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MCK Reimbursement and application procedure in the Netherlands

  • 02 May 2025

Are you insured in the Netherlands? Then you may be eligible for reimbursement of a microprocessor-controlled knee replacement (MCK) through your health insurer. The conditions for this vary by policy and insurer, but generally the following criteria apply:

  • A medical specialist determines that an MCK is medically necessary for your situation.
  • You meet the functional requirements and have sufficient mobility to make the most of an advanced knee.
  • You belong to one of the recognised activity levels to which an MCK fits (see below).

During a no-obligation introduction and free gait analysis at Amputee Care Center by Spronken, we will check together whether you qualify and which type of MCK suits your lifestyle.

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Book an introductory meeting with a delicious cup of coffee!

Contact us by completing the Contact Form or by calling +32 (0)470 500 888.

We are at your service.

Activity levels in the Netherlands

Your health insurer partly determines your eligibility for MCK based on your activity level. The most commonly used classification is:

  • Level 1: You use your prosthesis mainly for transfers or slow walking on flat floors.
  • Level 2: You can step quietly and take simple obstacles such as a kerb or a few steps.
  • Level 3: You can walk independently with variation in pace, overcoming natural obstacles.
  • Level 4: You move almost without restriction outdoors, with high functional demands such as sports or heavy work.

When are you not eligible for an MCK?

You usually do not qualify for reimbursement of an MCK if:

  • There is no medical necessity according to your treating physician
  • Your functional capabilities are limited to level 1
  • You do not have a stable stump or your prosthesis does not fit properly
  • You have serious health problems that severely impede your mobility
  • Your health insurer does not offer coverage for the desired type of MCK within your policy

Are you in doubt about eligibility? We will help you identify your options and help you think of suitable alternatives.

What is the application process for an MCK in the Netherlands?

The route to reimbursement and placement of a microprocessor-controlled knee usually involves the following steps:

  1. Intake and gait analysis at Amputee Care Center by Spronken
  2. Medical advice from your doctor or rehabilitation specialist
  3. Application and motivation towards your health insurer
  4. Test period with a suitable MCK model
  5. Assessment and approval by your insurer
  6. Ordering and delivery of your definitive knee replacement

We guide you through every step of this process and take care of all necessary documents and communication with your insurer.

Why choose the Amputee Care Center by Spronken?

Spronken Orthopaedics is a - in the Netherlands - SEHM approved prosthetic supplier. We work with all health insurers in the Netherlands. Spronken Orthopedie Nederland has more than 60 years of experience in fitting and delivering arm prostheses and leg prostheses. 

We make arm prostheses and leg prostheses and offer a wide and brand-independent range of prosthetic components, which enables us to select what best suits each individual patient worldwide.  We fully customise every leg prosthesis with MCK.

Our team of prosthesis experts has in-depth knowledge of  microprocessor-controlled knee replacements. We accompany leg prosthesis users step by step with a total concept, including free gait analysis, MCK knee fitting, intensive follow-up and aftercare.

Specialised Prosthesis Centre for Benelux prosthesis wearers

We are present in several locations in the Netherlands and have our own branch in Beek (South Limburg) and Tiel (Gelderland). The main workshop of our specialised prosthetic centre is strategically located in Genk, at the Drielandenpunt - where Belgium, the Netherlands and Germany meet. This unique location enables us to provide specialised and cross-border care and be accessible to a wide international audience.

Thanks in part to our branches in the Netherlands and accredited Dutch prosthetists, we can collaborate with healthcare providers and insurers from the Netherlands. Moreover, our approach is perfectly in line with European standards of care, which makes our BeNeLux centre ideal for those looking for high-quality, accessible and specialised prosthetic care regardless of national borders.

Why many Dutch people choose a BeNeLux centre

More and more Dutch people are choosing to have their arm or leg prostheses measured and made at a specialised BeNeLux centre, for example just across the border in Belgium. This choice is rarely accidental - there are several clear advantages that make this step attractive:

Access to specialised, cross-border expertise

Specialised prosthesis centres - like the Amputee Care Center by Spronken - benefit from economies of scale and knowledge sharing between countries. This allows them to specialise more strongly in complex arm and leg prostheses such as bionic arms, sports prostheses or prostheses for high-activity users. Belgian centres often have experience with patients from both the Netherlands and France, allowing them to respond quickly to different needs, technical requirements and more favourable prices. The Amputee Care Center is thus a focus centre for specialised prosthetic care.

Short waiting lists and personal approach

In Belgium, waiting lists for fitting and delivery of an orthosis or prosthesis are generally shorter than in the Netherlands. Also, more time is often allowed for a comprehensive intake and individual fitting. For people who value speed and personal follow-up, this is a decisive factor.

Sometimes cheaper for self-payers or with limited reimbursement

In case of non-contracted care or limited reimbursement in the Netherlands (e.g. cosmetic options or upgrades outside the basic insurance), choosing a prosthetic centre in Belgium may be more advantageous. Belgian centres are transparent about costs, and in some cases rates are lower. This is especially relevant for clients who have to pay partly themselves or opt for a more expensive or high-tech solution.

More flexibility and innovation in supply

With a slightly less tightly regulated care system and more customisation options, independent centres - such as the Amputee Care Center by Spronken - sometimes have more room to offer innovative solutions. Think modular arm prostheses, design options, quick access to trial models and options from a wide range of global brands of prosthetic components. Internationally oriented companies sometimes develop high-tech prostheses at lower costs than traditional manufacturers.

Ready to take the next step MCK electronically controlled?

Wondering if a microprocessor knee could make a difference for you too? Or would you like advice on switching to a more advanced prosthesis? Then make an appointment today for a free introductory consultation or a free gait analysis at Amputee Care Center by Spronken.

We will listen to your story, analyse your mobility and give you honest, clear and non-binding advice tailored to your needs.

Book an introductory meeting

Book an introductory meeting with a delicious cup of coffee!

Contact us by completing the Contact Form or by calling +32 (0)470 500 888.

We are at your service.

Frequently asked questions by Dutch prosthesis wearers

When you need an arm or leg prosthesis, a lot often comes your way. One of the first questions is: how does applying for authorisation from the health insurer work? In addition, clients often want to know: what is the difference between contracted and non-contracted care? And just as important: what documents are needed to make the application go smoothly? As an SEHM-approved orthopaedic company that works with various insurers - sometimes by contract, sometimes on a reimbursement basis - we guide clients step by step through this process. Below, we answer the most frequently asked questions. If your question is not among them, please contact us. We are happy to be at your service.

How is an application for a prosthesis started with a contracted health insurer?

With our contracted health insurers, the application usually follows a simplified procedure. After the initial intake interview and technical fitting, we, as an orthopaedic company, prepare an offer and a prescription, including the medical opinion of the treating doctor or rehabilitation doctor. We send these documents directly to the health insurer. Because there is a contract, the arrangements are fixed in advance and a smoother assessment usually follows. Most insurers give a decision within 10 to 15 working days.

What is the difference in application procedure with non-contracted health insurers?

The Amputee Care Center is a focus unit of Spronken Orthopaedics Netherlands and Belgium.  We have contracts with all mutualities in Belgium and with many health insurers in the Netherlands, but not all of them!

With non-contracted health insurers, the procedure is often more extensive. We also submit an offer and medically substantiated request, but in many cases the customer must apply for the authorisation himself. This means we provide the documents, after which the client sends or uploads them to the health insurer. The assessment may take longer, and there is more chance of additional questions or requests for information. Reimbursement may also be lower or on a refund basis.

What is reimbursement on a refund basis?

Reimbursement on a refund basis means that, as the insured person, you yourself choose which healthcare provider or prosthesis centre you visit, regardless of whether they have a contract with your healthcare insurer. You initially pay for the healthcare costs incurred yourself and then claim them from your insurer, who will reimburse all or part of these costs to you. It is important to note that the pure restitution policy will no longer be offered from 1 January 2025; existing policies have been converted to combination policies, which contain both features of in-kind and restitution policies. 

What is the difference between in-kind and restitution policies?

The distinction between in-kind and restitution policies relates to the degree of freedom of choice and the way healthcare costs are reimbursed:

Natura policy:

  • Contracted healthcare providers: With a natura policy, the health insurer enters into contracts with specific healthcare providers, such as Spronken Orthopaedics Netherlands - the company behind the Amputee Care Center by Spronken.  When you purchase care from a contracted healthcare provider, the bill is usually fully reimbursed and paid directly by the insurer.
  • Non-contracted care providers: If you choose a non-contracted care provider, usually only part of the costs will be reimbursed, often between 65% and 85% of the average contracted rate. You pay the remaining amount yourself. 

Refund policy:

  • Free choice of care: With a restitution policy, you have the freedom to choose your own healthcare provider or prosthetist, regardless of whether they have a contract with your insurer.
  • Reimbursement: In principle, the insurer will reimburse 100% of the market-based rate. However, if a healthcare provider charges a higher rate than usual, you may have to pay the difference yourself.  

In practice, this means that a natura policy can be more advantageous in terms of premium, but offers less freedom of choice at no extra cost. A restitution policy offers more freedom of choice of healthcare providers, but is often accompanied by a higher premium.

What documents are always required for an authorisation request for an MCK or new prosthesis?

Regardless of whether it is contracted or non-contracted care, the following documents are usually required:

  • A medical prescription from the attending physician or rehabilitation doctor.
  • A substantiated motivation as to why a particular prosthesis or prosthetic component (e.g. MCK, myo-electric or mechanical) is necessary.
  • A quotation from the SEHM-approved orthopaedic company, such as Spronken Orthopaedics in the Netherlands.
  • Possibly a functional report or additional information (for complex care requests).
What happens after the authorisation is approved?

Once the authorisation is granted, we plan the next steps in the customisation process together with the client. For contracted care, we arrange the claim directly with the health insurer. For non-contracted care, the client may receive a (partial) invoice which he or she must submit to the insurer for (partial) reimbursement.

What if the application is rejected or only partially reimbursed?

In case of a rejection, we look at the reason together with the client. Sometimes information is missing or the motivation is insufficiently substantiated. In that case, we can object or submit a reapplication with additional information. With non-contracted care, it is also possible that part of the costs are for your own account. In that case, we always discuss the financial consequences in advance so that the client is not faced with any surprises.

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Spronken is a NEN-EN-ISO 13485-certified supplier of orthopaedic equipment. Over the past 60 years, Spronken has grown into one of the largest companies in the fields of orthoses, prostheses, mobility and state-of-the-art rehabilitation equipment in Europe.

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