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Dutch health insurance

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What is included in the basic Dutch health insurance package?

Health insurance companies have an obligation to accept everyone for the basic package, irrespective of gender, age and health. It is compulsory for all residents of the Netherlands to take this package, but you may choose your own insurance company.

The coverage of the basisverzekering (basic health insurance) is determined by the government and is subject to annual review. However, insurance companies can decide themselves how the coverage will work. For example, some providers will only allow you to see local doctors, while others may offer the possibility to travel abroad for healthcare if the service is not available in the Netherlands.

It generally covers the following (but not always 100% of all costs):

hospital care
medication
rehabilitation
medical care by specialists, GPs and midwives
dental care for children up to age 18
therapists, such as speech therapists and dieticians
mental health care
maternity care
necessary medical help during a holiday or business trip abroad, worldwide

If you want to get medical help abroad, please check with your health insurance company which costs are covered, as it depends on the country you are going to visit. Emergency care abroad is covered for a maximum of 100% of the Dutch tariffs. Please be advised to contract an extra travel insurance that covers the costs on top of the 100% when visiting, for instance, the USA where healthcare costs are much higher. Click here for a list of Dutch health insurance providers.

Are there different health insurance policies? And what is the difference?

All Dutch health insurance companies are restricting free choice of health care providers (doctors, physiotherapists, pharmacies, psychologists, hospitals and clinics), but some more than others. The implication is that when you go to a non-preferred provider, the insurance company will usually not reimburse the full cost. The reimbursement varies from 100% to 40%, depending on the company and particularly the health insurance polisvoorwaarden (policy).

There is only one kind of health care policy, the natura polis (in-kind policy). It will only allow you to go to providers that the company has contracted and they will pay your medical bills directly. If you decide to go to non-contracted providers, they will reimburse you for a (much) lower percentage and/or amount or you will not be reimbursed at all.

It is usual for all GPs to be contracted under the healthcare system (meaning that you can go to any huisarts (GP) and it will be covered by your insurance). That is not the case for all specialist care and paramedical services.

Is dental healthcare covered by the insurance?

Dental care is covered in the basisverzekering (basic healthcare insurance) for children under the age of 18. If you are 18 years or older, dental care can be covered by taking out a tandarts aanvullende verzekering (additional insurance dental care). The premium and coverage vary per health insurance company. In most cases, orthodontics are not covered.

Can I get additional coverage for my health insurance?

Not all health care is covered by the basic health insurance. You can opt for a aanvullende verzekering (additional health insurance) to cover physiotherapy, glasses, contact lenses, tandarts (dentist) or other services. Some insurances may also cover alternative medicine such as homeopathy and acupuncture. The coverage and premium differ per insurance company. On the website zorgverzekeringslijn you can find an explanation of the Dutch health insurance system in English and several other languages.

Additional health insurance is not obligatory and you are not obliged to take out the basic health insurance and additional health insurance with the same insurance company. However, insurance companies sometimes charge extra administration costs if you want to take out an additional insurance without the basic insurance. Please note that health insurance companies are not obliged to accept everyone who applies for additional health insurance. An insurance company can refuse to accept you as a client or can ask you about your health before accepting you.

How will my children be insured?

Children under the age of 18 are always covered under their parent’s premium for the basic package and dental care. Parents must register their child with an insurance company within four months of its birth.

Do I need to take out Dutch health insurance if I am on a short-term stay?

If you are temporarily residing in the Netherlands (fewer than four months), you are not allowed to take out a Dutch health insurance. In that case, you should make sure to extend the international or travel insurance from your home country.

I just took out a Dutch health insurance policy but now the insurance company wants me to pay the premium for a few months retrospectively. Can they do that?

If you take out a Dutch health insurance, you have to pay from the day you registered with the gemeente (municipality). Therefore, you may have to pay insurance premiums to the insurance company retrospectively. Please note that most insurance companies should allow you to pay the amount you owe in instalments.

My residence permit has expired and my application to renew it has been rejected. Can I still get medical help here?

If you are living illegally in the Netherlands, you can get urgent medical help without paying. The doctor decides which help is urgent in each individual case.

Do I need a Dutch health insurance or can I use an international health insurance?

When you are legally living or working in the Netherlands for longer than four months, it is compulsory to get a Dutch health insurance, the so-called basisverzekering (basic insurance). If you have an international health insurance, please be aware that this might not be accepted, as it is not recognised as a valid Dutch health insurance. Upon arrival, it is best to have a look in your policy to see what the coverage of your international health insurance is.

The following rule applies:

If you are insured under the Wet Langdurige Zorg – Wlz (Long-term Care Act) you are obliged to take out a Dutch health insurance. You can ask the Social Security Office (Sociale Verzekeringsbank- SVB) if you are insured under this act.

If I don’t have a Dutch health insurance policy yet, is there a way to get my medical costs reimbursed?

You need to have a Dutch health insurance within four months from the day you have a residence permit and are registered with the gemeente (municipality). Please note that you will pay Dutch health insurance from the day you registered. Meaning, if you registered on 1 January but you take out the Dutch insurance on 1 March, you still have to pay for January and February. You can arrange reimbursement for health care costs incurred during that period.

If obtaining a verblijfsvergunning (residence permit) takes a while, it is possible to take out a voluntary and temporary health insurance. This is a health insurance for those who do not have a verblijfsvergunning yet. An example of such an insurance can be found on the website of insurance company Oom https://www.oominsurance.com/to-the-netherlands/schengen-visitor-insurance/

What will happen if I don’t take out Dutch health insurance?

If you don’t take out Dutch health insurance within four months after registering in the Netherlands, you will get a letter from the CAK, the Dutch Healthcare Institute, reminding you to take out health care insurance within three months. If you fail to do so, you will have to pay a penalty. Then you will get another three months to take out a health insurance. If you still haven’t done that after this time, you will have to pay a second penalty and the CAK will arrange a health insurance for you. The verzekeringspremie (insurance premium) will be higher than if you had taken out health insurance yourself. Please note that this premium will be automatically deducted from your income during 12 months.

Is there a deductible (eigen risico)?

The eigen risico (deductible) is the amount you have to pay yourself before you receive a reimbursement from your health insurance company. Everyone over 18 years of age is required to pay a deductible on the basic insurance coverage. The deductible is decided by the government and updated annually.

You can voluntarily raise your deductible; then you will receive a discount on the insurance premium. The higher your voluntary deductible, the lower the premium you will be charged. While this may be attractive for relatively healthy individuals, it may become a risk on the long run. For example, if you get ill or get involved in an accident, the insurance company is able to claim the total of the deductible in one payment.

Does the deductible apply to all types of care?

The eigen risico (deductible) does not apply to all care from the basic health insurance. The following care services are excluded from the deductible:

Visits to your huisarts (GP) or huisartsenpost (GP centre that opens outside office hours). Tests or prescribed medicine are not excluded from the deductible
Maternity care and assistance at delivery
Loans of medical equipment
Certain care for some chronic diseases like diabetes type 2
Healthcare for children under the age of 18
Follow-up check-ups for organ donation and travel costs for organ donation

Find more information at the government’s website (in Dutch only):

www.rijksoverheid.nl/onderwerpen/zorgverzekering/vraag-en-antwoord/eigen-risico-zorgverzekering

Can I use my Dutch health insurance abroad?

When you are traveling in the EU/EEA (including Switzerland) and carry Dutch health insurance, you are entitled to the same health care as the locals. However, administration and reimbursement for public health care will be easier if you have the European Health Insurance Card (EHIC). You can apply for the EHIC with your health insurance company and you will need to show it if you go to see a doctor or get hospital treatment abroad. Please bear in mind the following:

EHIC is accepted only by doctors or hospitals under the local public health care system or so-called ‘statutory’ health care system. Therefore, private health care is not covered. If you are unsure, check with your insurance company about where you can go
Only emergency care abroad is covered.
If you are travelling abroad specifically for medical treatment the EHIC does not apply.

Your regular Dutch insurance covers costs abroad up to the Dutch tariff. In other countries tariffs are often higher and you might get financial problems paying the bill. Therefore it is suggested to take out a travel insurane for medical costs.

If you work in the Netherlands but reside in another country, different rules apply. In this case you can ask your Dutch health insurance company for an E106 form. With the 106 form, you are entitled to the statutorily insured medical care in your country of residence without having to pay a premium. However, costs will not always be reimbursed 100%. For more information, please contact your Dutch health insurance company.

Information for EU citizens

http://europa.eu/youreurope/citizens/health/unplanned-healthcare/going-to-hospital-abroad/index_en.htm

Information for Dutch residents

https://www.government.nl/topics/travelling-outside-the-netherlands/question-and-answer/am-i-covered-by-my-health-insurance-when-i-go-on-holiday-abroad

I have recently moved to the Netherlands and I don't have a BSN number. Is it possible to have health insurance without a BSN number?

It is not possible to obtain Dutch health insurance without a burgerservicenummer (BSN – citizen service number).

If you are coming to stay in the Netherlands for more than four months, you are required to have a residence permit and BSN. The BSN It is required for starting a job in the Netherlands, opening a bank account, using the health care system, applying for benefits, etc. When you are legally living or working in the Netherlands for longer than four months, it is compulsory to get Dutch health insurance. This is the so-called basisverzekering (basic insurance). It may take a while before you can get your BSN. If you need medical help while you don’t have your BSN yet, you can get the necessary care but will probably have to pay for it yourself. Once you have a health insurance, you can send the bill to your health insurance company and they will refund it according to their policy.

If you are temporarily residing in the Netherlands (fewer than four months), you are not obliged to take out Dutch health insurance. If you do not have a BSN, you are not registered in the Netherlands. If you still would like to take out Dutch health insurance, you will need to apply at the Social Security Office (Sociale Verzekeringbank – SVB). If you are working, it is likely that the request will not be accepted. In that case, you should make sure to extend the international or travel insurance from your home country.

If you have further questions, contact the SVB on 020 656 4848.

For more information related to your first three months in the Netherlands:

access-nl.org/relocating-to-netherlands/first-three-months/formalities/

I have a Dutch health insurance and would like to change to another insurance company. How can I arrange this?

You can change your health insurance company only once a year and only on 1 February. There is one exception: you can change your health insurance company during the year if you switch from one collective employer’s agreement to another (i.e. if you switch jobs).

You have to cancel your health insurance before 31 December. Your new health insurance company may offer to cancel your old insurance on your behalf. If they don’t offer this, it is best to send an aangetekende brief (registered letter) well in advance. A health insurance company is obliged to accept you for basic insurance, unless there are some payments overdue/outstanding at the current health insurance company. In such a case, the new company can refuse you basic health insurance.

The new health insurance company is allowed to refuse you for additional health insurance if you don’t meet its requirements. Therefore, it is suggested not to cancel your current additional health insurance until you have received an email or letter that the new company accepts you for additional insurance.

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