Health Insurance and Healthcare in the Netherlands Explained

How Healthcare Works in the Netherlands

The healthcare system in the Netherlands is unlike many others around Europe. Here, the public healthcare as such does not exist. However, medical care is made accessible to everyone.

Does the Netherlands Have Free Public Healthcare?

In short, no, healthcare in the Netherlands is not free. Everyone who lives or works in the country must take out private health insurance.

The Netherlands Healthcare Facts

• To be granted health insurance in the Netherlands you must have a Dutch resident permit.
• International insurance for residents is not accepted in the Netherlands.
• You need to take out medical insurance in the Netherlands within four months of your arrival.
• If you do not take out the mandatory health insurance within the first four months in the country, you will be notified of its necessity. If you fail to get it in the next three months you will be fined and given three additional months to take care if it. If after that you are still not insured, you will need to pay another fine and the government will choose your insurance with higher-than-usual premiums.
• You can switch your health insurance once a year. To do so, you have to cancel your current policy before 1 January and get a new one before 1 February.
• In case of an emergency you should call the EU emergency number 112 or go to a hospital’s emergency care. If you opt for the latter option, calling your general practitioner (GP) in advance is advisable.

How Does Healthcare Work in the Netherlands?

You are free to choose any healthcare provider you want. While, technically, the public healthcare does not cover anything, all of the providers offer a standard package (zorgverzekeringswet or ZVW) of services that covers the basic necessities (listed further in the guide). No-one can be denied the basic package, no matter the pre-existing conditions or person’s lifestyle. You can also opt for plans that have additional services included, such as physiotherapy or dental care.

Children under 18 years of age are insured automatically with no additional fee. Long-term and elderly care (Medicare) is covered by social insurance (wet langdurige zorg or WLZ). People with low incomes might be eligible for health insurance benefits, sometimes referred to as allowances.

The Netherlands Healthcare System Explained

The government in the Netherlands is responsible for the quality and accessibility of healthcare; however, they do not manage it. They decide what has to be included in basic insurance packages, but they cannot set the price for premiums.

Why is the Netherlands’s healthcare so expensive? At the moment, the premiums are on the rise because of a strong economy and increasing salaries of the local medical staff. Additionally, the population is aging which requires more care, and new required medicines keep being added to standard policies.

The Netherlands Healthcare Costs

In addition to paying direct monthly premiums for the insurance of your choosing, you also need to make contributions to the Health Insurance Fund. This payment, often called the ZVW contribution, is income related. Each month, your employer takes a certain percentage off your salary and makes the contribution.

Pros and Cons of the Netherlands’s Healthcare System

Pros

• The care for critical illnesses is of very high quality.
• Waiting times for doctor appointments are short compared to other countries.
• Many professionals speak English as well as other languages, such as German or French.
• No matter what tests are necessary or what complications occur, you will not need to cover any additional costs after paying the monthly premium and deductible.

Cons

• The healthcare is not public and can be expensive.
• Basic care can be limited as many family doctors choose a very non-intervening approach to medical care. This means that medication is only prescribed when the doctor is sure that your issue is serious.
• There are fewer preventative healthcare checks and tests than elsewhere in Europe.

An Overview of Private Health Insurance

How does health insurance work in the Netherlands? You pay monthly installments directly to your insurer and cover the deductible. In turn, your visits to medical facilities do not cost you anything.

Do You Need Health Insurance in the Netherlands?

Yes, you do. Because public health insurance as such does not exist in the country, people need to take out private health insurance when living in the Netherlands.

Health Insurance Coverage

The standard health insurance plan includes the following:

• outpatient care (by GPs, specialists, and obstetricians)
• hospital care
• medication
• medical devices
• maternity care
• dental care (children up to 18 years old)
• limited therapies (physiotherapy, speech therapy, occupational therapy, dietary advice, etc.)

You will need to take out supplementary insurance if you want your policy to cover:

• dental care (for adults)
• glasses and contact lenses
• physiotherapy
• homeopathic and alternative medicine

Types of Health Insurance Plans

While there are many plans and providers you can choose form, medical insurance is categorized into two basic types:

• Restitutie – allows you to visit any hospital or clinic of your choosing
• Natura – only allows you to go to medical facilities that your insurance company has a contract with. You are not forbidden for visiting other hospitals, but they will not be covered by your insurance.

The Netherlands Health Insurance Average Costs

When budgeting for your expenses, it is important to know how much health insurance in the Netherlands is. The price for a standard package can cost 80–130 EUR (90–140 USD) per month. The average monthly price for most is around 110 EUR (120 USD).

In addition to that, you will need to pay the deductible, also called policy excess in the Netherlands. This is a sum you need to pay before your insurance starts covering your expenses. The deductible is set by the government and is 385 EUR (425 USD).

How to Get Dutch Health Insurance as a Self-Employed Person

The mandatory insurance needs to be taken out by everyone, including entrepreneurs. How and what you need to pay is determined once your venture is assessed by the Dutch Tax and Customs Administration and the Social Insurance Bank.

How to Find a Doctor or Dentist

If the thought of how to find a doctor and dentist that speaks your language worries you, know that you should not have many problems in the Netherlands. Many doctors are very well-versed in English and other common languages such as German and French. However, if you do not feel comfortable using these languages, you are allowed to bring a friend or a relative to help you out with communicating your needs.

How to Find a Family Doctor

Finding a family doctor (huisarts) is crucial when living in the Netherlands as they are the so-called gatekeepers to the rest of the healthcare system. They are the ones to answer all your questions, assess your well-being, and perform minor examinations, including gynecological and pediatric.

How do you find a specialist in the Netherlands? Family doctors are also the only ones who can allow you to see a specialist. Take note that they will only refer you if your medical situation is serious. If you see a specialist without a family doctor’s referral, your insurance will not cover the visit.

To find a doctor that works in your area, refer to this online directory. Note that not all family doctors might be able to accept you as their practices might be full or you may live too far away from their clinic or hospital.

Average Wait Time to See a Doctor in the Netherlands

To see a family doctor, you should book an appointment at least three days in advance. Seeing a specialist, however, might take you some more time­––weeks or even months. However, if your condition requires immediate care, you might get access to it sooner.

How to Find a Dentist

Online directories such as this one will help you find a dentist in your area. Note that in the Netherlands the government has set prices for most orthodontal procedures, so you do not need to worry about the price difference between most dentists.

If you have health insurance that covers oral health, note how much they cover. Most packages will take care of annual cleanings and check-ups; however, you will have to pay for more extensive procedures that go above 250 EUR (275 USD).

Giving Birth in the Netherlands

Unlike in many other countries, giving birth in the Netherlands for residents and non-Dutch nationals is treated as a natural, not a medical condition. That means, if the mother does not have any complications, they do not need to visit a gynecologist through her whole pregnancy.

Having a Baby in the Netherlands: Midwives and Home-Births

The person in charge of prenatal care is usually a midwife, who you should find twelve weeks into the pregnancy at the latest. You can ask your family doctor for a recommendation, enquire with your family and friends, or look through advertisements.

Because of the way pregnancy is perceived, home-births are very popular in the Netherlands. The usage of epidurals (only available in hospitals) is very low compared to other countries. If you wish to give birth in the hospital, you need to inform your midwife about it. Also, note that not all insurance policies cover hospital births, so check with your insurance provider what options you have.

After the baby is born, you will need to register the birth at a local council in a matter of three days. Typically, the registration is done by the partner, but can also be done by a family member present at birth. Fathers in unmarried couples need to claim that the child is theirs before the birth. That can be done at the local council as well.

Having a Baby in the Netherlands as a Foreigner

The health insurance is the same for expats as it is for any other person living in the Netherlands. So, you should not expect to be treated any differently form the Dutch nationals when it comes to giving birth.

If you happen to be pregnant when you arrive in the Netherlands, and you are without any insurance, you will need to pay for the procedures out of pocket. However, once you do have your insurance, they should be able to reimburse your expenses.

Benefits of Giving Birth in the Netherlands

During the first trimester of your pregnancy, you should register for a maternity nurse (kraamverzorger), who can provide assistance for the first week of parenthood. They can be recommended to you by your midwife, but you are free to find one on your own as well.

Maternity nurses help you adjust to your new home life, which is especially useful for new parents. They can answer all the maternity related questions, such as how to breastfeed or bathe the baby, and check on the mother’s recovery. They can also help with household chores, cook meals, or take care of the older children in the family. What you want from the maternity nurse can be discussed beforehand as you get to meet her before the delivery.

The maternity nurse typically provides 49 hours of care over next eight days after the baby is born. However, this can be adjusted, depending on your needs. Be sure to check with your health insurance whether your policy covers the costs for the nurse and if it covers it fully.

Cost of Having a Baby in the Netherlands

Apart from the possible aforementioned expenses, all the costs should be covered by your health insurance. The price for an in-hospital delivery is about 300 EUR (330 USD).

Citizenship and Giving Birth in the Netherlands

Your child will not automatically become a Dutch citizen if you give birth in the Netherlands. Whether you are a permanent resident or not will also not determine the citizenship of your child. Your baby can become Dutch if one of the parents is Dutch. This rule, however, is applicable no matter what country the child is born in.