Health insurance in the Netherlands

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.

Every inhabitant of the Netherlands has to subscribe to the mandatory basic insurance package (basisverzekering). In addition, you can also purchase additional insurance (aanvullende verzekering), which offers a wider package of services. Regardless of which you choose, your insurance payment is made up of two main costs: 1. Your monthly premium (premie), which is a fixed fee that you pay each month (or year, if you choose lump sum payment). 2. Your deductible (co-pay) (eigen risico), an annual amount that you pay out of your own pocket.

The maximum is €385 per year, which you can voluntarily raise to €885 in return for a lower premium. This means that you will have to pay the first €385 per year that you spend on healthcare, 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.

If you live and work in the Netherlands, you are required to take out Dutch health insurance, no matter whether you also have insurance in another country (with some exceptions, such as international students; check studyinnl.org/plan-your-stay/ insurance ).

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; babies have to be registered within four months after birth. after the first three months of being uninsured, and another fine after the next three months. After two fines, the government agency CAK will automatically enroll you with an insurer, which will automatically deduct the last twelve months’ payments from your salary, and all upcoming monthly fees. If you need care 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 pay a personal contribution (eigen bijdrage) to cover their costs). • Dental care and standard vaccinations for children under 18. • Vaccinations for children that are part of the national vaccination programme. • 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. • Contraception for women under 21 years old. • Physiotherapy for chronic problems (up to a maximum number of visits per year). • Until at least 1 August 2023, basic insurance also covers recovery care after a Covid-19 infection, 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, best tailored to your personal health needs and lifestyle. If you have children registered on the same policy, they will automatically be insured for the same additional package that you have chosen. 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 for women over 21. • Non-standard vaccinations. • Glasses and contact lenses. • Emergency health care abroad. • Cosmetic surgery.

You will have to decide for yourself whether it’s useful 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 may want contraceptives to be covered, you may not need coverage for physiotherapy or glasses. Check if your insurance provider has a package that covers your specific needs, and if not, whether it’s worth shelling out on an additional package. It may not even be that much cheaper for some services: the typical cover for dental care will cost about € 240 per year, but only covers 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.

Those on a low income can apply for a health care allowance (zorgtoeslag) to help cover monthly premiums. To receive this allowance, your annual income may not exceed €31.500 for a single person, or €40.500 for a couple. The maximum monthly allowance you can receive is €111 per month for singles and €212 for couples. On the website of the Tax Office you can see if you are eligible for zorgtoeslag and how much you will receive. You can apply for this allowance on the website toeslagen.nl, using your DigiD.

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 an in-kind policy is cheaper, but 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 is an attractive option. Some providers offer a mixed (combinatie) policy. Read more about policy types here. If you have an in-kind policy, before visiting a health care provider, make sure that they have a contract with your insurance company.

• 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 independer.nl or zorgwijzer.nl. • You can change your health insurance provider only once a year. Usually insurers announce their prices for the next year in November. If you sign up with a new provider before 31 December, they will usually take care of cancelling your old policy. Provided you have cancelled your old insurance before 31

December, you can still arrange a new one before 31 January 2023. • 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 deductible et cetera. You have to do this in November or

December as well. This is worthwhile, for example, when you want to get pregnant in the upcoming year: some additional insurance covers pregnancyrelated services, such as prenatal courses, 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 insurance companies also offer health advice over the phone, through an app or through social media. Many also offer e-health, such as online courses on specific conditions or online symptom checkers.