What basic insurance covers, the must-haves before you apply, and what to do when your insurer says no.
| Treatment | Covered? | Note | Updated |
|---|---|---|---|
| Assessment and counselling | Yes | Deductible | 24 October 2026Edit Assessment and counselling |
| Hormones | Yes | Sometimes pharmacy contribution | 24 October 2026Edit Hormones |
| Breast augmentation | Only with agenesis/aplasia | Otherwise subsidy up to € 3,830 | 24 October 2026Edit Breast augmentation |
| Genital surgery | Yes | Including genital hair removal | 24 October 2026Edit Genital surgery |
| Mastectomy | Yes | Prior authorisation | 24 October 2026Edit Mastectomy |
| FFS | Only with passability problem | Authorisation, strict test | 24 October 2026Edit FFS |
| Adam's apple | If > 5 mm | Plus passability problem | 24 October 2026Edit Adam's apple |
| Voice surgery | After speech therapy, voice < 160 Hz | Authorisation | 24 October 2026Edit Voice surgery |
| Speech therapy | Yes | Referral | 24 October 2026Edit Speech therapy |
| Face/neck hair removal | Yes | Max. 10 laser or 20 electrolysis per authorisation | 24 October 2026Edit Face/neck hair removal |
| Body hair removal | No | 24 October 2026Edit Body hair removal | |
| Fertility preservation | Yes | With wish for children and planned surgery | 24 October 2026Edit Fertility preservation |
| Hair transplant, binders, travel | No | 24 October 2026Edit Hair transplant, binders, travel |
Take it out before your first request. Waiting period usually 3–6 months, and existing disputes are not covered. Check that disputes with your health insurer are included. In court you have the right to choose your own lawyer.
Restitution policies no longer exist since 2025. Choose a combination policy, or an in-kind policy that has a contract with your hospital. Ask in writing before the switching deadline (cancel before 31 December, new policy before 1 February).
In writing to your insurer, within the deadline. Ask for all documents and reports.
Within 12 months of the response. Ombudsman free; disputes committee € 37 and binding. 0800 64 64 644.
Legal aid, the Juridisch Loket (0800-8020) or Transvisie, which helps mediate after a rejection.
At the sub-district court (claims up to € 25,000) a lawyer is not required. See how it works (Dutch).