HEALTH INSURANCE IN THE NETHERLANDS
Having a basic health insurance is compulsory for all people living or working in the Netherlands. What is included in this basic insurance is set by the Dutch government. Apart from the basic insurances there are also additional insurances if you need more coverage. Health insurers are the ones who determine what is included in these additional insurances.
BASIC HEALTH INSURANCE
The basic insurance covers standard care from, for example, a general practitioner, hospital or pharmacy. An excess applies to most care in the basic package. Personal contributions may also apply.
The main features of basic health insurance are:
- Basic health insurance is compulsory for all people living or working in the Netherlands, including children
- The basic package and its cost is the same for everyone regardless of age or health
- The government determines annually what the basic insurance contains, and its content can change annually
- The government also sets the amount of the own risk and the health allowance
- The own risk does not apply to certain treatments such as GP care or obstetric care
- Health insurers are required to offer basic insurance to anyone and may not refuse anyone for any reason whatsoever
WHEN DO YOU HAVE TO PAY THE OWN RISK?
IN WHICH SITUATIONS DOESN’T YOUR OWN RISK APPLY?
The own risk is paid from the age of 18, when you use the care provided in the basic package. The amount of own risk is determined annually by the Dutch government. In 2023 it is set at €385. This means that you pay the first €385 yourself if healthcare costs are not insured.
For example, if you need an operation that costs €1000, you will pay €385 and the insurance will pay €615. The €385 is paid only once a year, so if after the €1000 surgery you need another €1000 surgery, this amount will be paid fully by the insurance.
- GP care (including out-of-hours GP service)
- Obstetric care and maternity care
- Non-invasive prenatal test (NIPT) and 20-week ultrasound
- Certain care for a number of chronic diseases (type 2 diabetes, COPD and CVR)
- District medical assistance
- Follow-up checks for organ donation
- Travel costs for organ donation
- Combined lifestyle intervention (a program for overweight or obese people)
WHEN DO YOU HAVE TO PAY THE OWN RISK?
The own risk is paid from the age of 18, when you use the care provided in the basic package. The amount of own risk is determined annually by the Dutch government. In 2023 it is set at €385. This means that you pay the first €385 yourself if healthcare costs are not insured.
For example, if you need an operation that costs €1000, you will pay €385 and the insurance will pay €615. The €385 is paid only once a year, so if after the €1000 surgery you need another €1000 surgery, this amount will be paid fully by the insurance.
IN WHICH SITUATIONS DOESN’T YOUR OWN RISK APPLY?
- GP care (including out-of-hours GP service)
- Obstetric care and maternity care
- Non-invasive prenatal test (NIPT) and 20-week ultrasound
- Certain care for a number of chronic diseases (type 2 diabetes, COPD and CVR)
- District medical assistance
- Follow-up checks for organ donation
- Travel costs for organ donation
- Combined lifestyle intervention (a program for overweight or obese people)
VOLUNTARY ADDITIONAL INSURANCE
Costs not covered by the basic medical insurance can be voluntarily insured. These insurances are not mandatory and their content is not determined by the government. Health insurers set the terms and reimbursements. They have the right to refuse insurance to certain people, for example because of an illness that requires more care.
Additional insurance can be dental insurance, physiotherapy, alternative medicine or contact lenses and glasses. For these insurances there is no mandatory own risk. They cover certain costs and the rest of the costs must be paid out of your own pocket. Additional insurances can be concluded with another insurer than that of the basic insurance. The cost of additional insurance differs depending on the package chosen and the selected health insurers.
WHEN AND WHERE CAN I TAKE OUT MEDICAL INSURANCE?
After you have registered at a town hall in the Netherlands, you have 4 months to take out health insurance. Since health insurance is mandatory in the Netherlands, you will pay it from the date you registered at the town hall (even if you only take out insurance in the 3rd or 4th month). For example, if you register at the town hall on February 1st and take out insurance on April 1st, the effective date of the insurance will be February 1st. You will receive a retroactive invoice for February and March.
You can take out medical insurance with any insurance company. Here you can see a list of insurance companies in the Netherlands and on this website you can compare them based on price and what is included in this price. If you want, we can arrange an insurance for you at Zorg en Zekerheid.
CONCLUSION
All people living or working in the Netherlands must have basic health insurance, including children. The insurance must be taken out after registering at the town hall and you can choose whichever Dutch insurance company you want or you can opt for Eastmen to register you at Zorg en Zekerheid. If you want to be insured for additional costs such as dentist costs, you must take out additional health insurance.
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