These are stressful times, certainly for expats living in The Netherlands. Here is some information about the Dutch Health Insurance System.
Health insurance is compulsory for all people who live or work in the Netherlands. Expats from outside the EU, EEA or Switzerland who arrive in the Netherlands must take out Dutch health insurance within four months of receiving their residence permit, even if they have an existing foreign policy. EU, EEA or Swiss nationals who are working in the Netherlands must take out Dutch health insurance within four months of registering at their city hall.
Main health insurance companies in the Netherlands
- LoonZorg (No mandatory excess)
- Zilveren Kruis
- LoonZorg (For international students)
The Dutch health insurance system
In contrast to many other European systems, the Dutch government is responsible for the accessibility and quality of the healthcare system in the Netherlands, but not in charge of its management. The Dutch health insurance system is a combination of private health plans with social conditions built on the principles of solidarity, efficiency and value for the patient. Healthcare in the Netherlands is funded through taxation: mandatory health insurance fees and taxation of income (pre-specified tax credits).
Health insurance in the Netherlands is mandatory if you are here on a long-term stay and is designed to cover the cost of medical care. As a rule, all expats must have a Dutch health insurance even if they are already insured for healthcare in their homeland (for exceptions see our other health insurances page). Within four months of receiving your residence permit (or registering at the Dutch city hall for EU/EEA nationals) you are subject to Dutch social security legislation and thus must obtain a basic health insurance (basisverzekering) package.
Premie and eigen risico costs
There are two main costs that you need to pay for your Dutch health insurance:
The monthly premium (premie), a fixed fee that is deducted from your bank account each month.
The “own risk” amount (eigen risico), which is an annual amount that you must pay out of your own pocket for some treatments and medicines before your health insurance will cover the rest. In 2020, the eigen risicois up to a maximum of 385 euros. If you do not have any medical costs in a year then you pay no eigen risico.
What happens if I don’t take out health insurance?
- If you do not take out basic Dutch health insurance within four months, and the government becomes aware that you are not covered, then you will receive a letter from the CAK asking to you to sign up for health insurance within three months.
- If you do not get health insurance within that period, then the CAK will issue you with a fine (410,49 euros in 2020).
- If you still haven’t taken action after six months then you will receive a second fine for the same amount.
- If you still haven’t obtained health insurance within nine months of the first letter, then the CAK will register you with an insurer on your behalf and they will deduct the monthly premium from your salary.
If you are uncertain about whether you need to take out health insurance in the Netherlands then you can contact the Sociale Verzekeringsbank to check whether your circumstances require you to have Dutch health insurance. If you become sick and you have no (Dutch or foreign) health insurance to cover treatment in the Netherlands, then you must pay for medical costs yourself.
Types of Dutch health insurance
There are two types of health insurance in the Netherlands:
Compulsory basic insurance (basisverzekering)
Optional additional insurance (aanvullende verzekering)
Basic health insurance in the Netherlands (basisverzekering)
The basic package in the Netherlands is compulsory and provides the same basic health coverage across all insurers, as it is set by the government.
Basic health insurance costs around 100 euros per month and covers:
- Appointments with your doctor (huisarts)
- Stays at the hospital, surgery and emergency treatment (ziekenhuis)
- Ambulance services and patient transport (ambulancevervoer)
- Medicine prescriptions (medicijnen)
- Blood tests (bloedonderzoek)
- Dental care for children under 18 years (tandarts)
- Limited dental care for adults over 18, restricted to dental surgery, dental x-rays
- Mental health care (geestelijke gezondheidszorg)
- Appointments with medical specialists such as dermatologists, allergists or internal specialists (medisch specialist)
- Pregnancy, birth care and midwifery services (zwangerschaps- en geboortezorg)
- Maternity care (kraamzorg)
- Handicapped care (gehandicaptenzorg)
- Aged care (ouderenzorg)
- Nursing on location (wijkverpleging)
- Some therapeutic services such as speech therapy, occupational therapy and diet advice
- Physiotherapy (fysiotherapie) for chronic disorders, covered from the 21st treatment onwards
Basic insurance and eigen risico
It is important to note that for most of the above services you will need to cover a portion of the costs via your annual eigen risico amount (up to a maximum of 385 euros). Services which do not require an eigen risico contribution include: Appointments with your doctor
- Dental health care and physiotherapy for children up to 18 years
- Pregnancy, birth care and midwifery services
- Maternity care (kraamzorg), however you need to pay a separate hourly rate
An up-to-date overview of basic insurance coverage can be found on the Dutch government website.
Additional insurance coverage (aanvullende verzekering)
You may also need to take out extra coverage for additional medical treatment. This is where private health insurance providers (zorgvezekeraars) compete to offer policies that are best tailored to your health needs and lifestyle. There are many health services that are (partially) covered by additional insurance, examples include:
- Dental care for adults over 18 including dentist check-ups, fillings, hygiene, cleaning and dental implants
- Emergency health care for travel abroad
- Alternative medical treatments such as acupuncture, chiropractic, homeopathy (alternatieve geneeswijzen)
- Vaccinations (vaccinaties)
- Contraception (anticonceptie)
- Glasses and contact lenses (brillen en lenzen)
- Hearing aids (gehoorapparaten)
- Plastic surgery (plastische chirurgie)
Register with a GP (huisarts)
After you have chosen your Dutch health insurance provider, you should register with a general practitioner. Once you have a GP you can easily schedule an appointment to discuss any health issues you may have. If you need a specific examination you should first liaise with your doctor, who will then refer you to the right specialist, clinic or hospital. You can find Dutch doctors in your area online, usually by searching for “huisarts” and your city name. Some websites also provide comparative listings of doctors based on patient reviews. You may also be required to register with your local pharmacy (apotheek) so they can keep a record of your medication history and so your GP can easily send prescriptions through.
Children and Dutch health insurance
Children under 18 must also be insured, however their insurance cover is free, with no monthly premium and no eigen risico. Children can usually be covered by the insurer of their parents, however it’s also possible to choose other providers. The first month after a child turns 18, they must start paying their monthly premium. Newborn babies must be registered for health insurance within four months of birth.
Hints and tips about Dutch health insurance
- Dutch insurance companies are obliged by law to offer you the basic package. They can not deny coverage because of gender, age or health profile.
- You may only change your health insurance provider once per year, for the following year. The deadline to switch is December 31.
- If you are on a low income you may be eligible to have your monthly health insurance premiums (partly) covered by the healthcare allowance (zorgtoeslag).
- Many businesses, including international companies, arrange collective agreements with insurance companies and offer a small discount to their employees.
- Be aware that there may be long waiting lists for certain services.
- Doctors can all be expected to speak English.