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.
|Basic Health Insurance||Reimbursement|
|HollandZorg basic health 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 a timely fashion, 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 (in Dutch).
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.
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 provide this type of treatment?
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 finder 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 non-contracted provider? In that case, you will 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. No rights can be derived from this page. You can only derive rights from our insurance conditions.
Your health insurance
In My HollandZorg you will find all information about your health insurance policy.
Maximum rates for a non-contracted care provider
Have you chosen a healthcare provider with whom we have no contract? Then, we will reimburse according to our maximum rates. If the rate invoiced by the non-contracted care provider is higher than our maximum rates, you will have to pay the difference yourself. You will be able to find contracted care providers with our Care finder.