Under 21: Reimbursement of contraception
Are you under 21? The costs of contraception are covered by the basic insurance. Between the ages of 18 and 20, contraception falls under the deductible. In addition, a personal contribution applies to some contraceptives. If you’re 21 or older, contraception isn’t reimbursed by the basic health insurance unless it’s to treat anemia. You can choose to take out supplemental insurance to cover contraception. Read more about this under the heading ‘The contraceptive pill: Pay for it yourself or insure it?’
Which contraceptives are covered for women under 21?
Are you under 21? In that case, contraceptives are covered by the basic insurance. The following contraceptives are reimbursed:
|Birth control pill||Commonly known as ‘the pill’, it contains hormones|
|Copper IUD||Intrauterine device made of plastic and copper inserted into the uterus|
|Diaphragm||A circular dome made of rubber or silicone that fits over the cervix|
|Evra patch||A sticky patch that releases hormones through the skin|
|Hormone injection||A 3-monthly injection of hormones|
|Hormone IUD (e.g. Mirena IUD)||Intrauterine device made of plastic inserted into the uterus|
|Implanon||A small rod inserted under the skin that slowly releases hormones|
|NuvaRing||A small and soft ring placed in the vagina|
Is your IUD being placed by a gynecologist? In that case, it won’t be reimbursed under the supplemental insurance but under the basic insurance. This care is considered hospital care. It falls under your deductible.
21 or older: Reimbursement of contraception
Are you 21 or older? Then contraceptives are not covered by the basic insurance. You can take out supplemental insurance for many contraceptive types. However, the reimbursement varies between health insurers. Some health insurers will reimburse you for all forms of contraception. Others will only reimburse you for specific forms of contraception. The reimbursement also depends on the supplier. Contraception from a supplier that has an agreement with your health insurer will often get you 100% of the costs reimbursed. If there is no agreement, then you may have to pay part of the costs.
The contraceptive pill: Pay for it yourself or insure it?
The cost of the contraceptive pill varies per brand, but is between € 10 - € 40 per year. Supplemental insurance that covers contraception can quickly add up to € 70 euros per year. It’s therefore wise to calculate if it’s beneficial to take out additional insurance for contraception. This depends on a number of factors:
- The price of the pill you have
- What your insurer will reimburse
- The insurance premium for the supplementary insurance
Don’t need other supplemental health care? In that case, paying for the contraceptive pill yourself often works out to be cheaper. Do you need other types of care from the supplemental insurance package? Then it could save you money to have supplemental insurance.
Personal contribution and deductible
If you’re 18-20 years old, you may have to pay a statutory contribution to the costs. The government's drug reimbursement system has set out the amount that you have to contribute yourself for medicine you use. Your pharmacist can tell you what the personal contribution for your contraceptive is. Are you under 21 and do you have supplemental insurance? If so, you may be able to get reimbursement for the personal contribution from your supplemental insurance.
If you’re 18-20 years old, the costs of contraception fall under the deductible. Have you chosen for a voluntary deductible? Then the costs will first be paid from the compulsory deductible and then from the voluntary deductible. Are you having an IUD placed by a gynecologist? Then you’ll always have to pay the deductible. It doesn't matter how old you are. This type of care is considered hospital care. Are you 21 years or older? In that case, you don't pay a deductible because it isn't covered by the basic insurance.
Getting contraception from the pharmacy
You can get contraceptives from the pharmacist. Is this the first time getting a contraceptive? You’ll always need to go to your GP, medical specialist or midwife for the first prescription. Once you have the first prescription, you can go directly to the pharmacy for repeat prescriptions. With some health insurers, you can only request repeat prescriptions from an online pharmacy.
Preference policies for medicine and contraception
In the Netherlands, there is a preference policy for medicines. Contraception, such as the pill, falls under this policy. This means that your doctor won’t name a specific brand on the prescription. Only the active ingredient in the medicine will be written on the prescription. The pharmacy will then give you the brand that will be reimbursed by your health insurance company. There may be several brands available with the same active ingredient. But your health insurer will have indicated a preference for a particular brand. That’s why you might get a different brand from your pharmacy the next time. But they all contain the same active ingredient.