A hearing aid can be an expensive purchase. However, it is covered in whole or in part by health insurance. But what exactly does this one cover, and when? We can imagine that this is difficult to understand properly. On this page, we explain it to you.
Reimbursement from basic insurance
The health insurer will reimburse 75% of the cost from the basic insurance when the conditions of the hearing protocol of Zorgverzekeraars Nederland are met. Those conditions are:
- Your hearing can be rehabilitated, or improved, with a hearing solution;
- There is at least 35 dB hearing loss;
- Your chosen hearing aids fall within the legal category;
- You have not purchased any hearing aids in the last five years.
Excess on your health insurance
Everyone in the Netherlands has a deductible. The legally required deductible is € 385, and you can set it to a maximum of € 885. Your premium will then go down, but when you incur healthcare costs, these will first be at your own expense until the specified amount is reached. If you have not used up your deductible in the current calendar year, this amount will be deducted from the reimbursement you receive from your health insurance company under the basic insurance.
Own contribution
Because the health insurance covers a maximum of 75% from the basic insurance, 25% remains. We call this the own contribution. In principle, you pay these costs yourself. If you have supplementary insurance, the health insurance company may pay all or part of the co-payment.
Calculation examples
When the conditions of the hearing protocol are met.
Calculation example 1
| Cost of hearing aid | € 1.000 |
| Health insurance reimbursement (75%) | € 750 |
| Outstanding deductible | € 250 |
| Reimbursement from basic insurance | € 500 |
| Own contribution (25%) | € 250 |
| Supplementary insurance, 50% of co-payment | € 125 |
| The health insurance company reimburses | € 625 |
| You pay | € 375 |
Calculation example 2
| Cost of hearing aid | € 1.000 |
| Health insurance reimbursement (75%) | € 750 |
| Outstanding deductible | € 0 |
| Reimbursement from basic insurance | € 750 |
| Own contribution (25%) | € 250 |
| Supplementary insurance, 100% of co-payment | € 250 |
| The health insurance company reimburses | € 1.000 |
| You pay | € 0 |
Frequently asked questions about health insurance reimbursement
What hearing care is covered by basic insurance?
Basic insurance covers up to 75% of the cost of your hearing aid. From this, any outstanding deductible will be deducted.
How does the deductible work for hearing aid reimbursement?
The reimbursement you receive from health insurance is always subject to your deductible. Only when this is used up will you receive reimbursements.
Can I purchase supplemental insurance for additional coverage
Yes, some insurers offer supplemental packages that provide additional coverage for hearing care. This allows you to cover your co-payment, for example. Consult your insurer or seek advice from our hearing specialists.
Will you help arrange reimbursement?
When we have a contract with your health insurance company, we submit your claim directly for you. You do not have to do anything yourself. If we do not have a contract with your health insurance company, we will send you an invoice which you can submit yourself. You only have to pay in that case when the health insurance has paid out.
