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 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.
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.
The information on this page is a brief outline of the reimbursements only. No rights can be derived from this page. You can only derive rights from our insurance conditions.
Your health insurance
In MyHollandZorg you will find all information about your health insurance policy.
Reimbursements, conditions and regulations 2022
Maximum rates for a non-contracted care provider
If, for care included in the public healthcare insurance, you choose a healthcare provider with whom we have not made any agreements, the rates in the Rate list for non-contracted care will apply. Do the rates charged by the non-contracted healthcare provider exceed our maximum rates? In that case, the difference will be payable by you. This will apply for reimbursement both under the public healthcare insurance, and the supplementary insurance.
Where to go for healthcare
Use our care guide to find a (contracted) care provider near you. For more information, contact customer services on +31(0)570 687 123. Our expert employees will be happy to help you.