Health insurers pledge rethink on breast reconstruction payment


The Dutch health insurance association Zorgverzekeraars Nederland has said it will look again at the current policy of not automatically paying for reconstructive surgery for women who have had mastectomies because of breast cancer.

The association of Dutch plastic surgeons has raised the alarm about payment for reconstruction operations which are covered in health insurance policies but which often require prior permission before they can go ahead, broadcaster NOS reported on Wednesday.

While basic reconstruction is paid for, dealing with follow-up issues, such as a leaking implant, is not. Reconstruction after other types of cancer is paid for automatically. 

Some 30% of such requests made to health insurer Zilveren Kruis are not honoured, NOS said. The three other big insurance companies – CZ, VGZ and Menzis – were unable to answer the broadcaster’s questions because of the holidays.  

“Breast cancer reconstruction has a special position, and that leads to a loss in quality of life for Dutch breast cancer patients,” Edin Hajder, a board member at the NVPC, told news broadcaster NOS. 

Insurers mistrust breast operations, said plastic surgeon and fellow board member Andrzej Piatkowski de Grzymala. “I get the feeling they secretly think we are doing breast enhancement surgery rather than operating on breast cancer patients,” he said. 

A spokesman for ZN said it appreciated the NVPC’s concerns and would rethink the current policy and discuss how it could be improved with the surgeons’ lobby group. The health ministry has also welcomed the move, NOS said.   

One in seven women in the Netherlands will be diagnosed with breast cancer and one third will undergo a mastectomy. Women with specific breast cancer genes often also undergo preventative surgery. 

Some 5,000 to 5,500 breast reconstructions are carried out every year.

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