In the Netherlands, the government guarantees access to healthcare for all, and care is generally of a high quality. It is funded through income taxes and mandatory health insurance fees. Aside from the mandatory basic insurance package (basisverzekering), you can also opt for additional insurance (aanvullende verzekering), which offers a wider package of services. Regardless of which you choose, all health insurance is made up of two main costs:
- Your monthly premium (premie), which is a fixed fee that you pay each month.
- Your deductible (co-pay) (eigen risico), an annual amount that you pay out of your own pocket for basic treatments and medication (with maximum excess of €385 pe year, which you can voluntarily raise to €885 in return for a lower premium), before insurance kicks in. If you have no medical costs, you won’t have to pay this. Some types of care are not part of the deductible and are therefore always paid by your insurer: visits to your GP, dental care and physiotherapy for children under 18, pregnancy and birth care and maternity care.
Mandatory and optional insurance
If you live and work in the Netherlands, you are required to take out Dutch health insurance, regardless of your insurance back home. If you come from outside the EEA (EU plus Norway, Iceland and Liechtenstein) or Switzerland, you have to register with a health insurer within four months of receiving your residence permit. You can enroll your children under 18 for free with your own insurance company; newborn babies have to be registered within four months after birth.
Failure to sign up for insurance leads to a €386,49 penalty for the first three months and the same amount for the next three months. After nine months, you will be automatically enrolled with an insurer, which will automatically deduct the monthly payments from your salary. If you happen to get sick while uninsured, you’ll have to pay for all medical costs yourself.
The following services are covered by the mandatory basic insurance:
- Visiting your GP.
- Ambulance services, hospital stays, emergency treatment and surgery.
- Medicine prescriptions and blood tests (for some medication and medical aids, you will have to make a personal contribution to cover their costs)
- Dental care for those under 18.
- Mental health care, care for the disabled and elderly and home care.
- Visits to medical specialists, like dermatologists, oncologists et cetera.
- Pregnancy and birth care and maternity care.
- Some therapeutic services.
- Physiotherapy for chronic problems (up to a certain number of visits)
- Until at least 18 July 2021, the basic insurance also covers recovery care after corona, e.g. physical therapy, occupational therapy and support by a dietician.
For services not covered by the basic package, you can choose to take out extra coverage (aanvullende verzekering), best tailored to your personal health needs and lifestyle. A large number of health services are fully or partially covered through additional insurance, such as:
- Dental care for adults over 18.
- Alternative medical treatments, including homeopathy, chiropractors and acupuncture.
- Contraception and vaccinations.
- Glasses and contact lenses.
- Emergency health care abroad.
- Plastic surgery.
You will have to decide for yourself whether you want to take out additional coverage. Usually an additional package covers a lot of services, which you may not be interested in. For example, while you want contraceptives to be covered, you may not need coverage for physiotherapy or homeopathic treatments. Check if your insurance provider has a package that just covers your needs, and if not, whether it’s worth shelling out on an additional package. It may not even be that much cheaper: the typical cover for dental care will cost about € 240 per year, but only cover costs of up to € 500. If you have no dental problems and just want a yearly check-up, it’s not worth paying for extra insurance. The same goes for glasses and contact lenses. On the other hand, if you need a lot of dental work, even with insurance you will have to pay most of the cost yourself, so don’t be surprised by a large bill.
For those on a low income, a health care allowance (zorgtoeslag) is available to help cover monthly premiums. To receive this allowance, your annual income as a single person should not exceed €30.481, or €38.945 if you have a fiscal partner (married or living together). Furthermore, you do not qualify if you own assets worth over €116.613 for an individual or a combined €147.459 for couples. The maximum monthly allowance you can receive is €104 per month for singles and €199 for couples, depending on your income. On the website of the Tax Office you can see if you are eligible for zorgtoeslag and how much you will receive. Here you can apply for this allowance, using your DigiD.
Two types of policy
All Dutch insurers offer two types of policy: a restitution policy or an in-kind (‘natura’) policy. A restitution policy offers a free choice of healthcare provider, while a cheaper in-kind policy limits your choice to providers that have been contracted by your insurance company. Check with your insurance provider if they offer an in-kind policy and if this would be an attractive option. Some providers offer a mixed (combinatie) policy. Read more about policy types here.
Some other quick facts
- Dutch insurance companies are not allowed to deny basic coverage to people with pre-existing conditions, but they can refuse additional coverage.
- Prices and coverage, especially for the additional coverage packages, vary widely from insurer to insurer, so it’s worth shopping around. You can use comparison websites such as www.independer.nl or www.zorgwijzer.nl
- You can change your health insurance provider only once a year. Usually insurers announce their prices for the next year in November, and you can change until 31 December. Provided you have cancelled the old insurance before 31 December, you can still arrange a new one before 31 January 2021. If you sign up with a new provider, they will usually take care of cancelling your old policy.
- You can also stay with your old provider, but change the policy you have with them, e.g. taking out additional insurance, change from restitution to in-kind policy, change your annual excess et cetera. You have to do this in November or December as well. This is worthwhile, for example, when you want to get pregnant: some additional insurance covers a wide range of pregnancy-related services, such as courses to prepare yourself for birth, lactation advice et cetera.
- Ask your employer whether they participate in a healthcare collective, which will give you a discount on the premium. If not, you can join a ‘coverage pool’ offered by some businesses and associations, or by your municipality (gemeente), which will give you a small discount on your premium.
- For certain medical services and procedures there are long waiting lists. Your insurer may be able to mediate in order to reduce the waiting time, so get in touch with them to ask for advice. Many insurers offer health advice over the phone or through social media, so do not hesitate to get in touch.