treatments. You can find the code at the type of treatment a the proposition or invoice of your dentist/orthodontist. The service codes are set by the NZA (Nederlandse Zorgautoriteit).

 

Dental insurance Reimbursement 2019
TandExtra 75% up to a maximum of € 250,- per calendar year
TandPlus 75% up to a maximum of € 500,- per calendar year

 

The maximum reimbursement applies to the following elements jointly:

  • General dental care;
  • Orthodontic treatment if you are younger than 18;
  • Technical costs;
  • Statutory personal contribution for dentures;
  • Urgent dental treatment outside the Netherlands.

4. No statutory personal contribution

There is no statutory personal contribution for dental care under the public healthcare insurance for insured parties under the age of 23.

5. No policy excess

Insured parties under the age of 18 will not have any policy excess for the cost of care under the public healthcare insurance.

6. Who may provide this type of care?

You may obtain dental care from:

  • a dentist for dental care.
  • an orthodontist for orthodontics.
  • removable (full) prostheses for the upper or lower jaw, whether or not secured on dental implants, may also be made and fitted by a prosthodontist. For the care provided by a prosthodontist 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).

 

If you have any questions or would like more information, contact customer services on +31(0)570 687 123. We will be happy to answer your questions.


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