Information about referrals
On this page you will find information about the differences between insured and uninsured care regarding plastic surgery procedures in the province of Limburg. As we regularly receive questions from family physicians about which patients can be treated where, we’d like to explain this. We understand that it’s not always clear when a patient is eligible for insured care, and when it’s a purely uninsured issue. By providing clarity, we can collectively avoid “the red tape” whenever possible, and get the patient to the right place without delay. We’re always willing to work together, should there be any ambiguity.
When is a referral letter required?
MOOI plastic surgeons form a regional partnership of plastic surgeons who provide insured care in hospitals across Limburg, and who offer uninsured care at MOOI clinic. At MOOI clinic, treatments performed are mainly of aesthetic nature such as: eyelid surgery, breast augmentation, facelifts and abdominoplasty. All treatments performed at MOOI Clinic do not require a referral letter from the family doctor. These treatments are also never reimbursed by health insurance companies.
In some cases however, the patient does qualify (in part) for health insurance reimbursement. For example, when there is a medical need, necessity or trauma. In that case , a referral letter is required. The patient should report to the hospital. MOOI plastic surgeons offer the unique opportunity to be helped by the same doctor, either at MOOI clinic or by our cooperating hospitals. Our surgeons also work at Zuyderland, MUMC+, VieCuri and Laurentius hospitals.
Is the patient expecting to be (partially) eligible for insured hospital care? Then the initial consultation must take place at the hospital and a referral is necessary.
Location
MOOI clinic
Sphinxcour 6C01
6211 XZ Maastricht
Telephone
043 311 8708
Or reach our surgeons directly through Siillo with search term: MOOI clinic
Overview
No rights can be derived from the overview below. Rules and criteria may have changed in the interim, and we do our best to keep this up to date. Last modified September 1, 2022.
Type of intervention | Insured (V) or Uninsured (O) | Plastic surgery hospital | Plastic surgery MOOI clinic |
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Breast Corrections |
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Aesthetic augmentation with implants (breast augmentation) | O | Yes, implants with aesthetic indications are never reimbursed | |
Breast reconstruction | V | All breast reconstructions after breast cancer are covered: DIEP, lipofilling breasttrail, as well as reconstruction with implants |
Never |
Breast Reduction | V/O | At least cup E, BMI under 30 | Yes, other |
Removal of breast implants | V/O | In case of leakage, infection or capsular formation Baker 4 ( see note ) |
Yes, other situations, without medical necessity. |
Changing breast implants | V/O | Partly. In case of leakage, infection or capsular Baker 4 (see note), only the removal of the implants is reimbursed. | Partly. Placement of new implants (refilling) is not covered. |
Breast Lift | O | Never | Yes, always uninsured |
Nipple correction | O | Never | Yes, always uninsured |
Gynecomastia | V/O | After demonstrating glandular tissue via ultrasound, BMI lower than 30 and breast formation for more than 12 months. | Yes, other |
Face |
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Upper eyelid surgery | V/O | Only in severe visual field limitation, pupil > 50% covered by skin and member gap <7mm (see note) | Yes, almost always uninsured |
Lower eyelid surgery | O | Only ectropion and entropion correction | Yes, always uninsured |
Eyebrow elevator | V/O | Only in severe lowering of the eyebrows | Yes, almost always uninsured |
Facelifts | O | Never | Yes, always uninsured |
Neck lifts | O | Never | Yes, always uninsured |
Ear correction |
V/O |
Protruding ears or other ear abnormalities:
|
Yes, flap ear correction and other abnormalities in adults. |
Nose job | V/O | Only in cases of extreme form and/or functional abnormality | Yes, other |
Skin abnormalities | V/O | All suspected skin abnormalities | Yes, Other |
Body |
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Abdominoplasty | V/O | In accordance with Pittsburg criteria at least pittsburg 3 (see notes) | Yes, other |
Excess skin removal arms and legs | V/O | In accordance with Pittsburg criteria at least pittsburg 3 (see notes) | Yes, other |
Pubic lip surgery | V/O | Rare, only when very severe, due to mutilation or disfigurement | Yes, almost always uninsured |
Liposuction | O | Never | Yes, always uninsured |
Hands |
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Hand Surgery | V | Yes, all hand surgery | Never |