Is your eyelid surgery covered?
Yes — where there is a medical indication. If your drooping eyelid demonstrably restricts your visual field, Dutch basic health insurance covers the procedure. Where the reason is purely cosmetic, you pay for the treatment yourself.
Basic insurance
Covered with a medical indication, after prior authorisation
Excess in 2026
€385 per year, and only if you have not already used it
Supplementary
No longer covers upper eyelid surgery from 2026
When does basic insurance cover it?
Insurers assess whether the drooping eyelid genuinely obstructs your sight. Broadly, they look at the following points. The exact criteria differ per insurer, and it is the insurer — not the clinic — who decides.
The pupil is covered
The upper eyelid, or the overhanging fold of skin, covers part of the pupil when you look straight ahead in a relaxed position.
Your visual field is restricted
There is a demonstrable restriction of the upper or lateral visual field, caused by the drooping eyelid or the skin fold.
Untreatable skin irritation
There is demonstrably untreatable intertrigo — persistent skin irritation — within the fold of the upper eyelid.
Please note: eyelid surgery without a medical indication — carried out for aesthetic reasons — falls outside the basic insurance and is not reimbursed. We will tell you honestly which category your situation falls into before you commit to anything.
Excess skin, or a muscle problem?
A drooping eyelid has two very different causes, and two different operations. Which of the two it is determines what needs to happen — and it is precisely why an ophthalmologist measures first.
Upper eyelid surgery
Excess skin on the upper eyelid sags over the lid margin, while the eyelid muscle works normally. The procedure removes the fold of skin.
About eyelid surgery →Ptosis surgery
The muscle that opens the eyelid is not working well enough, so the lid itself sits too low. Removing skin does not solve this — the muscle must be corrected.
About ptosis surgery →From referral to reimbursement
Referral from your GP
Ask your GP or a medical specialist for a referral. Without one, your health insurer will not assess the request.
Examination and measurement
Dr. Kloos examines your eyelids and measures your visual field. This establishes objectively whether there is a medical indication, and whether the cause is excess skin or the eyelid muscle.
Prior authorisation
Where there is a medical indication, we apply to your health insurer for prior authorisation — a machtiging. The insurer assesses whether you meet the conditions and decides.
Treatment
Once approved, we schedule the procedure. You are treated by a BIG-registered ophthalmologist, under local anaesthetic, with aftercare included.
Invoice and settlement
This depends on whether we hold a contract with your health insurer. Where we do, we bill your insurer directly and you need do nothing yourself — you pay only your excess, if any. Where we do not, you receive the invoice via Infomedics and submit it to your insurer yourself; once you receive the settlement statement you forward it to us, and pay the uncovered portion plus any excess. We will tell you in advance which of the two applies to you.
Questions about your cover?
Not sure whether your situation qualifies? Call or email us. We will tell you honestly whether it is worth requesting a referral. Consultations are in English.
Insurance in brief
Is eyelid surgery covered by Dutch health insurance?+
Upper eyelid surgery is covered by the basic health insurance when there is a medical indication: the drooping eyelid or overhanging skin fold must demonstrably restrict your visual field. Your insurer assesses this in advance through prior authorisation. Purely cosmetic eyelid surgery is never covered.
Is ptosis surgery covered as well?+
Yes, under the same condition. With ptosis the cause lies in the eyelid muscle rather than in excess skin, but here too the basic insurance covers the procedure when the drooping eyelid demonstrably restricts your visual field and the insurer gives prior approval.
How much do I pay myself if the procedure is covered?+
You pay your compulsory excess, which in 2026 is €385 per year. If you have already used your full excess this year on other care, you pay nothing extra.
Will my supplementary insurance cover eyelid surgery?+
No. From 2026, upper eyelid surgery is no longer covered by supplementary insurance. Reimbursement runs solely through the basic insurance, and only where there is a medical indication.
Do I need a referral?+
Yes. Insured care always requires a referral from your GP or a medical specialist. Please send it to us before your first appointment.
Do you bill my health insurer directly?+
Where we hold a contract with your health insurer, we bill the insurer directly. You submit nothing yourself and pay only your excess, if any. Where there is no contract, you receive the invoice via Infomedics and submit it yourself. Do ask us beforehand — we will check it for your insurer.
Can I come to you if you have no contract with my insurer?+
Yes. You can receive insured care with us even without a contract. The only difference is the settlement: you receive the invoice via Infomedics and submit it to your insurer yourself, rather than us billing them directly.
Have your visual field measured
A single consultation with a BIG-registered ophthalmologist establishes whether your eyelid restricts your sight — and whether your insurer will cover the procedure.