Dutch basic health insurance has covered a second cochlear implant for some adults with severe hearing loss or deafness in both ears since 27 October 2026. Zorginstituut Nederland made the coverage determination after concluding that the treatment is effective care for this group.

What has changed

The expanded coverage is for adults who already have one cochlear implant and are being considered for a second implant in the other ear. It does not cover placing two implants at the same time. Second implants were already covered in some cases involving deafblindness or deafness caused by meningitis.

Zorginstituut Nederland says cochlear-implant teams expect about 60 to 100 adults a year to receive a second implant under the expansion. The institute's formal position determines whether this care belongs in the basic package; no further decision by the health minister is required.

What the evidence shows

The institute reviewed two comparative studies, including one from the Netherlands, as well as supporting studies that followed patients after a second implant. It found that a second implant improved people's ability to locate sounds and understand speech in noisy surroundings. It also found no reason to expect more surgical complications than with a first implant.

The evidence does not mean every broader benefit is certain for every patient. Zorginstituut Nederland says better hearing with two implants can support independence, participation and safety, while the likely benefit and burden must still be assessed for each person.

Who may qualify

The national agreement applies to adults with severe hearing loss or deafness in both ears who already use one implant. A multidisciplinary cochlear-implant team must assess the medical and audiological situation, the person's functional difficulties and goals, the likely benefit of another implant, and the prospects for successful rehabilitation.

The published criteria cover both people whose first implant works well but who are expected to gain additional functional benefit, and people whose first implant produced a poorer-than-expected result when there are audiological reasons to expect the other ear to do better. A second implant is not an automatic next step.

Utrecht and Nijmegen's role

UMC Utrecht credits ear, nose and throat surgeon Diane Smit and Radboudumc professor Wendy Huinck with starting an initiative in 2023 to seek wider coverage. The hospitals worked with professional groups, patient representatives, insurers, cochlear-implant centres and ethicists. Zorginstituut Nederland, however, made the national coverage determination on the evidence and the resulting agreements on appropriate use.

People who already have one implant can ask their own cochlear-implant centre how the criteria apply to them. The centre, rather than the hospital announcement alone, makes the individual assessment.