General information

The pharmacist has dispensed FRAGMIN® 2500 to the patient. The health insurer will not reimburse the cost of this prescription in full. The producer of this medicine has therefore instructed TBR Nederland to reimburse to the patient the Personal Contribution charged.

Dose 2500
Type Injection solution
Active ingredient DALTEPARINE



The Personal Contribution for FRAGMIN (dalteparine)2500 INJVLST 12.500IE/ML WWSP 0,2ML® charged to the patient by the health insurer, is eligible for full reimbursement  to a maximium of € 250,- per patient per year. Therefore, the patient can submit a claim with TBR Nederland. The form can be downloaded here or below under 'Submit a claim by post'. Only declarations for patients with a date after January 1 2021 and before January 1 2022 can be submitted. Receipts for prescriptions from January 1 2022 are not reimbursed by TBR Nederland. 

Who can submit a claim

Patients or their carer can submit a claim for the Personal Contribution amount they paid for FRAGMIN® 2500, either online or by post. Online will be the fastest option. Pharmacists cannot submit claims on behalf of patients for this medicine.

From when till when can you submit a claim

Only declaration with a date after January 1 2021 and before January 1 2022 can be submitted. Receipts for prescriptions between these dates can be submitted until March 31, 2022.

Submit a claim online

Patients can claim online and will receive their reimbursement within 5 working days.

Read our tips on how to submit a claim online

Login & Submit a Claim          Open an Online Account


Submit a claim by post

Patients can claim by post and will receive their reimbursement within 15 working days.

Read our tips on how to submit your claim by post

Please mail the Claim Form and attachments to:

TBR Nederland
Antwoordnummer 1179
1180 VD Amstelveen 


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